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补肾法治疗HBeAg阳性慢性HBV感染者临床及相关机制研究

邢宇锋 韩志毅 周大桥 童光东

引用本文:
Citation:

补肾法治疗HBeAg阳性慢性HBV感染者临床及相关机制研究

DOI: 10.3969/j.issn.1001-5256.2023.06.002
基金项目: 

国家“十三五”科技重大专项 (2018ZX10725505-002);

童光东广东省名中医工作室 

利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:邢宇锋负责起草撰写文章;韩志毅协助起草;周大桥修改文章;童光东对撰写思路与设计有重要贡献。
详细信息
    通信作者:

    童光东,tgd755@163.com (ORCID:0000-0002-8577-574X)

Research advances in kidney-tonifying therapy for patients with HBeAg-positive chronic HBV infection

Research funding: 

National Science and Technology Major Project during the 13th Five-year Plan Period (2018ZX10725505-002);

Tong Guangdong Famous TCM Studio of Guangdong Province 

More Information
    Corresponding author: TONG Guangdong, tgd755@163.com (ORCID: 0000-0002-8577-574X)
  • 摘要:

    慢性HBV感染是HBV自然史中的重要阶段,但对于该阶段的治疗存在一定的争议。中医药自古以来在病毒性肝炎的防治中具有优势,在我国病毒性肝炎的防治中占有重要地位,深圳市中医院团队根据慢性HBV感染的病理过程,认为慢性HBV感染中医核心病机是“肾虚疫毒之邪伏于肝血”,并创立了补肾法治疗慢性HBV感染者;在国家“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项“十一五”“十二五”“十三五”项目支持下,开展了慢性HBV感染者的证候规律研究和系列临床研究,通过多中心、随机、双盲、安慰对照研究了补肾法的临床疗效,为中医药治疗慢性HBV感染者进行了初步探索,探讨了其疗效机制,但慢性HBV感染者的发病机制及其治疗仍然存在较大的难点,随着中医药的传承创新与现代化,相信中医药能够为解决慢性HBV感染者的治疗提供可靠方案。

     

  • [1] European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection[J]. J Hepatol, 2017, 67(2): 370-398. DOI: 10.1016/j.jhep.2017.03.021.
    [2] HUI CK, LEUNG N, YUEN ST, et al. Natural history and disease progression in Chinese chronic hepatitis B patients in immune-tolerant phase[J]. Hepatology, 2007, 46(2): 395-401. DOI: 10.1002/hep.21724.
    [3] LIU J, LIANG W, JING W, et al. Countdown to 2030: eliminating hepatitis B disease, China[J]. Bull World Health Organ, 2019, 97(3): 230-238. DOI: 10.2471/BLT.18.219469.
    [4] CHAN HL, CHAN CK, HUI AJ, et al. Effects of tenofovir disoproxil fumarate in hepatitis B e antigen-positive patients with normal levels of alanine aminotransferase and high levels of hepatitis B virus DNA[J]. Gastroenterology, 2014, 146(5): 1240-1248. DOI: 10.1053/j.gastro.2014.01.044.
    [5] XING YF, ZHOU DQ, HE JS, et al. Clinical and histopathological features of chronic hepatitis B virus infected patients with high HBV-DNA viral load and normal alanine aminotransferase level: A multicentre-based study in China[J]. PLoS One, 2018, 13(9): e0203220. DOI: 10.1371/journal.pone.0203220.
    [6] CAREY I, D'ANTIGA L, BANSAL S, et al. Immune and viral profile from tolerance to hepatitis B surface antigen clearance: a longitudinal study of vertically hepatitis B virus-infected children on combined therapy[J]. J Virol, 2011, 85(5): 2416-2428. DOI: 10.1128/JVI.01449-10.
    [7] XIAO Y, ZENG Y, ALEXANDER E, et al. Adsorption of recombinant poxvirus L1-protein to aluminum hydroxide/CpG vaccine adjuvants enhances immune responses and protection of mice from vaccinia virus challenge[J]. Vaccine, 2013, 31(2): 319-326. DOI: 10.1016/j.vaccine.2012.11.007.
    [8] D'ANTIGA L, AW M, ATKINS M, et al. Combined lamivudine/interferon-alpha treatment in "immunotolerant" children perinatally infected with hepatitis B: a pilot study[J]. J Pediatr, 2006, 148(2): 228-233. DOI: 10.1016/j.jpeds.2005.09.020.
    [9] WANG YX, HUANG JZ, TONG GD, et al. The treatment strategies of chronic HBV carrier state from the perspective of "pre-ventive treatment of disease"[J]. Chin J Integr Tradit West Med Liver Dis, 2021, 31(2): 114-116. DOI: 10.3969/j.issn.1005-0264.2021.02.004.

    王宇新, 黄锦桢, 童光东, 等. 基于"治未病"理论探讨慢性乙型肝炎病毒携带状态的治疗策略[J]. 中西医结合肝病杂志, 2021, 31(2): 114-116. DOI: 10.3969/j.issn.1005-0264.2021.02.004.
    [10] ZHOU DQ, TONG GD, HE JS, et al. Integrated traditional Chinese and western medicine diagnosis and treatment for chronic HBV carriers[J]. Infect Dis Info, 2012, 25(3): 138-142. DOI: 10.3969/j.issn.1007-8134.2012.03.004.

    周大桥, 童光东, 贺劲松, 等. 慢性HBV携带者的中西医诊治概况[J]. 传染病信息, 2012, 25(3): 138-142. DOI: 10.3969/j.issn.1007-8134.2012.03.004.
    [11] TONG GD, PENG SQ. Discussion on the treatment of chronic hepatitis B based on the Liu's theory of kidney deficiency and incubative pathogen[J]. J Tradit Chin Med, 2004, 45(10): 726-728. DOI: 10.3321/j.issn:1001-1668.2004.10.002.

    童光东, 彭胜权. 从"肾虚伏气"论慢性乙型肝炎的治疗[J]. 中医杂志, 2004, 45(10): 726-728. DOI: 10.3321/j.issn:1001-1668.2004.10.002.
    [12] TONG GD, LIU YM. Peng Shengquan's experience in treating chronic hepatitis B by invigorating kidney and clearing poison[J]. J Anhui Tradit Chin Med, 2001, 20(1): 25-26. DOI: 10.3969/j.issn.1000-2219.2001.01.014.

    童光东, 刘亚敏. 彭胜权补肾清毒法治疗慢性乙型肝炎经验[J]. 安徽中医学院学报, 2001, 20(1): 25-26. DOI: 10.3969/j.issn.1000-2219.2001.01.014.
    [13] XING YF, ZHANG XH, CHEN YJ, et al. Investigation on TCM Syndrome Distribution and pathogenesis of chronic hepatitis B virus carriers[C]. The 15th Academic Conference of Internal Medicine and Hepatobiliary Diseases of the Chinese Association of Traditional Chinese Medicine and the meeting of the Special Disease Cooperation Group (Liver Disease Group, Infectious Disease Group) of the State Administration of Traditional Chinese Medicine. Jinan, 2012.

    邢宇锋, 张晓晖, 陈英杰, 等. 慢性乙型肝炎病毒携带者中医证候分布规律调查及病机探讨[C]. 中华中医药学会第十五届内科肝胆病学术会议暨国家中医药管理局专科专病协作组(肝病组、传染病组)会议. 济南, 2012.
    [14] HE JS. A study for syndromes regularity of chronic hepatitis B virus carriers and treatment of a Chinese Herbal Formula(invigorating the kidney and the spleen decoction) on it[D]. Guangzhou: Guangzhou University of Chinese Medicine, 2012.

    贺劲松. 慢性乙肝病毒携带者证候规律及补肾健脾法治疗的研究[D]. 广州: 广州中医药大学, 2012.
    [15] XING YF, ZHANG XH, CHEN YJ, et al. Pathogenesis discussion and TCM syndrome distribution law of chronic hepatitis B virus carriers[J]. Chin J Integr Tradit West Med Liver Dis, 2012, 22(4): 196-199. DOI: 10.3969/j.issn.1005-0264.2012.04.002.

    邢宇锋, 张晓晖, 陈英杰, 等. 慢性乙肝病毒携带者中医证候分布规律调查及病机探讨[J]. 中西医结合肝病杂志, 2012, 22(4): 196-199. DOI: 10.3969/j.issn.1005-0264.2012.04.002.
    [16] HE J, ZHOU D, TONG G, et al. Efficacy and safety of a chinese herbal formula (invigorating kidney and strengthening spleen) in chronic hepatitis B virus carrier: results from a multicenter, randomized, double-blind, and placebo-controlled trial[J]. Evid Based Complement Alternat Med, 2013, 2013: 961926. DOI: 10.1155/2013/961926.
    [17] XING YF, TONG GD, ZHOU DQ, et al. Liver histological features analysis of 459 cases chronic hepatitis B virus carriers[J]. Chin J Integr Tradit West Med Liver Dis, 2015, 25(6): 324-327. DOI: 10.3969/j.issn.1005-0264.2015.06.002.

    邢宇锋, 童光东, 周大桥, 等. 459例慢性HBV携带者肝脏组织学特征分析[J]. 中西医结合肝病杂志, 2015, 25(6): 324-327. DOI: 10.3969/j.issn.1005-0264.2015.06.002.
    [18] XING YF. Histological features of liver in Chronic Hepatitis B virus carriers over 30 years old and the pathological changes after tonifying kidney therapy[D]. Guangzhou: Guangzhou University of Chinese Medicine, 2015.

    邢宇锋. 30岁以上慢性HBV携带者肝脏组织学特征及补肾法干预后的病理变化[D]. 广州: 广州中医药大学, 2015.
    [19] LI ZY, ZHOU DQ, YANG DG, et al. The relationship between serum HBeAg, HBV DNA and liver pathological change in chronic hepatitis B virus carriers[J]. China Med Herald, 2010, 7(20): 15-16. DOI: 10.3969/j.issn.1673-7210.2010.20.007.

    李知玉, 周大桥, 杨大国, 等. 慢性HBV感染者血清HBeAg及HBV DNA与肝组织病理分级、分期的关系[J]. 中国医药导报, 2010, 7(20): 15-16. DOI: 10.3969/j.issn.1673-7210.2010.20.007.
    [20] XING YF, WEI CS, ZHOU TR, et al. Efficacy of a Chinese herbal formula on hepatitis B e antigen-positive chronic hepatitis B patients[J]. World J Gastroenterol, 2020, 26(30): 4501-4522. DOI: 10.3748/wjg.v26.i30.4501.
    [21] XING YF, XU LY, FENG L, et al. A multicenter, randomized, double-blind clinical trial on a Chinese Herbal Formula (Bushen Jianpi Jiedu Prescription) in the treatment of chronic hepatitis B virus carriers[J]. Chin J Integr Tradit West Med Liver Dis, 2021, 31(7): 586-589. DOI: 10.3969/j.issn.1005-0264.2021.07.003.

    邢宇锋, 许林艺, 冯楝, 等. 补肾健脾解毒方治疗慢性乙型肝炎病毒携带者的临床研究[J]. 中西医结合肝病杂志, 2021, 31(7): 586-589. DOI: 10.3969/j.issn.1005-0264.2021.07.003.
    [22] PENG DT, XING YF, WEI CS, et al. Clinic study of the method of invigorating the kidney and detoxification on the immune resistance in chronic HBV carriers[J]. Lishizhen Med Mater Med Res, 2016, 27(12): 2949-2951. DOI: 10.3969/j.issn.1008-0805.2016.12.044.

    彭得倜, 邢宇锋, 魏春山, 等. 补肾解毒方对慢性HBV携带者免疫耐受的临床研究[J]. 时珍国医国药, 2016, 27(12): 2949-2951. DOI: 10.3969/j.issn.1008-0805.2016.12.044.
    [23] CHEN YJ, ZHOU DQ, TONG GD, et al. Immunomodulatory effect of the Bushen Jianpi recipe on HBeAg-positive hepatitis B virus carriers[J]. Clin J Chin Med, 2013, 5(12): 1-5. DOI: 10.3969/j.issn.1674-7860.2013.12.001.

    陈英杰, 周大桥, 童光东, 等. 补肾健脾方HBeAg阳性乙肝病毒携带者的免疫调节作用[J]. 中医临床研究, 2013, 5(12): 1-5. DOI: 10.3969/j.issn.1674-7860.2013.12.001.
    [24] ZHENG YJ, HE JS, CHEN L, et al. Effects of Bushen Ylpi Fang on hepatitis B virus replication and Th1/Th2 cytokines in chronic hepatitis B virus carriers[J]. J Nangjing Univ Tradit Chin Med, 2012, 28(3): 211-215. DOI: 10.3969/j.issn.1000-5005.2012.03.005.

    郑颖俊, 贺劲松, 陈亮, 等. 补肾健脾方对慢性乙肝病毒携带者病毒复制及Th1/Th2型细胞因子的影响[J]. 南京中医药大学学报, 2012, 28(3): 211-215. DOI: 10.3969/j.issn.1000-5005.2012.03.005.
    [25] TONG GD, ZHOU DQ, LIU HL, et al. Effect of clearing and penetrating therapy on Th1/Th2 in 33 patients with chronic hepatitis B[J]. Chin J Tradit Chin Med Pharm, 2002, 17(12): 737-738. DOI: 10.3969/j.issn.1673-1727.2002.12.011.

    童光东, 周大桥, 刘惠玲, 等. 清透法对33例慢性乙型肝炎患者Th1/Th2状态的影响[J]. 中国医药学报, 2002, 17(12): 737-738. DOI: 10.3969/j.issn.1673-1727.2002.12.011.
    [26] LIU XL, XIONG YQ, ZHOU DQ, et al. Influence of Bushenqingtou Decoction on serum IL-2, IL-4, IL-10, TNF-α and IFN-γ in chronic hepatitis B patients with positive HBeAg[J]. Int J Lab Med, 2014, 35(5): 565-571. DOI: 10.3969/j.issn.1673-4130.2014.05.024.

    刘心亮, 熊益群, 周大桥, 等. 补肾清透方对慢性乙肝HBeAg阳性患者血清IL-2、IL-4、IL-10、TNF-α及IFN- γ的影响[J]. 国际检验医学杂志, 2014, 35(5): 565-571. DOI: 10.3969/j.issn.1673-4130.2014.05.024.
    [27] LU YP, ZHOU DQ, XIONG YQ, et al. Effect of dendritic cells and HBV-DNA to chronic hepatitis B patients with Liangxue Zishen Yiqi method[J]. Chin J Exp Med Formul, 2015, 21(13): 160-164. DOI: 10.13422/j.cnki.syfjx.2015130160.

    鲁艳平, 周大桥, 熊益群, 等. 凉血滋肾益气法对慢性乙肝患者树突状细胞和HBV-DNA的影响[J]. 中国实验方剂学杂志, 2015, 21(13): 160-164. DOI: 10.13422/j.cnki.syfjx.2015130160.
    [28] WANG YX, TONG GD, HUANG JZ, et al. Clinical observation of optimized Bushen Shugan Decoction in treating chronic HBV carrying state and its effect on PD-1[J]. Tradit Chin Drug Res Clin Pharmacol, 2022, 33(4): 531-536. DOI: 10.19378/j.issn.1003-9783.2022.04.015.

    王宇新, 童光东, 黄锦桢, 等. 补肾疏肝优化方治疗慢性HBV携带状态的临床观察及对血清中PD-1水平的影响[J]. 中药新药与临床药理, 2022, 33(4): 531-536. DOI: 10.19378/j.issn.1003-9783.2022.04.015.
    [29] HE MY, LI X, PAN XP, et al. Exploration of mechanism of Bushen Jianpi Decoction in the treatment of chronic hepatitis B based on network pharmacology and molecular docking[J]. J Zhejiang Univ Tradit Chin Med, 2022, 46(1): 50-59. DOI: 10.16466/j.issn1005-5509.2022.01.008.

    贺旻洋, 李想, 潘小平, 等. 基于网络药理学及分子对接探究补肾健脾方治疗慢性乙型肝炎的作用机制[J]. 浙江中医药大学学报, 2022, 46(1): 50-59. DOI: 10.16466/j.issn1005-5509.2022.01.008.
    [30] TONG GD, ZHOU DQ. Difficulties in treatment of chronic HBV Carrying state patients and TCM treatment practice[J]. Chin J Integr Tradit West Med Liver Dis, 2021, 31(7): 577-581. DOI: 10.3969/j.issn.1005-0264.2021.07.001.

    童光东, 周大桥. 慢性HBV携带状态的治疗难点及中医治疗实践[J]. 中西医结合肝病杂志, 2021, 31(7): 577-581. DOI: 10.3969/j.issn.1005-0264.2021.07.001.
    [31] CAO Z, LIU Y, MA L, et al. A potent hepatitis B surface antigen response in subjects with inactive hepatitis B surface antigen carrier treated with pegylated-interferon alpha[J]. Hepatology, 2017, 66(4): 1058-1066. DOI: 10.1002/hep.29213.
    [32] SU R. Characteristics of regulatory B cells and serum cytokines in patients with chronic hepatitis B virus infection during different immune status[D]. Nanjing: Nanjing Medical University, 2015.

    苏然. 不同免疫状态下慢性HBV感染者外周血调节性B细胞及IL-10、IP-10变化特点[D]. 南京: 南京医科大学, 2015.
    [33] Branch of Hepatobiliary Diseases, Chinese Association of Chinese Medicine. The standards of traditional Chinese medicine syndrome differentiation for viral hepatitis[J]. J Clin Hepatol, 2017, 33(10): 1839-1846. DOI: 10.3969/j.issn.1001-5256.2017.10.002.

    中华中医药学会肝胆病分会. 病毒性肝炎中医辨证标准[J]. 临床肝胆病杂志, 2017, 33(10): 1839-1846. DOI: 10.3969/j.issn.1001-5256.2017.10.002.
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