中醫藥對無症狀B型肝炎病毒攜帶者治療之剖析

A Review on Chinese Medicine for Asymptomatic Carriers of Hepatitis B Virus

無症狀B型肝炎病毒攜帶者雖無明顯不適應症狀和體徵，且肝功能指標正常。但本病患者若進行多年的追蹤觀察，卻發現有相當多的人發生了慢性肝炎、肝硬化、肝癌等所謂的肝病三部曲；同時，許多患者肝組織病理學檢查均會出現不同程度的肝臟炎症樣改變及微循環障礙。因此，對本病進行早期的治療，阻止其發展具有很重要的意義。且當前西醫對本病的治療不僅療效尚未肯定，且由於成本昂貴，療程較長，並有一定的副作用，且停藥後易產生病毒反噬作用，故西醫在推廣上亦頗覺為難。無症狀B型肝炎病毒攜帶者的所謂無症狀，是相對於臨床性肝炎而言，事實上按中醫四診八綱方法探求，對絕大多數患者是能夠做出辨證歸類的。B肝 病毒是一種“雜氣”、“疫毒”或“伏邪”在其內侵機體，與正氣相搏的時期，必然引起相關臟腑和氣血津液的功能變化，而這種變化，可以在病人的舌苔、脈象、面色等方面體現出來，這也正是中醫辨證論治的基礎。本病治療許多醫家均強調了以扶正祛邪為治療的基本原則，扶正包括益氣健脾、疏肝理氣、滋補肝腎、溫腎通陽等法，祛邪多為清熱解毒、清熱利濕、活血化瘀、涼血解毒等。中醫藥對本病的治療無論在辨證論治、專方專藥、中西醫結合治療、外治及針灸療法上均取得了很好的療效，故將相關文獻稍加整理，希望能引起大家更多的注意，讓中醫藥在防治這個國病上能有更突出的貢獻。

Asymptomatic carriers of hepatitis B virus in general have no uncomfortable signs and symptoms, and their indicators of liver function are normal. After many years tracing observation on these carriers, it can be found that many of them had chronic hepatitis, liver cirrhosis and liver carcinoma. Additionally, most patients' liver histological examination revealed liver inflammatory change and microcirculation disorder on different levels. For this reason, early treatment is important for stopping the development of this disease. The treatment effect of western medicine in this disease has not yet been widely recognized. Besides, it has some defects, such as expensive cost, long-term treatment, significant side-effects, and virus bites back after stop of medicine. For these reasons, the promotion of western medicine treatment in this disease is difficult. Asymptomatic means there are no symptoms, it is in contrast to clinical liver diseases. Actually, most of these patients can be differentiated according to the four medical diagnosing methods and eight symptoms in traditional Chinese medicine. Hepatitis B virus is a kind of za qi, epidemic toxin, latent pathogen. After infection of hepatitis B virus, the virus can cause the functional changes in the related Zang-Fu organs, qi, blood and fluid during when it is fighting with healthy qi. These changes will be reflected on tongue-coating, pulse con condition and face color. This is the basis of Chinese medical syndrome differentiation. For treating this disease, many doctors insist on the therapy of 'strengthening anti-pathogenic qi and dispelling pathogenic qi'. 'Strengthening anti-pathogenic qi' includes the methods of 'nourishing qi to invigorate spleen', 'soothing liver and regulating qi', 'nourishing the liver and kidneys'. 'Dispelling pathogenic qi' means to clear heat and detoxicatior, to clear away heat and dampness, to promote blood circulation and remove blood stasis, and to cool blood and remove toxic substance. With syndrome differentiation, special formula and drug, combination of traditional Chinese medicine with western medicine, outside therapeutic methods and acupuncture, traditional Chinese medicine has good outcome in treating this disease. This article aimed to make people pay more attention to the traditional Chinese medicine on preventing and treating this disease.