李平经方合用治疗乙型肝炎病毒性相关肾炎的经验

LI Ping′s Experience of Treating Hepatitis B Virus Associated Glomerulonephritis Through Combined Classic Prescriptions

目的我国为乙型肝炎病毒感染高发地区,乙型肝炎病毒的感染增加了乙型肝炎病毒性相关肾炎(HBV-GN)的发病率。该病病因复杂,目前尚无统一的诊断标准和治疗指南。现代医学虽在抗病毒治疗上有明显的优势,并且可辅以激素和免疫抑制剂,但都遇到一定的瓶颈。文章旨在总结李平教授经方合用治疗乙肝相关肾病经验,为临证提供思路。方法根据HBV-GN的中西医研究进展,结合李平教授的有效临床经验,归纳其应用经方合用治疗HBV-GN的思路和治疗手段。结果李平教授认为治疗原则为补肾健脾疏肝,利水渗湿,活血通络。在辨病的基础上结合辨证,常合用肾气丸、小柴胡汤、五苓散、当归芍药散、麻黄附子细辛汤、茵陈蒿汤等经方,同时注重降蛋白尿和抗病毒中药的使用。结论中医药治疗乙型肝炎病毒性相关肾炎具有良好的应用前景,在辨病辨证的基础上,经方合用能有效缓解乙型肝炎病毒性相关肾炎的病情进展。

Objective China is a region with high incidence of hepatitis B virus infection,and hepatitis B virus infection increases the prevalence of hepatitis B virus-related nephritis(HBV-GN).The etiology of the disease is complicated,and there is no unified diagnostic standard and treatment guidelines.Although modern medicine has obvious advantages in antiviral treatment,and can be supplemented by hormones and immunosuppressive agents,but they have encountered certain bottlenecks.This article aimed to provide clinical thinking by summarizing professor LI Ping′s experienceof treating HBV-GN through combined classic prescriptions.Methods According to the research progress of traditional Chinese and western medicine on HBV-GN,and combined with professor LI Ping′s effective clinical experience,the ideas and methods of treating HBV-GN through combined classic prescriptionswere summarized.Results Professor LI Ping believes that the therapeutic principles are tonifying kidney,strengthening spleen and soothing liver,clearing damp and promoting diuresis,activating blood circulation and dredging collaterals.On the basis of distinguishing disease and syndrome differentiation,professor LI often combines Xiaochaihu Decoction(小柴胡),Wuling Powder(五苓散),Danggui Shaoyao Powder(当归芍药散),Mahuang Fuzi Xinxin Decoction(麻黄附子细辛汤),Yinchen Decoction(茵陈蒿汤) and other classicprescriptions.At the same time,he pays attention to the use of proteinuria reduction and antiviral Chinese drugs.Conclusion Traditional Chinese medicine has a good application prospect in the treatment of HBV-GN.On the basis of disease differentiation and syndrome differentiation,combined use of classic prescriptionscan effectively alleviate the progress of HBV-GN.