冯因克　刘亚敏　陈启龙

[摘要] 慢性乙型肝炎后肝硬化是乙型病毒性肝炎发展到终末期的常见表现，后期可因出现肝性脑病、原发性肝癌、感染等严重并发症而导致死亡，临床治疗一直收效甚微。目前，尽管西医抗病毒依然是乙肝后肝硬化治疗的首选，但中医辨证治疗乙肝后肝硬化也具有独特作用。近年来，中医药在临床辨证及对症治疗乙肝后肝硬化已经有了大量的探索。本文从中医、西医及中西医结合三个方面综述了乙肝后肝硬化治疗的研究进展，并展望了精准医疗在乙肝后肝硬化个性化治疗上的应用前景，以期为乙肝后肝硬化精确治疗的发展提供参考。

[关键词] 乙肝后肝硬化；中医；西医；中西医结合；精准医疗

[中图分类号] R575.2 [文献标识码] A [文章编号] 1674-4721（2016）10（b）-0028-04

[Abstract] Cirrhosis due to hepatitis B is a common pathological consequence of chronic hepatitis B in final stage， which might lead to the emergence of hepatic encephalopathy， primary liver cancer， infection and other serious complications and death. However， the therapeutic efficacy of cirrhosis due to hepatitis B is challenging in clinical treatment. Presently， the western medicine is still the first choice for the treatment of hepatitis B cirrhosis， but the traditional Chinese medicine has a special therapeutic efficacy for the treatment of cirrhosis due to hepatitis B. In past decades， traditional Chinese medicine causing prospect for cirrhosis due to hepatitis B treatment. This paper reviews the development of cirrhosis due to hepatitis B treatments from traditional Chinese medicine， western medicine and the combination of traditional Chinese medicine and western medicine， respectively. Furthermore， this paper outlooks the application prospects of personalized treatment in cirrhosis due to hepatitis B process， in order to provide a theoretical reference for the development of precision treatment of cirrhosis due to hepatitis B.

[Key words] Cirrhosis due to hepatitis B； Traditional Chinese medicine； Western medicine； Integrated Chinese and western medicine； Precision medicine

慢性乙型肝炎后肝硬化是由乙肝病毒（hepatitis B virus，HBV）引起的进行性慢性疾病。我国是乙肝病毒感染高发区，超过30%的慢乙肝患者会在未来15年内会发展成肝硬化[1]。由于发生肝硬化时肝脏已经出现实质性的不可逆转损害，临床治疗效果并不理想。中医在辨证的基础上结合西医抗病毒治疗，对乙肝后肝硬化有着独特的作用。本文分别从西医、中医及中西医结合等三个不同角度探讨乙肝后肝硬化治疗的效果及进展，以期为乙肝后肝硬化的临床治疗方案提供理论依据。

1 乙肝后肝硬化的西医治疗研究

西医认为乙肝后肝硬化是由于乙肝病毒等因素导致肝细胞呈反复性弥漫性变性坏死，继而出现纤维组织增生和肝细胞结节状再生等原因造成。……