从“三焦分消”探讨甘露消毒丹治疗慢性乙型肝炎的临证思路  

Clinical Thinking of Ganlu Xiaodu Micropills(甘露消毒丹)Treating Chronic Hepatitis B Based on the Concept of Eliminating Pathogens in Sanjiao

作　　者：袁萌婕 陈斌[2] YUAN Mengjie;CHEN Bin(Hunan University of Traditional Chinese Medicine,Changsha 410208,Hunan,China;The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410007,Hunan,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《实用中医内科杂志》2025年第4期88-91,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家中医药管理局高水平中医药重点学科中医肝胆病学项目(国中医药人教函[2022]226号);湖南省高层次卫生人才“225”工程学科带头人培养项目(湘卫函[2019]196号)。

摘　　要：慢性乙型肝炎(chronic hepatitis B,CHB)起病隐匿,缠绵难愈,传染性强,临床症状多不明显,现多使用核苷(酸)类似物、干扰素等药物治疗,但部分患者应答较差,长期服用可出现交叉耐药等不良反应。中医将其归为“黄疸”“胁痛”“肝着”“肝瘟”等范畴,认为湿热内蕴是CHB的基本病机,三焦负责通畅气机和运化水液,湿热邪气阻滞三焦,导致气机不畅,水液代谢失常。甘露消毒丹具有清热解毒、利湿化浊的功效,全方从上中下三焦分消湿热,临床治疗CHB效果颇佳。文章从三焦分消探讨甘露消毒丹治疗CHB的临证思路,以期为CHB的临床防治提供参考。Chronic hepatitis B(CHB)has an insidious onset,lingering and difficult to heal,highly infectious,and the clinical symptoms are mostly indistinct.Nucleos(t)ide analogues,pegylated interferon and other drugs are mostly used for treatment,but some patients have poor response,and adverse reactions such as cross-drug resistance can occur after long-term use.Traditional Chinese medicine classifies it into the categories of"jaundice""Hypochondriac pain""Ganzhuo""Ganwen"and believes that the basic syndrome type of CHB is damp-heat syndrome.Sanjiao is responsible to regulate qi activity and transport water.Damp-heat pathogene block Sanjiao,leading to qi activity and water metabolism disorder.Ganlu Xiaodu Micropills(甘露消毒丹)has the effect of clearing heat,detoxifying dampness and removing turbidity.The whole recipe eliminates dampness and heat through Sanjiao,and has a good clinical effect on CHB.Therefore,based on the concept of eliminating pathogens in sanjiao,this paper discusses the clinical thinking of Ganlu Xiaodu Micropills in the treatment of CHB,in order to provide reference for the clinical prevention and treatment of CHB.

关 键 词：三焦分消 甘露消毒丹 慢性乙型肝炎 中医治疗 

分 类 号：R256.4[医药卫生—中医内科学]