慢性HBV携带者的中西医诊治概况

Integrated traditional Chinese and western medicine diagnosis and treatment for chronic HBV carriers

通过分析近年来有关慢性HBV携带者的中医病因病机、证候与体质辨识、中医药治疗的研究概况,发现以HBVDNA高水平复制、ALT正常或低水平为特点的HBV免疫耐受状态的患者具有高度传染性,且存在向肝硬化和肝癌进展的较大风险。因公认有效的抗HBV药物对慢性HBV携带者不适用,现代医学建议随访观察,不进行治疗。结合现代医学,中医对慢性HBV携带者的病因病机及证候规律认识逐渐深入,并采用中医体质辨识解决辨证困局,运用中医药治疗取得了一定疗效。由此可见,中医药治疗是具有前景的治疗途径。

By analyzing traditional Chinese medicine （TCM） etiology and pathogenesis, syndrome and constitution differentiation and TCM treatment of chronic HBV carriers based on the literature published in recent years, it is found that the patients with the immune tolerance to HBV characterized by high-level HBV DAN replication and normal or low level of ALT have the high infectivity and risk of progression to cirrhosis and liver cancer. Since the adopted anti-HBV drugs are unsuitable for chronic HBV carriers, modem medicine suggests follow-up visits rather than treatment. Combined with modern medicine, TCM has achieved a deeper understanding of etiology, pathogenesis and syndrome rules of chronic HBV carriers, TCM constitution differentiation is applied to tackle the puzzle of syndrome differentiation, and TCM treatment has achieved certain therapeutic efficacy. Therefore, it is inferred that TCM treatment has significant potential in the treatment of chronic HBV carriers.