【摘要】 全球范圍內乙型肝炎病毒（HBV）攜帶者約3.5億人，是人類最常見的病毒性感染之一，其中大部分分布在亞洲地區。我國屬于HBV感染高發區，2006年衛生部關于全國1～59歲人群乙型肝炎等有關疾病血清流行病學調查顯示，我國人群乙型肝炎表面抗原（hepatitis B surface antigen，HBsAg）攜帶率達7.18%，總數約1.2億人，慢性乙型肝炎患者約3000萬，其中10%～20%可發展為肝硬化，1%～5%可演變為肝癌。 在乙肝病毒導致肝硬化的過程中，將有一個慢性的過程，那就是肝纖維化。肝纖維化是指肝細胞發生壞死及炎癥刺激時，肝臟中膠原蛋白等細胞外基質（ECM）的增生與降解失去平衡，進而導致肝臟內纖維結締組織異常沉積的病理過程，輕者稱為肝纖維化，重者進而使肝小葉結構改建、假小葉及結節形成，稱為肝硬化。 然而，肝纖維化是可逆的，早期進行診斷并進行有效的治療將有助于抑制肝纖維化的發展，并且在一定程度上逆轉肝纖維化，可減少肝硬化的發生而提高慢性乙型病毒性肝炎患者的生存率和生活質量。因此有效地阻斷肝纖維化的發生發展，對防治肝硬化、肝癌就具有重要意義。然而，目前臨床仍缺乏高效、無明顯毒副作用的治療肝纖維化的西藥，近十多年來，隨著核苷類抗病毒藥物的不斷研發與臨床應用，在抑制乙肝病毒復制、阻止肝纖維化等方面顯示出較為有效的治療，但仍有一定的局限性；而中醫藥近年已成為國內防治肝纖維化研究的熱點，目前已由較成熟的實驗研究轉向臨床研究，并積累了極為豐富的臨床經驗。本文主要綜合中國期刊網全文數據庫和中文科技期刊全文數據庫近年來有關中醫藥治療慢性乙型肝炎肝纖維化代表文獻，總結其成果，分析目前仍存在的問題，以期為中醫藥更有效地治療慢性乙型肝炎肝纖維化提供理論依據。

【關鍵詞】中醫；慢性乙型肝炎肝纖維化；研究進展

【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 relevant 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 people， 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 will be a gradual process， that is， liver fibrosis. Liver fibrosis is the occurrence of liver cell necrosis and inflammatory stimuli， such as liver collagen extracellular 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 called hepatic fibrosis， or false lobule and nodule and make the structure of hepatic lobule rebuild， formation， called cirrhosis of the liver. However， liver fibrosis is reversible， early diagnosis and effective treatment of development will 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， effectively blocking the occurrence and development of liver fibrosis， it has important significance for prevention and treatment of liver cirrhosis and hepatocellular carcinoma. However， the current clinical still lack efficient and no obvious toxic side effects for the treatment of liver fibrosis of Western medicine， in recent ten years， with the continuous development and clinical application of nucleoside antiviral drugs， showing that treatment is effective in suppressing the replication of hepatitis B virus， prevent liver fibrosis， but there are still 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 Full-text Database and Chinese Science & Technology Journal Full-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， analysis of the current problems still exist， in order to provide a theoretical basis for the Chinese medicine more effective in the treatment of liver fibrosis in patients with chronic hepatitis B.

推薦訪問： 乙型肝炎 研究進展 中西醫結合 治療慢性 肝纖維化