全国名老中医袁长津从“虚毒”论治慢性乙型病毒性肝炎的经验  

Experience of National Renowned TCM Physician YUAN Changjin in treating chronic hepatitis B from the perspective of"deficiency-toxin"

作　　者：王石中 郑润锈 袁宇晴 孙克伟[2] WANG Shizhong;ZHENG Runxiu;YUAN Yuqing;SUN Kewei(Hunan University of Chinese Medicine,Changsha,Hunan 410208,China;The First Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410007,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学附属第一医院,湖南长沙410007

出　　处：《湖南中医药大学学报》2025年第3期534-537,共4页Journal of Hunan University of Chinese Medicine

基　　金：国家自然科学基金项目(8197152432);湖南中医药大学双一流学科建设项目(6001001007)。

摘　　要：慢性乙型病毒性肝炎作为一种普遍存在的感染类疾病,具有患者基数大、传染性高、治愈率低及癌变风险高等特点,目前治疗以抗病毒为主,但治疗周期漫长、疗效欠佳,常出现耐药以及毒副作用。袁长津教授从“虚毒”立论,认为本病病机为正气虚损,病毒侵袭,湿热疫毒蕴结,久则血瘀水聚,形质恶变,病位在肝,与脾肾密切相关,病理产物多有瘀、湿、水相互搏结。治疗上基于“虚毒”的病机提出了“清利肝胆,祛湿解毒”“疏肝健脾,补虚扶正”“利水散瘀,丸药缓攻”等基本治法,根据不同证型及其阶段性变化,有所侧重和兼顾,临床疗效显著。Chronic hepatitis B,as a prevalent infectious disease,is characterized by a large patient base,high infectivity,low cure rate,and high risk of cancerization.Current treatment primarily focuses on antiviral therapy,but it involves a lengthy treatment period,suboptimal efficacy,and frequent occurrences of drug resistance and side effects.Professor YUAN Changjin has posited the theory of"deficiency and toxin",believing that the pathogenesis of this disease includes deficiency of healthy qi,invasion of the virus,accumulation of damp-heat and epidemic toxins,leading to blood stasis and fluid accumulation over time,and eventually malignant transformation of the tissues.The disease is located in the liver and closely related to the spleen and kidneys,with pathological products often involving the interplay of blood stasis,dampness,and fluid accumulation.Based on the pathogenesis of"deficiency and toxin",Professor YUAN has proposed basic treatment methods,including"clearing and soothing the liver and promoting bile flow,eliminating dampness and removing toxins","soothing the liver and strengthening the spleen,tonifying deficiency and supporting the healthy qi",and"inducing urination and transforming stasis,using pills for gradual treatment".These methods emphasize and balance different aspects according to various patterns and their staged changes,achieving remarkable clinical efficacy.

关 键 词：慢性乙型病毒性肝炎 虚毒 清利肝胆 疏肝健脾 名医经验 袁长津 

分 类 号：R249.2[医药卫生—中医临床基础]