清利活血健脾法治疗慢性乙型肝炎

Relationship between Principles of Qingli Huoxue Jianpi and Chronic Hepatitis B

中医药治疗慢性乙型肝炎(CHB)具有显著的临床疗效。唐旭东根据多年临床经验提出"清利活血健脾法"治疗CHB,此法即:清热利湿、活血化瘀、健脾扶正三法的总括,临床疗效确切。CHB病机中湿热内蕴贯穿疾病始终,故清热利湿为治疗法则的主线。湿热邪毒阻碍气机,肝失疏泄,气机壅塞,血行迟滞,则易成血瘀;又湿热疫毒易灼伤血络,或久病阳虚温煦失司,皆可致瘀血阻滞;瘀血日久,既可伤阴损阳,又易耗伤气血,进而使病情迁延反复,故有瘀血内停征象的患者,活血化瘀法应贯穿治疗的始终。湿热毒邪内蕴,湿邪困脾,脾运不及,水湿之邪无以得散,反为害于脾脏,此为本病虚证之肇始,健脾扶正是治本之策。临床应用"清利活血健脾法"的同时,亦应该照顾到CHB兼挟证的治疗,辅以疏肝、清热解毒及补肾之法。

The traditional Chinese medicine has significant effect on treating chronic hepatitis B （CHB）. Professor TANG Xudong summarized his clinical experiences for many years in order to improve clinical efficacy in the treatment of CHB patients. He advocated the therapeutic principles of Qingli Huoxue Jianpi to treat hepatitis B, which made tangible therapeutic effectiveness in clinical practice. This principle is a summarization and includes three aspects ： clearing heat and promoting urination, the sec- ond is promoting circulation and removing stasis, invigorating spleen and supporting the healthy energy. As the pathogenesis of CHB, damp - heat accumulation is the truck of the development which often exists in the course, so clearing heat and promoting u- rination is the dominant treatment principle. Toxic dampness and heat depress the liver - qi, so the liver qi stagnation occurs as well,which result in that liver qi cannot excrete. But the qi fails to transport the blood, the stagnant blood block the activities of qi ; meanwhile, toxic dampness and heat is apt to burn the blood network ; with the progress of the disease, weakness of yang can not warm the body,which makes more stagnant blood. The blood stasis can impair both the body yin and yang, and damage the blood and qi, which makes the CHB hard to be cured or replacement of the illness. So once the CHB patient has the stagnant blood in the body by syndrome differentiation, the therapy of activating blood circulation must be used throughout the course of treat- ment. And the damp and heat always puzzle the spleen, which makes the spleen fail to transport the nutritiousness and water, and dampness encumbers the spleen in turn,so invigorating spleen to eliminate water - dampness is the basic treatment for CHB. At last, when the therapeutic principles of Qingli Huoxue Jianpi is used to treat hepatitis B, other complication of syndromes must be considered, such as soothing liver, clearing heat and removing toxicity and tonifying kidney.