从温论治慢性乙型肝炎的中医思考
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摘要
目前中医对慢性乙型肝炎的辨证分型虽然很多,但对慢性乙型肝炎阴证认识不足,反映出目前现行的中医辨证分型尚不完全符合慢性乙型肝炎的临床实际,影响了中医治疗慢性乙型肝炎的疗效。从乙肝病毒属性,慢性肝炎免疫应答的特点出发,对慢性乙型肝炎的寒温进行了一个明确的定性,认为慢性乙型肝炎的性质为寒,治疗时当从温论治。刘完素提出了肝气本温思想,对慢性乙型肝炎从温论治有着重要的启示,维护和重建一个"肝气温"的体内环境,或许可能是抑制乙肝病毒生存和复制的关键所在。
At present,TCM has many syndromes differentiation for chronic Hepatitis B(CHB),but the understanding of yin syndrome of CHB is insufficient,which reflects that TCM differentiation of syndromes can not completely conform with clinical reality of CHB,and has an influences on the effect of TCM on CHB.This article pays attention to the nature of hepatitis B virus and the immune response of chronic hepatitis,which determines the clear nature of cold and warm for CHB,i.e.the nature of CHB is cold and the treatment should use warm herbs.Liu Wan-su put forward the thougth that liver qi should be warm,which has an important revelation for treating CHB from warm.Maintaining and rebuilding the internal environment of" warm liver qi"may be the key of inhibiting the survival and reproduction of hepatitis B virus.
At present,TCM has many syndromes differentiation for chronic Hepatitis B(CHB),but the understanding of yin syndrome of CHB is insufficient,which reflects that TCM differentiation of syndromes can not completely conform with clinical reality of CHB,and has an influences on the effect of TCM on CHB.This article pays attention to the nature of hepatitis B virus and the immune response of chronic hepatitis,which determines the clear nature of cold and warm for CHB,i.e.the nature of CHB is cold and the treatment should use warm herbs.Liu Wan-su put forward the thougth that liver qi should be warm,which has an important revelation for treating CHB from warm.Maintaining and rebuilding the internal environment of" warm liver qi"may be the key of inhibiting the survival and reproduction of hepatitis B virus.
引文
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[2]李凡,刘晶星.医学微生物学[M].北京:人民卫生出版社,1979.
[3]巩增锋,蒋妮,帅佃魁.恩替卡韦联合IFN-a治疗慢性乙肝的系统评价[J].中国循证医学杂志,2014,14(10):1 241-1 246.
[4]杨绍基,任红.传染病学[M].北京:人民卫生出版社,1980:24.
[5]黄玉芳.病理学[M].北京:中国中医药出版社,2012:246-247.
[6]王晓慧,吴同玉.基于“阳化气”理论探讨肝硬化的中医治疗思路[J].云南中医学院学报,2016,39(4):74-76.
[7]缪希迪,秦雍.“阳化气,阴成形”与扶阳抑阴-培元固本治肿瘤[J].实用中医内科杂志,2016,30(4):50-52.
[8]董正平,肖相如.外感病滥用寒凉的原因分析[J].中华中医药杂志,2012,27(5):1 238-1 240.
[9]李可.李可老中医急危重症疑难病经验专辑[M].太原:山西科学技术出版社,2002:166-172.
[10]艾海花.肝病诊疗需重视补肝气与温肝阳[J].浙江中医药大学学报,2016,40(8):589-592.
[11]张庆华,黄敏,图娅.中药在慢性乙型肝炎治疗中的定位思考与研究[J].中西医结合肝病杂志,2016,26(1):56-58.
[12]李卫强,朱西杰,徐建虎.慢性乙型肝炎证治探讨[J].山西中医,2015,31(1):1-6.
[2]李凡,刘晶星.医学微生物学[M].北京:人民卫生出版社,1979.
[3]巩增锋,蒋妮,帅佃魁.恩替卡韦联合IFN-a治疗慢性乙肝的系统评价[J].中国循证医学杂志,2014,14(10):1 241-1 246.
[4]杨绍基,任红.传染病学[M].北京:人民卫生出版社,1980:24.
[5]黄玉芳.病理学[M].北京:中国中医药出版社,2012:246-247.
[6]王晓慧,吴同玉.基于“阳化气”理论探讨肝硬化的中医治疗思路[J].云南中医学院学报,2016,39(4):74-76.
[7]缪希迪,秦雍.“阳化气,阴成形”与扶阳抑阴-培元固本治肿瘤[J].实用中医内科杂志,2016,30(4):50-52.
[8]董正平,肖相如.外感病滥用寒凉的原因分析[J].中华中医药杂志,2012,27(5):1 238-1 240.
[9]李可.李可老中医急危重症疑难病经验专辑[M].太原:山西科学技术出版社,2002:166-172.
[10]艾海花.肝病诊疗需重视补肝气与温肝阳[J].浙江中医药大学学报,2016,40(8):589-592.
[11]张庆华,黄敏,图娅.中药在慢性乙型肝炎治疗中的定位思考与研究[J].中西医结合肝病杂志,2016,26(1):56-58.
[12]李卫强,朱西杰,徐建虎.慢性乙型肝炎证治探讨[J].山西中医,2015,31(1):1-6.