何若苹治疗乙肝病毒性肝病经验探析

目的]总结何若苹治疗乙肝病毒性肝病经验。方法]通过侍诊学习以及对典型医案的收集、整理,试从病因病机、辨证论治、用药法度三方面总结何若苹诊治乙肝病毒性肝病经验,并举一则验案加以分析。结果]何若苹认为乙肝病毒性肝病属湿热疫毒为患,病机为湿热疫毒熏蒸肝胆而急性起病,日久耗肝阴,克脾土,伤肾阴,瘀热入络成肝积,血水不利成臌胀,毒瘀积聚成肝癌。初期宜清利,常需顾护脾胃;中期宜辨证调脏,可益阴柔肝、健脾疏肝、滋肾养肝;末期宜扶正祛邪兼顾,及时治疗变证。用药需分期论治,明察宜忌,初期忌补,中期需活血,末期忌攻,并结合天人相应观,根据四时调整用药,若微观指标异常则对症用药。所举验案,以健脾疏肝法疗肝病,效果肯定。结论]何若苹治疗乙肝病毒性肝病初期重清利,中期重调脏,末期重达变,经验独到,疗效显著,值得借鉴。

HE Ruoping's Experiences in Treating Hepatitis B Virus Liver Disease

Objective] To introduce Professor HE Ruoping''s experiences in treating hepatitis B virus liver disease.Method] Through the way of clinical practice with teacher, clinical observation and arranging medical records, try to systematically arrange HE Ruoping''s clinical experiences about etiology, pathogenesis, treatment ideas and drug characteristics, and further explain the characteristics of the treatment of HE through case analysis.Result] Professor HE Ruoping proposes that hepatitis B virus liver disease''s etiology is damp-heat toxin. Pathogenesis is that damp-heat toxin fumigates hepatobiliary, and with the passing of time consumes liver Yin, spleen Qi and kidney Yin. Blood stasis causes mass in the liver, retention of water-dampness causes tympanites, toxic stasis accumulation causes liver cancer. In the early stage, damp heat should be cleared, and spleen and stomach should be taken care of. In the middle period, it is suitable to regulate and adjust the viscera, including nourishing Yin and softening the liver, invigorating the spleen and dispersing the liver also nourishing the kidney and the liver. At the end of the period, it is advisable to strengthen the body resistance to eliminate pathogenic factors and treat the changeable syndrome in time. Herbs can be selected by stages and perceive compatibility and incompatibility, avoid tonifying in the early stage, could activate blood in the mid-term, and avoid activating blood in the last phase. According to concept of correspondence between man and nature, adjust medication according to season also microscopic index. Conclusion] Pro.HE pays attention to eliminating pathogen at primary stage, recuperating viscera at mid-term and treating changed syndrome at the end of the disease. Pro.HE is expert in treating hepatitis B virus liver disease and her experiences deserve us to learn.