This article tried to discuss that spleen deficiency is the key mechanism of hepatitis B virus associated glomerulonephritis from TCM and Western medicine viewpoint. From the view of pathophysiology, energy metabolic disorder caused by mitochondrial injury and its series of damages are similar to symptoms caused by spleen deficiency appeared as yin fire and organs dystrophy, so mitochondrial injure belongs to spleen deficiency. And mitochondrial damage can further aggravate the virus replication of hepatitis B virus associated glomerulonephritis, causing damage to the kidney. Therefore, from the view of Western medicine, it can be known that spleen deficiency determines whether the liver function damage in the process of hepatitis B virus associated glomerulonephritis and lower energizer transformation. In terms of TCM, spleen deficiency plays an important role in all stages of the disease, and determines the outcome and prognosis of the disease. Therefore, this article proposed that the spleen deficiency is the mechanism of hepatitis B virus associated glomerulonephritis, which can provide references for clinic.%本文试从中西医角度探讨脾虚是乙型肝炎病毒相关性肾炎的关键机转.在病理生理学上,线粒体损伤导致的能量代谢障碍及其引起的系列损伤与脾虚所致阴火内焚、脏腑不养导致的病症类似,故推及线粒体损伤属脾虚一端;而线粒体损伤可进一步加重乙型肝炎相关性肾炎的病毒复制,对肾脏造成损伤.由此,从西医角度可知,脾虚决定着乙型肝炎相关性肾炎发病中乙型肝炎病毒是否对肝功能造成损害及向下焦传变.中医方面,脾虚在该病的各期都具有重要意义,决定着病情转归及预后.因此提出脾虚为乙型肝炎病毒相关性肾炎的机转,以期为临床提供借鉴.
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