5. Etiological Examination

This is the most important basis for diagnosing hepatitis B. Since the symptoms of hepatitis A, B, and non-A/non-B are basically the same, without etiological indicators, hepatitis B cannot be diagnosed. By "etiological indicators," we mean Surface Antigen, Surface Antibody, Core Antigen, Core Antibody, e Antigen, e Antibody, Hepatitis B Virus deoxyribonucleic acid, deoxyribonucleic acid polymerase, human polyprotein receptor, and other markers whose significance has been described above.

The clinical classification of hepatitis B is the same as that of general viral hepatitis, divided into acute and chronic types. Acute is further subdivided into non-jaundiced, jaundiced, and severe hepatitis; chronic is subdivided into chronic persistent, active, and cholestatic types. The previous view that illnesses lasting less than six months are acute and those lasting more than six months are chronic is very limited; duration can only serve as a secondary reference for classifying hepatitis B.

V. Complications of Hepatitis B

In addition to affecting the liver, the hepatitis B virus can also impact other vital organs, such as the brain, kidneys, joints, connective tissue system, and cardiovascular system. Among these, the most serious complication is hepatic encephalopathy, commonly known as hepatic coma. This condition arises from liver metabolic disorders, impaired detoxification function, and hyperammonemia, leading to mental disturbances, coma, and even death. In some cases, ammonia levels are not high, and scholars believe it is caused by false neurotransmitters: liver cell necrosis causes a sudden drop in excitatory mediators such as catecholamines, acetylcholine, glutamate, and aspartate, resulting in dementia, stupor, and comatose sleep; a sudden decrease in excitatory mediators like y-tyrosine, serotonin, and 5-hydroxytryptamine, on the other hand, leads to excitement and mania. In addition, severe hepatitis B, along with liver failure, can also be complicated by acute renal failure, known as hepato-renal syndrome. Cases of hepatitis B-related nephritis, hepatitis B-related arthritis, hepatitis B-related multiple vasculitis, and hepatitis B-related dry syndrome are also occasionally reported.

VI. Treatment of Hepatitis B

To date, there has been no breakthrough in the treatment of hepatitis B, and no effective cure has yet been discovered.

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Ideal drugs for liver treatment. Proper rest, a low-fat, high-carbohydrate diet, and hepatoprotective medications such as vitamins and glucose are still commonly used in clinical practice. The clinical efficacy of interferon and its inducer polyinosinic acid, immunomodulators such as levamisole, thymosin, transfer factor, immune ribonucleic acid, coenzyme Q10, and others remains controversial. Traditional Chinese medicine is currently one of the most effective therapies for treating hepatitis B. Since 1984, our institute has established a research group on the treatment of hepatitis B with traditional Chinese medicine, conducting comparative treatment observations on 489 cases of chronic active hepatitis, achieving satisfactory therapeutic effects. The main approach combines tonifying the body's vital energy and consolidating the root with clearing heat and detoxifying; the former promotes antibody formation, while the latter inhibits antigen growth. The relative emphasis between these two approaches should be determined based on TCM syndrome differentiation and individualized treatment.

(“Research on Integrated Traditional Chinese and Western Medicine,” 1989.1)

Integrated Traditional Chinese and Western Medicine Treatment of Liver Cirrhosis with Ascites

Clinical Comparative Observation Report on 154 Cases

Pei Zhengxue, Zhang Taifeng, Li Wei, Xue Wenhan

Western medicine currently lacks specific effective treatments for patients with portal hypertension-related liver cirrhosis complicated by ascites. Since 1984, our institute has established a specialized liver disease outpatient clinic and admitted patients with post-hepatitic cirrhosis complicated by ascites for inpatient treatment, focusing on observation and therapy. Among them, 154 cases received integrated traditional Chinese and Western medicine treatment as the treatment group, while 60 cases received conventional Western medical treatment as the control group.

I. Case Selection

A total of 214 cases were included in the treatment and control groups, with strict efforts made to ensure consistency and comparability among patients in terms of age, gender, disease duration, and severity of illness. Treatment group: 90 males, 64 females; 4 under 25 years old, 48 aged 26–35, 52 aged 36–50, 40 aged 51–65, and 10 over 65. Control group: 36 males, 24 females; 2 under 25, 28 aged 26–35, 22 aged 36–50, and 8 aged 51–60. All cases were patients with liver cirrhosis complicated by ascites, all exhibited signs of portal hypertension, and all had varying degrees of liver function impairment and albumin-globulin ratio abnormalities. A history of hepatitis was present in all cases, and other potential causes of portal hypertension were ruled out. Among the 154 cases in the treatment group, 30 had upper gastrointestinal bleeding, while among the 60 cases in the control group, 8 did; in the treatment group, 6 cases developed hepatic encephalopathy, compared with 2 in the control group; in the treatment group, 41 cases had infections, compared with 19 in the control group.

All cases underwent barium swallow, ultrasound, liver function tests, protein electrophoresis, and hepatitis B surface antigen testing before and after treatment.

II. Treatment Methods and Adjustments to Traditional Chinese Medicine Formulas