Work

Herbal ingredients: 3 grams of Amomum villosum, 10 grams of Polygonum cuspidatum, 10 grams of Artemisia capillaris, 7 grams of Clematis armandii, 10 grams of silkworm excrement, 6 grams of Corydalis yanhusuo, 6 grams of Coptis chinensis, fresh ginger, and red dates as a guide. Decoct in water and take daily, for a total of 20 doses. After treatment, the patient's liver pain disappeared, appetite increased, complexion became rosy, and overall mental and physical strength improved markedly. The liver was no longer palpable, the spleen could be felt 2 centimeters below the ribs, and except for TFT+, all other liver function indicators returned to normal. HBSAg dropped to 1:64, e antigen turned negative, and e antibody turned positive. The original prescription was adjusted by removing Corydalis yanhusuo and Coptis chinensis, and an additional 20 doses were administered. All symptoms completely resolved, the patient was full of energy, appetite normalized, and apart from the persistent e antibody remaining positive, all other test results were within the normal range. It was advised to continue taking the second decoction for 30 days to consolidate the therapeutic effect. Case 3: Chen ××, male, 40 years old, engineer, first visit on August 27, 1986. The patient had hepatitis 10 years ago, and two years ago tested positive for surface antigen, with distending pain in the liver region, bitter taste in the mouth, dry throat, leg weakness, fatigue, nausea, and had tried various Western hepatoprotective drugs without much effect. Two months ago, he noticed worsening liver pain, fatigue, loss of appetite, noticeable weight loss, low spirits, mild afternoon fever, hot palms and soles, and impaired liver function. He had a history of exposure to hepatitis B. Physical examination: body temperature 36.4°C, pale complexion, no jaundice of sclera. Two spider nevi were visible on the face and neck, heart and lungs showed no abnormalities. The abdomen was flat and soft, the liver could be felt 4 centimeters below the xiphoid process, slightly firm with tenderness, the spleen was not palpable, ascites sign was negative, and no edema was observed in the lower limbs. Laboratory tests: hemoglobin 10 g/dL, red blood cells 3.6 million/mm³, liver function SGPT 240 units (Kinase method), TTT 6 units, TFT+ ++, ZnT 14 units, bilirubin index 6 units, total plasma protein 7.7 g/dL, albumin 4.7 g/dL, globulin 3.0 g/dL, electrophoresis r-globulin 14 units. HBSAg 1:256, HBeAg (+), anti-HBe (-), HBV-DNA-P (+). Western medical diagnosis: viral hepatitis B, chronic active type. Traditional Chinese Medicine diagnosis: pale complexion, fatigue, loss of appetite, shortness of breath and reluctance to speak, five-center heat, right flank pain, plump and pale tongue with red tip and tooth marks on the edges, deep, fine, and weak pulse—indicating initial qi-yin deficiency, liver depression and spleen deficiency. Prescription: Hepatitis B No. 1 with added ingredients: 6 grams of Cimicifuga, 10 grams of Chinese yam, 10 grams of Atractylodes macrocephala, 30 grams of Astragalus membranaceus, 30 grams of Salvia miltiorrhiza, 10 grams of Angelica sinensis, 10 grams of Gentiana macrophylla, 10 grams of Isatis indigotica, 10 grams of Pueraria lobata, 10 grams of Ligustrum lucidum, 10 grams of Lycium barbarum, 10 grams of Platycodon grandiflorus, 10 grams of Trichosanthes kirilowii, 4 pieces of Prunus mume, 10 grams of Polygonum cuspidatum, 20 grams of wild chrysanthemum, 10 grams of Cicada slough, 10 grams of Codonopsis pilosula. Decoct in water and take one dose daily; after 20 doses, the patient's liver pain disappeared, spirits improved, appetite increased, five-center heat significantly alleviated, the liver could be felt 2 centimeters below the xiphoid process, soft and non-tender. Except for TFT+, all other liver function indicators returned to normal; total plasma protein 3.1 g/dL, albumin 4.9 g/dL, globulin 3.2 g/dL. HBSAg dropped to 18:32, HBeAg turned negative, anti-HBe turned negative, HBV-DNA-P turned negative. The original prescription was adjusted by removing Isatis indigotica and Artemisia capillaris, and an additional 20 doses were administered. All symptoms disappeared, liver function normalized, and HBSAg turned negative. It was advised to continue taking the first decoction for 30 days to consolidate the therapeutic effect. Letter.

Case 4: Zheng ××, female, 27 years old, railway worker, first visit on January 11, 1986. The patient tested positive for surface antigen 8 years ago, but since she had no symptoms at the time, it was not taken seriously. Over the past six months, she has felt fatigued, drowsy, loss of appetite, abdominal distension, pain in the liver area, and gum bleeding. She had tried both traditional Chinese and Western medicines for liver disease, but none showed significant efficacy. Recently, her abdominal distension worsened, she lost a lot of weight, and developed mild edema in the lower limbs, prompting her to seek medical attention. She had a history of exposure to hepatitis B, and her mother was a hepatitis B patient. Physical examination: dark complexion, thin build, mild jaundice of sclera, heart and lungs (1-1), abdominal distension, shifting dullness (+), liver palpable 3.5 cm below the xiphoid process and 2 cm below the ribs, medium hardness with tenderness, spleen palpable 2 cm below the ribs. Mild edema was observed in the lower limbs. Laboratory tests: hemoglobin 9 g/dL, red blood cells 2.8 million/mm³, platelets 60,000/mm³. Liver function: bilirubin index 10 units, TTT 12 units, TFTH+++ ZnT 20 units, SGPT 160 units, total plasma protein 5.6 g/dL, albumin 1.6 g/dL, globulin 4 g/dL, electrophoresis r-globulin 29%, HBSAg 1:512 or higher, HBeAg (+), anti-HBe (=), HBV-DNA-P (+). Western medical diagnosis: (1) viral hepatitis B, chronic active type. (2) cirrhosis with ascites. Traditional Chinese Medicine diagnosis: dark complexion, feeling cold despite being in a warm environment, thin build, fatigue, drowsiness, loss of appetite, abdominal distension, pain in both flanks, lower limb edema, gum bleeding, swollen tongue with tooth marks AQ1 Issue 2, 1989

Work

Proceed immediately according to the experimental requirements. The items to be tested include whole blood viscosity (nb) and plasma viscosity (np), both expressed as ratios relative to physiological saline, hence the term "viscosity ratio." Whole blood viscosity is further divided into high-shear and low-shear values depending on the shear rate. Red cell electrophoresis time (EPT, s) refers to the total time, in seconds, it takes for red blood cells to swim a certain distance 20 times under the influence of an electric field when viewed under a microscope; erythrocyte sedimentation rate (ESR, mm/h); hematocrit (Ht, %) measured using a Westergren tube. In addition, whole blood reduced viscosity and the ESR equation K value are calculated according to specific formulas. All measurements are conducted at a constant temperature of 25°C. Platelet aggregation rate (AGG, %) involves separating platelet-rich plasma (PRP) and platelet-poor plasma (PPP), then using a turbidimetric method with 5 μM adrenaline hydrochloride as an inducer to measure platelet phase I and phase II aggregation rates; this test is performed at a constant temperature of 37°C. All experiments are carried out by trained personnel.

Results

Comparison of results between the yin-deficiency group and the normal group reveals that, for both men and women in the yin-deficiency group, whole blood reduced viscosity at high and low shear rates, plasma viscosity, red cell electrophoresis time, erythrocyte sedimentation rate, and platelet phase I and phase II aggregation rates are all significantly higher than those of the normal group (P < 0.05–0.01); hematocrit is significantly lower than that of the normal group (p < 0.01); however, there is no significant difference in the ESR equation K value between the two groups (P > 0.05).

Comparison between the yang-deficiency group and the normal group shows that, for both men and women in the yang-deficiency group, whole blood viscosity at high and low shear rates, whole blood reduced viscosity at high and low shear rates, red cell electrophoresis time, hematocrit, and platelet phase I and phase II aggregation rates are all significantly higher than those of the normal group (P < 0.05–0.01); plasma viscosity is significantly lower than that of the normal group (p < 0.05–0.01); however, there is no significant difference in erythrocyte sedimentation rate or the ESR equation K value between the two groups (P > 0.05).

Comparison between the yin-deficiency group and the yang-deficiency group indicates that the yin-deficiency group has significantly higher plasma viscosity, red cell electrophoresis time, and erythrocyte sedimentation rate than the yang-deficiency group (P < 0.01), while the yang-deficiency group has significantly higher hematocrit than the yin-deficiency group (P < 0.01); the remaining parameters show no significant differences between the two groups (P < 0.05). Discussion Among

1. This study demonstrates that the yin-deficiency and yang-deficiency syndromes exhibit significant differences in hemorheology compared with the normal population, both characterized by increased blood viscosity, slower red cell movement and prolonged swimming time, and increased platelet aggregation rates. This suggests that the fundamental pathological feature of both syndromes is the loss of the physiological state of blood flowing smoothly through the vessels like water, and that blood stasis leads to increased blood viscosity4). However, the degree of blood stasis does not differ significantly between the two syndromes (P > 0.05), meaning that both yin-deficiency and yang-deficiency involve blood stasis, though the severity of the stasis differs.

2. This study found that the plasma viscosity of the yin-deficiency group is significantly higher than that of the normal group (P < 0.05–0.01), while hematocrit is significantly lower than that of the normal group (P < 0.01); the decrease in hematocrit leads to faster erythrocyte sedimentation, so the erythrocyte sedimentation rate is significantly higher than that of the normal group (p < 0.01). Excluding the effect of hematocrit on sedimentation, the sedimentation equation K value shows no significant difference between the two groups (P > 0.05). These findings indicate that the yin-deficiency group primarily exhibits an increase in plasma components, i.e., higher plasma viscosity and lower red cell components; whereas the yang-deficiency group is just the opposite, with lower plasma viscosity and higher red cell components, resulting in lower plasma viscosity.

3. This study also shows that there is no significant difference in whole blood viscosity, whole blood reduced viscosity, sedimentation equation K value, or platelet aggregation rates between the yin-deficiency and yang-deficiency groups (P > 0.05), but plasma viscosity is significantly higher in the yin-deficiency group than in the yang-deficiency group (p < 0.01). The increased plasma viscosity in the yin-deficiency group causes red cells to move more slowly in the highly viscous plasma, resulting in significantly longer red cell electrophoresis time in the yin-deficiency group than in the yang-deficiency group (P < 0.01). Meanwhile, the yang-deficiency group has significantly higher hematocrit than the yin-deficiency group (P < 0.01), which makes its erythrocyte sedimentation rate significantly lower than that of the yin-deficiency group (P < 0.01). However, the sedimentation equation K value shows no significant difference between the two groups (P > 0.05). These findings further demonstrate that, in terms of hemorheology, both yin-deficiency and yang-deficiency syndromes involve blood stasis.(Total 98) i8 · China Insurance Academic Board 》 8 9 Vol. 4, No. 2, April 1989 Chinese Medical Journal

ACTA MEDICA SINICA

Vol.4 No.2 April,1989

Observation on the Therapeutic Effect of Traditional Chinese Medicine in Treating 289 Cases of Chronic Active Hepatitis B Pei Zhengxue, Cheng Jiechen, Zhong Xiang, Min Wei, Peng Youjia, Zhang Yusheng, Zhang Huifang, Li Nai Xiang, Han Duxin, Li Jianjun, Yao Baicheng (Gansu Provincial Institute of New Medicine, Gansu 730050)

Abstract Through objective indicators such as liver function, plasma protein electrophoresis, the three systems of hepatitis B, and HBV-DNA-P, we conducted a comparative observation of the therapeutic effects of traditional Chinese medicine-based syndrome differentiation treatment on 289 cases of chronic active hepatitis B. The overall effective rate was 87.53%, with an HBSAg seroconversion rate of 39.9%, an HBeAg seroconversion rate of 68.5%, and an HBV-DNA-P seroconversion rate of 56.14%. All indicators were significantly better than those of the control group, with statistically significant differences. Keywords Hepatitis B/Traditional Chinese Medicine therapy, Xiao Chaihu Tang/Therapeutic application, Yiguanyan/Traditional Chinese Medicine therapy, Heat-clearing and detoxifying drugs/Therapeutic application

Chronic active hepatitis B (referred to as chronic active hepatitis B) Currently, there is still no specific cure for this condition. Since our institute established the hepatitis B research task force in May 1984, up to February 1988, we have successively treated 289 cases of chronic active hepatitis B using traditional Chinese medicine-based syndrome differentiation, while also setting up a control group for comparative observation, achieving relatively satisfactory therapeutic effects.

General Information

All 429 cases were confirmed as having chronic active hepatitis B (according to the diagnostic criteria of the 1983 National Viral Hepatitis Prevention and Control Plan). Random grouping was employed, with 289 cases assigned to the treatment group and 140 cases to the control group. Both groups were carefully matched in terms of age, gender, disease duration, and severity of illness to ensure comparability. Treatment group: 163 males and 126 females. 36 cases under 15 years old, 91 cases aged 16–30, 121 cases aged 31–45,

However, the underlying material basis and changes in objective indicators caused by the two conditions are different. Yin-deficiency mainly involves an increase in plasma components, while yang-deficiency mainly involves an increase in blood cell components. This suggests that yin-deficiency and yang-deficiency each have their own specific hemorheological basis, and these indicators can serve as one of the pathophysiological bases for differentiating yin-deficiency and yang-deficiency.

References

(1) Kuang Ankun et al. Endocrine, immune, and cyclic nucleotide changes in patients with yang-deficiency

14·(Total 94)

46–60-year-olds: 40 cases, over 60: 1 case. Disease duration: 1–2 years: 127 cases, 2–3 years: 86 cases, over 3 years: 76 cases. Control group: 78 males and 62 females. 10 cases under 15, 53 cases aged 16–30, 48 cases aged 31–45, 27 cases aged 46–60, 2 cases over 60. Disease duration: 1–2 years: 66 cases, 2–3 years: 49 cases, over 3 years: 25 cases. All cases underwent liver function tests, the three systems, HBV-DNA-P, protein electrophoresis, and other examinations upon admission, and met the diagnostic criteria for chronic active hepatitis B.

Treatment Methods

1. Syndrome differentiation and agreed-upon prescriptions The 429 cases were classified into the following four types based on traditional Chinese medicine syndrome differentiation:

Qi-yin initial deficiency type: Symptoms include fatigue, loss of appetite, tidal heat, restlessness, deep and fine pulse, red tongue, thin coating. Prescription: Shengshan Baige Decoction (Hepatitis B No. 1): 17 herbs including Cimicifuga, Chinese yam, Atractylodes macrocephala, Astragalus membranaceus, Salvia miltiorrhiza, Angelica sinensis, Gentiana macrophylla, Isatis indigotica, etc., decocted in water and taken once daily.