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
Wang Huei-Syun 1,3 Tsai Cheng-Hsun1,*
1Department of Traditional Chinese Medicine, Chung Ho Memorial Hospital,
Kaohsiung Medical University
【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.