中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 6
Jun.  2023
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(6): 1274-1279

Clinical efficacy and mechanism of action of kidney-tonifying, spleen-strengthening, and diuresis-promoting therapy in treatment of chronic hepatitis B

DOI: 10.3969/j.issn.1001-5256.2023.06.003
  • 1.

    Department of Hepatopathy, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

  • 2.

    Laboratory of Cellular Immunity, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

Research funding:

National Science and Technology Key Project for the Prevention and Treatment of Major Infectious Diseases such as AIDS and Viral Hepatitis (2018ZX10725504);

National Natural Science Foundation of China (82274467);

National Natural Science Foundation of China (81774256);

Shanghai Three-year Action Plan to Further Accelerate TCM Inheritance and Innovation Development (2021-2023) (Construction of TCM specialty disease Alliance in East China Region and Municipal Level-Construction of TCM Liver Disease Specialty Alliance in Yangtze River Delta) (ZY(2021-2023)-0302);

Pudong Famous Traditional Chinese Medicine Training Project of Shanghai Pudong New Area Health Commission (PWRzm2020-02);

Shanghai Famous Old Chinese Medicine Academic Experience Research Studio for Yueqiu Gao (SHGZS-202246)

More Information
  • Corresponding author: GAO Yueqiu, gaoyueqiu@hotmail.com (ORCID: 0000-0001-7276-9810)
  • Received Date: 2023-03-29
  • Accepted Date: 2023-04-30
  • Published Date: 2023-06-20
    Abstract
  • Chronic hepatitis B is a public health issue worldwide. Nucleotide analogues and interferon therapy can effectively inhibit HBV replication, but they still have the shortcomings such as inability to achieve the clearance of HBV cccDNA and low HBsAg clearance rate. The academic viewpoint of "kidney-tonifying therapy for chronic hepatitis B" provides new ideas and methods for the treatment of hepatitis B. During long-term clinical practice, Department of Hepatology in Shuguang Hospital has identified that "deficiency of spleen and kidney with damp heat remaining" is the key pathogenesis of the continuous progression of chronic hepatitis B and has established the treatment regimen for chronic hepatitis B with the basic treatment method of tonifying the kidney, strengthening the spleen, and promoting diuresis. The clinical research of National Science and Technology Major Project from The 11th Five Year Plan to The 13th Five Year Plan has validated the clinical efficacy of this regimen and clarified that regulating the immune function of the body is the main mechanism of the kidney-tonifying, spleen-strengthening, and diuresis-promoting therapy in the treatment of chronic hepatitis B.

     

    • FullText(HTML)
  • loading
    • References(28)
  • [1]
    World Health Organization. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Accountability for the global health sector strategies 2016-2021: actions for impact[EB/OL]. https://apps.who.int/iris/bitstream/handle/10665/342808/9789240030985-eng.pdf.
    [2]
    LIU J, LIANG W, JING W, et al. Countdown to 2030: eliminating hepatitis B disease, China[J]. Bull World Health Organ, 2019, 97(3): 230-238. DOI: 10.2471/BLT.18.219469.
    [3]
    LIAW YF, KAO JH, PIRATVISUTH T, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2012 update[J]. Hepatol Int, 2012, 6(3): 531-561. DOI: 10.1007/s12072-012-9365-4.
    [4]
    LOK AS. Hepatitis: Long-term therapy of chronic hepatitis B reverses cirrhosis[J]. Nat Rev Gastroenterol Hepatol, 2013, 10(4): 199-200. DOI: 10.1038/nrgastro.2013.13.
    [5]
    MARCELLIN P, GANE E, BUTI M, et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study[J]. Lancet, 2013, 381(9865): 468-475. DOI: 10.1016/S0140-6736(12)61425-1.
    [6]
    Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Guidelines for the prevention and treatment of chronic hepatitis B (2022 version)[J]. Chin J Infect Dis, 2023, 41(1): 3-28. DOI: 10.3760/cma.j.cn311365-20230220-00050.

    中华医学会肝病分会, 中华医学会感染病分会. 慢性乙型肝炎防治指南(2022年版)[J]. 中华传染病杂志, 2023, 41(1): 3-28. DOI: 10.3760/cma.j.cn311365-20230220-00050.
    [7]
    GAO YQ. Regulation of immunity by traditional Chinese medicine is the dominant link in the treatment of chronic hepatitis B[J]. Chin J Integr Tradit West Med Liver Dis, 2010, 20(3): 129-130. DOI: 10.3969/j.issn.1005-0264.2010.03.001.

    高月求. 中医药调控免疫是治疗慢性乙型肝炎优势环节[J]. 中西医结合肝病杂志, 2010, 20(3): 129-130. DOI: 10.3969/j.issn.1005-0264.2010.03.001.
    [8]
    GAO YQ, ZHANG X, LI M, et al. Immunological mechanism of traditional Chinese medicine in treatment of chronic hepatitis B[J]. World Chin J Dig, 2016, 19: 2943-2949. DOI: 10.11569/wcjd.v24.i19.2943.

    高月求, 张鑫, 李曼, 等. 中医药治疗慢性乙型肝炎的免疫学机制研究进展[J]. 世界华人消化杂志, 2016, 19: 2943-2949. DOI: 10.11569/wcjd.v24.i19.2943.
    [9]
    Hepatobiliary Specialized Committee of China Association of Chinese Medicine, Liver Diseases Specialized Committee of China Medical Association of Minorities. The clinical guidelines of diagnosis and treatment of chronic hepatitis B with traditional Chinese medicine(2018)[J]. J Clin Hepatol, 2018, 34(12): 2520-2525. DOI: 10.3969/j.issn.1001-5256.2018.12.007.

    中华中医药学会肝胆病专业委员会, 中国民族医药学会肝病专业委员会. 慢性乙型肝炎中医诊疗指南(2018年版)[J]. 临床肝胆病杂志, 2018, 34(12): 2520-2525. DOI: 10.3969/j.issn.1001-5256.2018.12.007.
    [10]
    ZHANG MY, LIANG HQ, WU CC, et al. Discussion on the etiology and pathogenesis of liver stagnation and spleen deficiency syndrome of chronic hepatitis B based on the theory of liver and spleen[J]. Lishizhen Med Mater Med Res, 2020, 10: 2444-2446. DOI: 10.3969/j.issn.1008-0805.2020.10.041.

    张满英, 梁惠卿, 吴春城, 等. 基于肝脾理论的慢乙肝肝郁脾虚证证候漂变的病因病机探讨[J]. 时珍国医国药, 2020, 10: 2444-2446. DOI: 10.3969/j.issn.1008-0805.2020.10.041.
    [11]
    ZHANG CT, HU XY, ZHOU DJ, et al. Randomized, controlled clinical study about treaing HBeAg positive chronic asymptomatic hepatitis B virus carriers based on 'Kidney Deficiency Fuxie' theory[J]. Chin J Exp Med Formul, 2014, 20(3): 175-179. DOI: 10.11653/syfj2014030175.

    张传涛, 扈晓宇, 周道杰, 等. 基于"肾虚伏邪"理论论治HBeAg阳性慢性无症状乙型肝炎病毒携带者的临床观察[J]. 中国实验方剂学杂志, 2014, 20(3): 175-179. DOI: 10.11653/syfj2014030175.
    [12]
    HAN L, ZHENG XR. Discussion on treating chronic hepatitis B from kidney theory[J]. J Shaanxi Univ Chin Med, 2019, 42(1): 44-46. DOI: 10.13424/j.cnki.jsctcm.2019.01.015.

    韩乐, 郑旭锐. 慢性乙型肝炎从肾论治理论探讨[J]. 陕西中医药大学学报, 2019, 42(1): 44-46. DOI: 10.13424/j.cnki.jsctcm.2019.01.015.
    [13]
    GAO YQ, WANG LT. Discussion and study on Chinese medicine syndrome types of chronic hepatitis B[J]. Chin J Basic Med Tradit Chin Med, 2003, 9(9): 40-41. DOI: 10.3969/j.issn.1006-3250.2003.08.016.

    高月求, 王灵台. 慢性乙型肝炎中医证型研究探讨[J]. 中国中医基础医学杂志, 2003, 9(9): 40-41. DOI: 10.3969/j.issn.1006-3250.2003.08.016.
    [14]
    ZHU LL, MENG H, JIANG J, et al. Study on TCM syndrome typing of chronic hepatitis B[J]. Chin J Integr Trad West Med, 2008, 28(1): 20-23. DOI: 10.3321/j.issn:1003-5370.2008.01.007.

    朱蕾蕾, 孟虹, 蒋健, 等. 慢性乙型肝炎中医证型分类的研究[J]. 中国中西医结合杂志, 2008, 28(1): 20-23. DOI: 10.3321/j.issn:1003-5370.2008.01.007.
    [15]
    ZHU XJ, SUN XH, ZHOU ZH, et al. Lingmao formula combined with entecavir for HBeAg-positive chronic hepatitis B patients with mildly elevated alanine aminotransferase: A multicenter, randomized, double-blind, placebo-controlled trial[J]. Evid Based Complement Alternat Med, 2013, 2013: 620230. DOI: 10.1155/2013/620230.
    [16]
    ZHANG JH, ZHANG X, ZHOU ZH, et al. Bushen Jianpi Formula combined with Entecavir for the treatment of HBeAg-negative chronic hepatitis B: A multicenter, randomized, double-blind, placebo-controlled trial[J]. Evid Based Complement Alternat Med, 2022, 2022: 6097221. DOI: 10.1155/2022/6097221.
    [17]
    LI M, ZHOU ZH, SUN XH, et al. The dynamic changes of circulating invariant natural killer T cells during chronic hepatitis B virus infection[J]. Hepatol Int, 2016, 10(4): 594-601. DOI: 10.1007/s12072-015-9650-0.
    [18]
    LI M, ZHOU ZH, SUN XH, et al. Hepatitis B core antigen upregulates B7-H1 on dendritic cells by activating the AKT/ERK/P38 pathway: a possible mechanism of hepatitis B virus persistence[J]. Lab Invest, 2016, 96(11): 1156-1164. DOI: 10.1038/labinvest.2016.96.
    [19]
    WU SF, WANG WJ, GAO YQ. Natural killer cells in hepatitis B virus infection[J]. Braz J Infect Dis, 2015, 19(4): 417-425. DOI: 10.1016/j.bjid.2015.05.006.
    [20]
    LI M, SUN XH, ZHU XJ, et al. HBcAg induces PD-1 upregulation on CD4+T cells through activation of JNK, ERK and PI3K/AKT pathways in chronic hepatitis-B-infected patients[J]. Lab Invest, 2012, 92(2): 295-304. DOI: 10.1038/labinvest.2011.157.
    [21]
    JI LS, GAO QT, GUO RW, et al. Immunomodulatory effects of combination therapy with bushen formula plus entecavir for chronic hepatitis B patients[J]. J Immunol Res, 2019, 2019: 8983903. DOI: 10.1155/2019/8983903.
    [22]
    LI M, ZHOU ZH, BAO T, et al. Beneficial effects of bushen formula combined with enticavir on chronic hepatitis B patients with suboptimal response to enticavir by regulating B-cell differentiation[J]. Cell Physiol Biochem, 2018, 48(2): 633-643. DOI: 10.1159/000491891.
    [23]
    ZHOU ZH, SUN XH, LI M, et al. Effect of kidney-tonifying and spleen-strengthening prescription on PD-1 and PD-L1 expression in HBeAg-positive chronic hepatitis B patients with slightly increased ALT levels[J]. J Clin Hepatol, 2015, 31(1): 58-62. DOI: 10.3969/j.issn.1001-5256.2015.01.013.

    周振华, 孙学华, 李曼, 等. 补肾健脾方对ALT轻度升高的HBeAg阳性慢性乙型肝炎患者程序性死亡受体1/程序性死亡配体1表达的影响[J]. 临床肝胆病杂志, 2015, 31(1): 58-62. DOI: 10.3969/j.issn.1001-5256.2015.01.013.
    [24]
    LE F, ZHANG X, ZHU XJ, et al. Effects of Bushen Jianpi Recipe on NKT cell function in positive HBeAg chronic hepatitis B patients after entecavir treatment[J]. Acta Univ Tradit Med Sin Pharmacol Shanghai, 2018, 32(3): 22-27. DOI: 10.16306/j.1008-861x.2018.03.005.

    乐凡, 张鑫, 朱晓骏, 等. 补肾健脾方对恩替卡韦经治HBeAg阳性慢性乙型肝炎患者NKT细胞功能的影响[J]. 上海中医药大学学报, 2018, 32(3): 22-27. DOI: 10.16306/j.1008-861x.2018.03.005.
    [25]
    ZHANG JH, ZHENG C, ZHU XJ, et al. Anti-inflammation antiviral effects and mechanisms of Bushen recipe based on MAVS mediated signal pathway[J]. Chin J Integr Tradit West Med Liver Dis, 2019, 29(2): 155-158, Back insert 7. DOI: 10.3969/j.issn.1005-0264.2019.02.019.

    张景豪, 郑超, 朱晓骏, 等. 基于MAVS介导信号通路的补肾方抗炎抗HBV作用及机制研究[J]. 中西医结合肝病杂志, 2019, 29(2): 155-158, 后插7. DOI: 10.3969/j.issn.1005-0264.2019.02.019.
    [26]
    NIE H, MEI Z, WANG R, et al. Bushen recipe and its disassembled prescriptions inhibit inflammation of liver injury associated with concanavalin A through Toll-like receptor 3/9 signaling pathway[J]. Mol Med Rep, 2018, 18(2): 1682-1691. DOI: 10.3892/mmr.2018.9082.
    [27]
    LI M, SUN XH, ZHOU ZH, et al. Beneficial therapeutic effect of Chinese herbal Bushen formula on CHB patients with mildly elevated alanine aminotransferase by down-regulating CD4+CD25+T cells[J]. J Ethnopharmacol, 2013, 146(2): 614-622. DOI: 10.1016/j.jep.2013.01.038.
    [28]
    REVILL PA, CHISARI FV, BLOCK JM, et al. A global scientific strategy to cure hepatitis B[J]. Lancet Gastroenterol Hepatol, 2019, 4(7): 545-558. DOI: 10.1016/S2468-1253(19)30119-0.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索
    Get Citation
    PDF
    XML

    Article Metrics

    Article views (400) PDF downloads(51) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return