中醫治療B型肝炎病毒相關性腎炎－病例報告

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

10.6516/TJTCM.202403_27(1).0008

王慧薰(Wang Huei-Syun)；蔡政勳(Tsai Cheng-Hsun)

B型肝炎病毒相關性腎炎 ； 中醫證型 ； Hepatitis B associated membranous nephropathy (HBV-MN) ； TCM syndromes

中醫藥研究論叢

27卷1期（2024 / 03 / 30）

91 - 104

繁體中文;英文

B型肝炎病毒相關性膜性腎病變（Hepatitis B associated membranous nephropathy, HBV-MN）為B型肝炎病毒感染併發肝炎後的肝外表現之一，並約有25-35%的患者會進展到末期腎臟疾病（end-stage renal disease, ESRD），需進行透析療法以維持生命，嚴重影響生活品質。本案例為67歲HBV-MN腎臟分期CKD stage 3b的男性患者，經中醫診至以健脾補腎、疏肝解鬱為本，活血袪濕為標給予患者治療，患者具兩段中醫診治期間，初始段用藥期間腎臟分期由CKD stage 3b進步至CKD stage 3a，次段用藥期間腎臟分期維持在CKD stage 3b，接近至CKD stage 3a，eGFR具上升趨勢，故藉此個案說明中醫於B型肝炎病毒相關性膜性腎病變之治療。

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.