慢性B型肝炎中醫藥治療病例報告

A Case of Chronic Hepatitis B Treatment by Traditional Chinese Medicine

潘天健(Tien-Chien Pan) ； 陳丹霞(Tan-Hsia Chen) ； 張宏州(Hung-Chou Chang)

《中西整合醫學雜誌》 11卷1期 (2009/06) Pp. 27-33

https://doi.org/10.29613/JICWM.200906.0004

摘要

這是一位49歲的男性慢性B型肝炎患者，肝功能異常長達15年之久，因此尋求中聲門診治療。其主訴眠淺多夢，多思慮，情志抑鬱，早餐後易腹瀉，其舌色淡紅微暗，苔薄白，脈弦，右寸浮。中醫辨證爲肝鬱脾虛，處方加味逍遙散加丹參、五味子、靈芝、絞股藍、白扁豆爲主方隨證加減，以疏肝解鬱，活血健脾益氣。本病人在初期中醫治療肝功能指數ALT 335IU/L，腹部超音波可見肝實質粗糙和表面不規則，疑似肝硬化，血清B型肝炎病毒濃度(HBV-DNA)高達1,094,080copies/mL。經治療後，目前肝功能恢復正常，Anti-HBeAg由陰性轉爲陽性，腹部超音波所見肝實質粗糙改善，血清HBV-DNA也降至42，343copies/mL。由於本病例獲得較好的治療效果，建議可爲臨床治療慢性B型肝炎的參考。

關鍵字

慢性B型肝炎 ； 加味逍遙散 ； 肝鬱脾虛 ； B型肝炎病毒血清濃度

並列摘要

A 49 years old man with chronic hepatitis B and liver function impairment for 15 years, visited our outpatient department and received Chinese medicinal treatment. He chief complain insomnia, poor sleep quality, depressed mood, easy diarrhea after breakfast. His tongue was pink-mild dark, thin white fur and stringy pulse and floating sign in right inch. The identify pattern of Chinese Medicine was liver depression and spleen vacuity. The treatment formulas wereJia-wei-xia-yao-san plus Salvia miltiorrhiza Bge.(Dan shen), Schisandra chinensis (Turcz.) Baill (Wu wei zi). Ganoderma lucidum (Ling zhi), Gynostemma pentapbyllum (Thunb.) Makino (Jiaogulan) and Dolichos lablab L. (bai bian dou). The functions of formulas were liver-coursing depression-resolving, spleen-fortifying Qi-boosting as wll as blood quickening.
The patient the level of liver function was present ALT 335 IU/L in initial stage with treatment of Chinese Medicine. Abdominal sonography revealed that uneven liver surface with coarse echogeneeity and early liver cirrhosis was suspected before treatment. The level of serum HB V-DNA was increased of 1, 094, 080 copies/ml. The level of liver function was recovered normal limit after treatment 1.5 years and abdominal sonography showed that the coarse echogcnecity of the liver was improved. The level of Anti-HBeAg was conversed to positive. The level of serum HBV-DNA was decreased to 42, 343 copies/ml. The present chronic hepatitis B case got a better therapeutic effect. It suggests that may offer reference of treatment in clinic.

並列關鍵字

Chronic hepatitis B ； Jia-wei-xia-yao-san ； Liver depression and Spleen vacuity ； Serum level of HBV-DNA