浅谈从“伏邪温病”理论辨治慢性乙型肝炎

Treatment and Syndrome Differentiation of Chronic Hepatitis B Based on Theory of “Warm Disease Caused by Incubating Pathogens”

慢性乙型肝炎目前西医治疗仍有局限性,中医药治疗慢乙肝大有可为。我们上溯经典,借鉴"伏邪温病"理论,总结并提出:慢性乙型肝炎基本病机为脾胃亏虚,正气不足,湿热疫毒之邪伏于厥阴少阳,而以伏于厥阴为主的观点;治疗上以"扶正透邪"为基本大法,其中扶正以健脾益气、养阴为主,透邪以运转少阳枢机、驱邪外出为主并配合清热化湿、利湿、活血消瘀、导滞等治法,实践于临床,疗效满意,值得进一步推广应用。

Western medication has its limit in treating chronic hepatitis B（ CHB）,whereas TCM has its advantage in treatment of CHB. The classical therory of ＂warm disease caused by incubating pathogens＂was used for reference to put forward the basic pathogenesis of this kind of disease being deficiency of Spleen and Stomach,deficiency of vital-qi,dampness-heat and pestilent toxin lurking in Jueyin and Shaoyang,of which the former is dominant. Clinically,the treatment method of supporting healthy-qi and expelling pathogens is taken as the basic principle. Supporting healthy-qi refers to invigorating Spleen-qi and nourishing Yin; whereas expelling pathogens mainly focuses on making Shaoyang work,which is assissted by clearing heat and resolving dampness,draining dampness,activating blood to remove stasis,removing stagnancy and obstruction. These methods have achieved satisfactory effect in treatment of CHB in clinic,which is worthy of clinical promotion.