补肾健脾利湿法治疗慢性乙型肝炎临床效果及相关机制研究

Clinical efficacy and mechanism of action of kidney-tonifying,spleen-strengthening,and diuresis-promoting therapy in treatment of chronic hepatitis B

慢性乙型肝炎是世界范围内的公共健康问题,核苷酸类似物和干扰素治疗可以有效抑制HBV复制,但存在无法实现对HBV cccDN进行彻底清除、HBsAg阴转率低等不足。“补肾法治疗慢性乙型肝炎”的学术观点的提出为乙型肝炎的治疗提供了新的思路和方法;曙光医院肝病科在长期的临床实践中明确“脾肾亏虚、兼湿热未尽”是慢性乙型肝炎持续进展的关键病机,并确立了补肾健脾利湿为基本治法的慢性乙型肝炎论治方案,历经“十一五”至“十三五”的国家科技重大专项的临床研究验证了该方案确切的临床疗效,明确了补肾健脾利湿法治疗慢性乙型肝炎的主要作用机制在于调节机体免疫功能。

Chronic hepatitis B is a public health issue worldwide.Nucleotide analogues and interferon therapy can effectively inhibit HBV replication,but they still have the shortcomings such as inability to achieve the clearance of HBV cccDNA and low HBsAg clearance rate.The academic viewpoint of“kidney-tonifying therapy for chronic hepatitis B”provides new ideas and methods for the treatment of hepatitis B.During long-term clinical practice,Department of Hepatology in Shuguang Hospital has identified that“deficiency of spleen and kidney with damp heat remaining”is the key pathogenesis of the continuous progression of chronic hepatitis B and has established the treatment regimen for chronic hepatitis B with the basic treatment method of tonifying the kidney,strengthening the spleen,and promoting diuresis.The clinical research of National Science and Technology Major Project from The 11th Five Year Plan to The 13th Five Year Plan has validated the clinical efficacy of this regimen and clarified that regulating the immune function of the body is the main mechanism of the kidney-tonifying,spleen-strengthening,and diuresis-promoting therapy in the treatment of chronic hepatitis B.