中医药研究论丛

271.8中医治疗B 型肝炎病毒相关性肾炎─病例报告

TJ TCM.27(1) : 91-104, 2024

DOI : 10.6516/TJTCM.202403_27(1).0008

中医治疗B型肝炎病毒相关性肾炎─病例报告

TCM treatment of hepatitis B virus-associated nephritis-a case report

王慧薰1蔡政勋1,*

1服务单位/高雄医学大学附设中和纪念医院中医部

【摘要】
B 型肝炎病毒相关性膜性肾病变(Hepatitis B associated membranous nephropathy, HBV-MN)为B型肝炎病毒感染并发肝炎後的肝外表现之一,并约有25-35%的患者会进展到末期肾脏疾病(end-stage renal disease, ESRD),需进行透析疗法以维持生命,严重影响生活品质。本案例为67岁HBV-MN肾脏分期CKD stage 3b的男性患者,经中医诊至以健脾补肾、疏肝解郁为本,活血袪湿为标给予患者治疗,患者具两段中医诊治期间,初始段用药期间肾脏分期由CKD stage 3b进步至CKD stage 3a,次段用药期间肾脏分期维持在CKD stage 3b,接近至CKD stage 3a,eGFR具上升趋势,故藉此个案说明中医於B型肝炎病毒相关性膜性肾病变之治疗。
【关键词】B型肝炎病毒相关性肾炎、中医证型
【Summary】

Hepatitis B associated membranous nephropathy (HBV-MN) is one of the

extrahepatic manifestations of hepatitis B virus infection complicated by hepatitis,

and about 25-35% of patients will progress to the end stage Kidney disease

(end-stage renal disease, ESRD), requires dialysis therapy to maintain life, seriously

affecting the quality of life. This case is a 67-year-old male patient with HBV-MN

with CKD stage 3b. After TCM diagnosis, the treatment was based on strengthening

the spleen and kidney, soothing the liver and relieving stagnation, and promoting

blood circulation and removing dampness. The patient had two periods of TCM

diagnosis and treatment. During the initial period of medication, the renal stage

progressed from CKD stage 3b to CKD stage 3a, and during the second period of

medication, the renal stage remained at CKD stage 3b, and eGFR showed an upward

trend. Therefore, this case illustrates the role of traditional Chinese medicine in

hepatitis B virus-related membranous nephropathy of treatment.

【Keywords】
Hepatitis B associated membranous nephropathy (HBV-MN); TCM syndromes