摘要
全球范围内乙型肝炎病毒（HBV）携带者约3．5亿人，是人类最常见的病毒性感染之一，其中大部分分布在亚洲地区。我国属于 HBV 感染高发区，2006年卫生部关于全国1～59岁人群乙型肝炎等有关疾病血清流行病学调查显示，我国人群乙型肝炎表面抗原（hepatitis B surface antigen，HBsAg）携带率达7．18％，总数约1．2亿人，慢性乙型肝炎患者约3000万，其中10％～20％可发展为肝硬化，1％～5％可演变为肝癌。在乙肝病毒导致肝硬化的过程中，将有一个慢性的过程，那就是肝纤维化。肝纤维化是指肝细胞发生坏死及炎症刺激时，肝脏中胶原蛋白等细胞外基质（ECM）的增生与降解失去平衡，进而导致肝脏内纤维结缔组织异常沉积的病理过程，轻者称为肝纤维化，重者进而使肝小叶结构改建、假小叶及结节形成，称为肝硬化。然而，肝纤维化是可逆的，早期进行诊断并进行有效的治疗将有助于抑制肝纤维化的发展，并且在一定程度上逆转肝纤维化，可减少肝硬化的发生而提高慢性乙型病毒性肝炎患者的生存率和生活质量。因此有效地阻断肝纤维化的发生发展，对防治肝硬化、肝癌就具有重要意义。然而，目前临床仍缺乏高效、无明显毒副作用的治疗肝纤维化的西药，近十多年来，随着核苷类抗病毒药物的不断研发与临床应用，在抑制乙肝病毒复制、阻止肝纤维化等方面显示出较为有效的治疗，但仍有一定的局限性；而中医药近年已成为国内防治肝纤维化研究的热点，目前已由较成熟的实验研究转向临床研究，并积累了极为丰富的临床经验。本文主要综合中国期刊网全文数据库和中文科技期刊全文数据库近年来有关中医药治疗慢性乙型肝炎肝纤维化代表文献，总结其成果，分析目前仍存在的问题，以期为中医药更有效地治疗慢性乙型肝炎肝纤维化提供理论依据。
Abstract
the global scope of hepatitis B virus (HBV)carriers of about 350000000 people,is one of the most common human virus infection,most of which are distributed in the Asian region.Our country belongs to the area of high incidence of HBV infection,the Ministry of health in 2006 1 ~59 years old on displaying the national population with hepatitis B and other rele-vant diseases sero epidemiological investigation,China's population of hepatitis B surface antigen (hepatitis B surface antigen,HBsAg)carrying rate of 7.18%,a total of about 120000000 peo-ple,about 30000000 of patients with chronic hepatitis B,including 10% ~20% for the development of liver cirrhosis,1% ~5% can be turned into liver cancer.In hepatitis B virus lead to cirrhosis of the liver in the process,there wil be a gradual process,that is,liver fibrosis.Liver fibrosis is the occurrence of liver cel necrosis and inflammatory stimuli,such as liver col agen extracel ular matrix (ECM)proliferation and degradation of out of balance,and lead to the pathological process of liver abnormal deposition of fibrous connective tissue,light is cal ed hepatic fi-brosis,or false lobule and nodule and make the structure of hepatic lobule rebuild,formation,cal ed cirrhosis of the liver.However,liver fibrosis is reversible,early diagnosis and ef ective treat-ment of development wil contribute to the inhibition of liver fibrosis,and liver fibrosis to a certain extent,can reduce the occurrence of liver cirrhosis and improve the chronic hepatitis B patients survival rate and life quality.Therefore,ef ectively blocking the occurrence and development of liver fibrosis,it has important significance for prevention and treatment of liver cirrhosis and hepa-tocel ular carcinoma.However,the current clinical stil lack ef icient and no obvious toxic side ef ects for the treatment of liver fibrosis of Western medicine,in recent ten years,with the continu-ous development and clinical application of nucleoside antiviral drugs,showing that treatment is ef ective in suppressing the replication of hepatitis B virus,prevent liver fibrosis,but there are stil some limitations of traditional Chinese medicine;and medicine in recent years has become a hot research in prevention and treatment of liver fibrosis in domestic,at present already by the experimental study of mature to clinical research,and accumulated extremely rich clinical experience.This paper comprehensive Chinese Journal Ful -text Database and Chinese Science &Technology Journal Ful -text Database in recent years about traditional Chinese medicine treatment of liver fibrosis in patients with chronic hepatitis B to summarize the results of literature,anal-ysis of the current problems stil exist,in order to provide a theoretical basis for the Chinese medicine more ef ective in the treatment of liver fibrosis in patients with chronic hepatitis B.
NETL
NSTL
维普
万方数据