Resident physicians

The 429 cases were divided into the following four types based on traditional Chinese medicine syndrome differentiation: ① Initial Qi-Yin Deficiency: Symptoms include fatigue, loss of appetite, hot flashes, irritability, deep and fine pulse, red tongue body with pale coating. The formula used is Shengshan Baige Decoction (Hepatitis B No. 1): Shengma, Shanyao, Baizhu, Huangqi, Danshen, Danggui, Qinjiao, etc., decocted in water and taken once daily. ② Pathogenic Factors Invading Shaoyang: Symptoms include bitter taste in the mouth, dry throat, flank pain, abdominal distension, restlessness, rapid and tense pulse, red tongue body with slightly yellowish greasy coating. The formula used is Compound Chaihu Decoction (Hepatitis B No. 2): Chaihu, Huangqin, Banxia, Dangshen, Gancao, etc., decocted in water and taken once daily. ③ Qi Stagnation and Blood Stasis: Symptoms include dark complexion, tightness on both sides of the flanks, severe right flank pain, enlarged liver and spleen, fullness in the epigastric region, rapid pulse, red tongue body with stasis spots and sparse coating. The formula used is Yi Yin Jian Jiawei (Hepatitis B No. 3): Chuan Niuxi, Danpi, Danshen, Maidong, Shengdi, Bai Shao, Huangqi, Banlan Gen, Danggui, etc., decocted in water and taken once daily.

Resident physicians

If the original indicators are not met, hepatitis B cannot be diagnosed. The so-called pathogen indicators refer to the surface antigen, surface antibody, core antigen, core antibody, e antigen, e antibody, hepatitis B virus DNA, DNA polymerase, human polyprotein receptor, and so on. Their significance has already been discussed earlier. The western medical approach is short-lived.

The clinical classification of hepatitis B is similar to that of general viral hepatitis, divided into acute and chronic categories. Acute hepatitis is further subdivided into non-jaundiced, jaundiced, and severe hepatitis; chronic hepatitis is subdivided into chronic migratory, chronic active, and cholestatic types. Previously, it was commonly believed that a disease course of less than six months constituted acute hepatitis, while a course of more than six months was considered chronic. This view is very limited; the disease course can only serve as a secondary reference for classifying hepatitis B. The definition should be updated!

V. Complications of Hepatitis B Fewer effects sought

In addition to attacking the liver, the hepatitis B virus can also affect other vital organs in the human body, such as the brain, kidneys, joints, collagen system, and cardiovascular system. Among these, the most serious complication is hepatic encephalopathy, commonly known as hepatic coma. This condition arises from metabolic disturbances in the liver, impaired detoxification function, and hyperammonemia, leading to mental disorders, even coma and death. In some cases, blood ammonia levels are not high, and scholars believe this is caused by pseudo-neurotransmitters—liver cell necrosis leads to a sudden surge in excitatory neurotransmitters such as catecholamines, acetylcholine, glutamate, and aspartate.

Contracting out brought vitality and dynamism to the Chinese medicine pharmacy Gansu Provincial Cancer Hospital Chinese Medicine Pharmacy Peng Youjia

Since June 1988, the Chinese medicine pharmacy has been operating under a comprehensive contracting arrangement for over a year. Practical experience over the past year has proven that deepening reform is the only way to run a hospital well. The comprehensive contracting arrangement has brought vitality and dynamism to the Chinese medicine pharmacy. The contracting arrangement has gradually improved various rules and regulations, significantly enhanced service attitude, raised service quality, and greatly increased economic income. Over the past year, total sales have reached over 300,000 yuan (compared to a total of 360,000 yuan in the three years prior to contracting, which not only increased the hospital’s total revenue but also significantly boosted employees’ economic income).

Our specific approach is:

ME 1. Incorporate service attitude and service quality into the contracting agreement as mandatory targets for contractors and every employee, closely linking them to individual economic income. On this basis, continuously provide professional ethics education to employees, guiding them to self-discipline and ensuring that the entire Chinese medicine pharmacy operates consciously under social supervision.

Decreases, leading to dementia, rigidity, somnolence, and coma; r- the sudden reduction of excitatory neurotransmitters such as tyrosine, phenylethanol, and serotonin causes excitement and mania. Additionally, in severe cases of hepatitis B, liver failure can be accompanied by acute renal failure, known as hepatorenal syndrome. There are also occasional reports of hepatitis-related nephritis, hepatitis-related arthritis, multiple hepatitis-related vasculitis, and hepatitis-related dryness syndrome. Clinical departments often encounter

VI. Treatment of Hepatitis B Shower

To date, there has been no breakthrough in the treatment of hepatitis B, and no ideal drug for treating hepatitis B has yet been discovered.

Appropriate rest, a low-fat, high-carbohydrate diet, and hepatoprotective medications such as vitamins and glucose remain widely used in clinical practice. Interferon and its inducers like polyinosinic acid, immunomodulators such as levamisole, thymosin transfer factor, immune ribonucleic acid, and coenzyme Q10—all have mixed clinical efficacy claims. Traditional Chinese medicine is currently one of the most effective treatments for hepatitis B. Our institute has established a research team dedicated to TCM treatment of hepatitis B since 1984, conducting comparative treatment observations on 489 cases of chronic active hepatitis and achieving satisfactory therapeutic effects. The main approach is to combine tonifying and strengthening the body with clearing heat and detoxifying—while the former promotes antibody formation, the latter inhibits antigen growth. The relative emphasis placed on these two aspects depends on the specific syndrome differentiation in traditional Chinese medicine. People udH

2. Leadership by example is key to doing a good job. Step out of the office

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The office has been dispatched to the front lines to gather first-hand information and resolve problems on-site, which has now been incorporated into the contractor's daily work schedule. The contractor is tasked with offering suggestions, devising solutions, motivating every employee, and leading by example—ensuring that whatever they require of their staff, they must do themselves first. This approach fosters a spirit of working alongside and sharing hardships with the workforce, while also continuously soliciting feedback and recommendations from employees to refine and improve work methods.

III. Mastering the balance between benefits. It is essential to rigorously implement the Drug Administration Law, placing economic benefits on an equal footing with social benefits. Over the past year, the hospital generated a profit of 598.5993 million yuan, paid 267.0187 million yuan in taxes, and retained 331.5806 million yuan (including wages, bonuses, and various other expenses). During this period, no major technical errors or accidents occurred, and numerous exemplary individuals and deeds emerged. The so-called "long-standing difficult issues" that existed prior to the contracting initiative have now been completely resolved. Hong

The comprehensive contracting of the traditional Chinese medicine pharmacy represents the first pilot program at our hospital, and the results over the past year demonstrate that this contracting model has been largely successful. However, it remains necessary to further refine the contracting mechanism to create more practical and viable experience for deepening hospital reform.

Table 6. Comparison of Treatment Course Duration Between the Treatment Group and the Control Group

Treatment Course | > 1 | > 2 | > 3 | > 3–5 | > 5 | Number of Cases | > % | Number of Cases | > % | Number of Cases | > % | Number of Cases | > % | Number of Cases | > % Treatment Group n=101 | > 13 | > 12.87 | > 38 | > 37.62 | > 21 | > 20.79 | > 19 | > 18.81 | > 10 | > 9.9 Control Group n=12 | > 0 | > 0 | > 0 | > 0 | > 2 | > 16.66 | > 4 | > 33.33 | > 6 | > 50.0 P Value | > P<0.01 | > P<0.01 | > P<0.01 | | > A Note: In the treatment group, one course of treatment consists of 20 doses of traditional Chinese medicine. In the control group, one course of treatment consists of 20 days of medication.

Laboratory Tests: Hemoglobin 8.5 g/dL, red blood cells 3 million/μL. Platelets 90,000/μL, liver function tests: bilirubin index 4 units, thymol turbidity test 18 units, thymol flocculation test ++, zinc sulfate turbidity test 22 units, ALT 580 units, total plasma protein 5.8 g/dL, albumin 2.6 g/dL, globulin 3.2 g/dL.

Protein electrophoresis shows y-globulin at 27%. HBsAg 1:512, HBeAg*, anti-HBe-, anti-HBeIgM-, HBV-DNA-P+. Western medical diagnosis: viral hepatitis B, chronic active type. Traditional Chinese medicine differentiation: patient presents with right flank pain, abdominal distension, dull complexion, hepatosplenomegaly, wiry rapid pulse, tongue body red with ecchymoses and slightly greasy yellow coating. Syndrome is qi stagnation and blood stasis, prolonged stagnation transforming into heat; formula used is Modified Hepatitis B No. 3: Achyranthes root 10 g, Salvia miltiorrhiza 20 g, Ophiopogon japonicus 10 g, licorice 6 g, Rehmannia glutinosa 12 g, white peony 15 g, Ligusticum chuanxiong 6 g, angelica sinensis 10 g, Atractylodes lancea 6 g, Solanum lyratum 15 g, Polygonum cuspidatum 10 g, Corydalis yanhusuo 6 g, Coptis chinensis 6 g, Astragalus membranaceus 20 g, Curcuma wenyujin 6 g, Citrus reticulata peel 20 g. After taking 20 doses, flank pain and abdominal distension both alleviated, complexion slightly improved, pulse remained wiry and rapid, but tongue still showed ecchymoses and the greasy yellow coating became thinner. The original formula was adjusted by removing Solanum lyratum and Polygonum cuspidatum, adding Gentiana macrophylla 10 g, Isatis indigotica 10 g, and Codonopsis pilosula 10 g, followed by another 20 doses. All symptoms completely subsided, ecchymoses on the tongue disappeared, complexion turned rosy, liver palpable 1.5 cm below the xiphoid process, tenderness absent, spleen not palpable. Liver function tests: TET(-), TTT 6 units, ZnT 11 units, GPT 85 units (Goldman method), total plasma protein 6.8 g/dL, albumin 4.2 g/dL, globulin 2.6 g/dL, protein electrophoresis showing r-globulin at 20%. HBsAg(-), HBeAg(-), anti-HBe(+), HBV-DNA-P(-).

It is recommended to continue taking the No. 3 decoction for 30 days to consolidate the therapeutic effect.

Case 2: Gao ××, male, 25 years old, hotel waiter, first visit on February 24, 1986. The patient began experiencing fatigue, abdominal distension, bland taste, occasional irritability, aversion to oil, and pain in the hepatic region one year ago. Laboratory tests revealed positive surface antigen, with significant liver function impairment. Despite receiving Western hepatoprotective therapy without success, his condition recently worsened, with persistent liver pain, low-grade fever, bitter taste, and marked aversion to oil, prompting him to seek medical attention. He has a history of exposure to hepatitis B. No family members have hepatitis B. Physical examination: body temperature 36.9°C, sallow complexion, no jaundice of sclera, no spider angiomas on face or neck, heart and lungs normal, abdomen flat and soft with no shifting dullness, liver palpable 2 cm below the xiphoid process, soft with tenderness, spleen palpable 4 cm below the ribs, no edema in lower extremities. Laboratory tests: hemoglobin 10 g/dL, red blood cells 3.2 million/μL, platelets 120,000/μL, liver function tests: bilirubin index 4 units, TFT++, TTT 7 units, ZnT 15 units, SGPT 575 units (Goldman method), total protein 8.3 g/dL, albumin 4.82 g/dL, globulin 3.48 g/dL, electrophoresis showing r-globulin at 19.6%, HBsAg 1:512 or higher, HBeAg(+), anti-HBe(-), HBV-DNA-P(+). Western medical diagnosis: viral hepatitis B, chronic active type. Traditional Chinese medicine differentiation: patient presents with sallow complexion, flank pain, bitter taste and dry throat, irritability, poor appetite, abdominal distension, hepatosplenomegaly, tongue body red with ecchymoses, thick greasy yellow coating. Syndrome is pathogenic factors invading Shaoyang, liver wood overcoming earth; formula used is Modified Hepatitis B No. 2: Bupleurum 10 g, Scutellaria baicalensis 10 g, Pinellia ternata 6 g, Codonopsis pilosula 10 g, licorice 6 g, Salvia miltiorrhiza 30 g, Astragalus membranaceus 30 g, angelica sinensis 10 g, white peony 10 g.

Table 3. Comparison of HBsAg, HBeAg, and HBV-DNA-P Positive-to-Negative Conversion Rates Between the Treatment Group and the Control Group Before and After Treatment

+----------:+----------:+-------+--------+------+--------+--------+--------+--------+--------+ Item | > HBsAg(%) | | > HBeAg(%) | > HBV---DNA-P(%) | | | | Group Number | | | |

Treatment | > Pre-treatment | > 289 | > 100 | | > 229 | > 79.2 | > 186 | > 64.4 Group | | | | | | | | n=289 | | | | | | | +-----------+-------+--------+------+--------+--------+--------+-----------------+ | > Post-treatment | > 176 | > 60. | | > 72 | > 24.9 | > 81 | > 28.0 Control | > Pre-treatment | > 140 | > 100 | > 109 | > 77.9 | > 92 | > 65.7 Group | | | | | | | n=140 | | | | | | | +-----------+-------+---------------+--------+--------+--------+-----------------+ | > Post-treatment | > 119 | > 85.0 | > 102 | > 72.9 | > 86 | > 61.4 Treatment Group vs. Control Group Treatment Comparison | > P<0.01 | > P<0.01 | > P<0.01 | Post-treatment Comparison P-value | | | | No significant difference between the treatment group and the control group before treatment (P>0.05). Table 4. Comparison of Efficacy by Subtype Between the Treatment Group and the Control Group

Group | > Treatment Group | > Control Group | > P-value | | | | Subtype Classification | | | | +----------+------------+----------+-------+------------+--------+ | > Number of Cases | > Effective Cases | > % | > Number of Cases | > Effective Cases | > % | | | | | > Number | | | Qi-Yin Deficiency | > 39 | > 32 | > 82.1 | > 18 | > 13 | > 72.2 | > P<0.05 Pathogenic Factors Invading Shaoyang | > 73 | > 67 | > 91.8 | > 39 | > 14 | > 35.9 | > P<0.01 Qi Stagnation and Blood Stasis | > 169 | > 149 | > 88.2 | > 80 | > 34 | > 42.5 | > P<0.01 Yang Deficiency and Water Overflow | > 8 | > 5 | > 62.5 | > 3 | > 0 | > 0 | > P>0.05 Total | > 289 | > 253 | > 87.5 | > 140 | > 64 | > 45.7 | > P<0.05 Note: Effective cases = cured + improved. Table 5. Comparison of Treatment Efficacy and Disease Duration Between the Treatment Group and the Control Group

+-------------:+-------+-------+------------+--------+----------+------------+----------+-------+-------+ Group | > Treatment Group n=289 | > Control Group n=140 | P-value | +--------------+---------------+------------+--------+----------+------------+----------+ |

Disease Duration | > Number of Cases | > Effective Cases | > % | > Number of Cases | > Effective Cases | > % | | Within 1.5 Years | > 69 | > 68 | > 98.6 | > 35 | > 20 | > 57.1 | > P<0.01 1.5–2 Years | > 91 | > 85 | > 93.4 | > 44 | > 29 | > 65.9 | > P<0.01 2–2.5 Years | > 56 | > 46 | > 82.1 | > 29 | > 9 | > 31.0 | > P<0.01 2.5–3 Years | > 43 | > 38 | > 88.4 | > 21 | > 4 | > 19.0 | > P<0.01 Over 3 Years | | > 30 | > 16 | > 53.3 | > Capacity | > 2 | > 18.2 | > P>0.05 Total | | > 289 | > 253 | > 87.5 | > 140 | > 64 | > 45.7 | > P<0.05

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