5. Pathogenetic Examination

5. Pathogenetic Examination

This is the most important basis for diagnosing hepatitis B. Since the symptoms of type A, type B, and other types of hepatitis are basically the same, without pathogenetic indicators, it is impossible to diagnose hepatitis B. The so-called pathogenetic indicators include surface antigen, surface antibody, core antigen, core antibody, e antigen, e antibody, hepatitis B virus deoxyribonucleic acid, deoxyribonucleic acid polymerase, polymeric human serum albumin receptor (PHSA-R), and others, whose significance has been previously mentioned.

The clinical classification of hepatitis B is the same as 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 divided into chronic migratory, chronic active, and cholestatic types. Previously, it was commonly believed that a disease course of less than six months was acute, while more than six months was chronic—a view that is very limited. The disease course can only serve as a secondary reference for classifying hepatitis B.

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Pei Zhengxue’s Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases

Published by Hefei Four Provinces Publishing House

Clinical Comparative Observation Report on Combined Traditional Chinese and Western Medicine Treatment of Cirrhosis Complicated by Ascites in 154 Cases

Zhang Taifeng, Li Wei, Xue Wenhan

For patients with portal hypertension-related cirrhosis complicated by ascites, Western medicine currently lacks effective treatments. Our institute established a specialized liver disease outpatient clinic in 1984 and began admitting patients with post-hepatitic cirrhosis complicated by ascites for inpatient treatment, focusing on observation and treatment. Among them, 154 cases received combined traditional Chinese and Western medicine treatment as the treatment group, while another 60 cases received Western medicine alone as the control group.

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Pei Zhengxue’s Traditional Chinese Medicine—Discussion on TCM Theory and Clinical Cases

Published by Hefei Four Provinces Publishing House

Rehmannia root 12g, Astragalus root 30g, Polygonatum rhizome 20g, Salvia miltiorrhiza 30g, Soft-shelled turtle shell 15g, Drynaria rhizome 10g

Medication Adjustments:

• For jaundice, add Artemisia capillaris, Rheum palmatum, Hedyotis diffusa, and Andrographis paniculata;
• For ascites, add Plantago seeds, Pericarpium citri reticulatae, Lagenaria siceraria peel, and Stephania tetrandra;
• For hepatosplenomegaly, add Hirudo, Sparganium stoloniferum, and Curcuma wenyujin;
• For flank pain, add Corydalis yanhusuo, Sichuan pepper, Frankincense, and Myrrh;
• For esophageal variceal bleeding, add Rheum palmatum, Coptis chinensis, and Scutellaria baicalensis, and for massive hematemesis, add Pinellia ternata, fresh ginger, raw cinnabar, and burnt soil;
• For persistent high fever, add Rheum palmatum, Glauber's salt, gypsum, and Halite;
• For bone-steaming and tidal heat, add Soft-shelled turtle shell, Turtle plastron, Bupleurum chinense, Artemisia annua, Cortex Moutan, and Anemarrhena asphodeloides;
• For dry stools, add Rheum palmatum, Glauber's salt, and Cannabis sativa seed;
• For inverted albumin/globulin ratio and worsening liver function turbidity, increase the dosage of Astragalus and Salvia miltiorrhiza (up to 60g);
• For rising transaminases, add Eupatorium fortunei, Houttuynia cordata, Hedyotis diffusa, Polygonum cuspidatum, and Andrographis paniculata;
• For thick, greasy yellow tongue coating, add Coptis chinensis, Scutellaria baicalensis, and Phellodendron amurense;
• For purplish-red, smooth tongue without coating, add Glehnia littoralis, Ophiopogon japonicus, and Schisandra chinensis.