Chronic Hepatitis

Chronic hepatitis is liver inflammation or necrosis lasting more than six months or more, usually persistently abnormal liver function may be learned . Because most patients with chronic hepatitis have no symptoms , so most patients do not knowing ; persistent inflammation and liver cell necrosis, it will cause damage to the liver tissue , leading to cirrhosis occurred .
1 What are the causes of chronic hepatitis ?
Not only are many causes of chronic hepatitis , hepatitis activity and severity also varies widely, often need a liver biopsy to identify. Including chronic viral hepatitis ( mainly chronic B, C hepatitis ) , autoimmune hepatitis, drug-induced chronic hepatitis, alcoholic hepatitis, fatty liver or other metabolic abnormalities caused by abnormal liver function and so on.
(2) to obtain B, C hepatitis how to do ? The daily life of patients with chronic hepatitis how to adjust ?
Should first understand what kind of condition they are in : be healthy carriers of chronic hepatitis or cirrhosis has progressed ? But no matter what those who have regular follow-up , including liver function tests , abdominal ultrasound and fetal serum protein examination . General recommendations for the tracking frequency : Healthy carriers once a year, once every six months, chronic hepatitis , cirrhosis, then once every three months . The daily life of patients with chronic hepatitis without overshooting , but should pay attention to balanced nutrition, living a normal life , do not stay up all night , drinking less alcohol , drug use caution to avoid ingestion of aflatoxin -containing sources of foods such as peanut products , tofu, fermented bean curd , bean paste and so on. Marital sex life is not affected, diet you do not need isolation.
3 How should the treatment of chronic hepatitis ?
General hepatoprotective agent for liver tissue repair or help, but in the course of chronic hepatitis is no impact . The treatment of chronic hepatitis B There subcutaneous interferon and oral qian'an energy (Lamivudine, Latin America Fu ingot ) in two ways. Interferon is an important material body against viruses , currently used for the treatment of chronic active hepatitis B GPT rose more than twice or more, there is efficiency of about 30%. Qian'an could be approved only in 1999 for the treatment of chronic hepatitis B antiviral drugs , can effectively suppress viral replication and reduce inflammation of the liver , so GPT values ​​tended to be normal ; but after stopping about 15-30 % recurrence rate .
Further resistance occurred in 14% after one year , and up to 69 percent after five years . So now the Department of Health approved indication for chronic hepatitis B patients with GPT increased by more than five times , but the best treatment period of nine months or less, in order to reduce the incidence of drug resistance . As for the treatment of chronic hepatitis C , currently combined oral antiviral interferon Ribavirin therapy six months , efficiency of approximately 45%. Future trends in the treatment places the first six months after treatment , good response by continuous treatment to one year ; nonresponders then switch pegylated interferon combined Ribavirin therapy. As for the treatment of autoimmune hepatitis in renal cortical steroid -based.
4 How to avoid contracting hepatitis virus ?
To interrupt the "Chronic B, C hepatitis - cirrhosis - liver cancer " in progress three sections , the first hepatitis virus to prevent infection . Prevention of hepatitis B vaccination can , but there is still no vaccine can prevent hepatitis C . Since B, C type hepatitis infection through blood or body fluids , so to avoid hepatitis virus infection and should avoid unnecessary medical practices, injection or blood transfusion, sexual contact to avoid unclean , pay attention to personal hygiene, do not share toothbrushes, razors , avoid piercing and so on.

The best treatment for acute hepatitis is it?

The best treatment for acute hepatitis what? This is what many patients with liver disease who want to understand the problem, after all, who do not want to be disease-ridden, wants to restore health as soon as possible. So, following on from the treatment of liver diseases specialist to patients who introduced you, the best treatment of acute hepatitis.

Experts said that acute hepatitis C infection in the initial stage, the general course of not more than six months, while those infected will appear fever, general fatigue, weakness, loss of appetite, nausea, vomiting and other symptoms, and did not improve after the break. The best way for hepatitis treatment is to use combined therapy, namely the combination of medication and diet.

1 diet. To supply more adequate protein and various vitamins, in order to facilitate the repair and regeneration of liver cells. But the acute phase of the vicious, vomiting heavy, should be given light, easily digestible to food. Jaundice, increased appetite, may be appropriate to eat lean meat, eggs, fish, tofu and fresh vegetables, and fruits. Finally, more rest, can not be too tired.

2, drug treatment. The first is the use of drugs generally hepatoprotective, mainly to protect liver function, reduce aminotransferase?, Such as biphenyl double fat, sarmentosum granules, potenline, liver Shenlixin, hepatitis Lingjun is a common drop Medicine.

Acute hepatitis

Acute hepatitis and chronic hepatitis main difference is the length of the two different periods suffering .
Specifically , patients with liver disease can rapidly within one to three months treatment called " acute hepatitis " , six months or one year delay if the symptoms above , it is called " chronic hepatitis ."
The causes include acute hepatitis caused by viruses , pharmacy and poisons are three of them were caused by the virus known as acute viral hepatitis, hepatitis , acute virus that also includes A -, B- and non-A, non-B type three.
Had not been infected with hepatitis virus people more susceptible to acute viral hepatitis. But when the virus attacks the body to form antibodies . The liver can be cured .
(A ) prior to the symptoms of jaundice .
Chills , mental unhappiness, heavy head, a cold feeling, the amount of a body temperature of about 37 degrees or so, sometimes the temperature higher. Sometimes the body lazy, no appetite , nausea , vomiting , diarrhea , constipation, abdominal pain , gastrointestinal seem unreasonable . This period of about two , three days, more than ten days or so , the doctor diagnosed as liver disease is unlikely , most of it as a cold or gastrointestinal disorders.
( Two ) jaundice symptoms :
After jaundice , jaundice concentrations increased rapidly from 25 to reach its peak within a week . Jaundice to the highest amount that is slowly decreased to four weeks or less disappeared from the attack , there are patients in the six weeks after this , there is still mild jaundice .
Urine color fade early jaundice one week , while the restoration of urine output before jaundice , patients themselves have " hepatitis have recovered " a conscious feeling.During jaundice , fever, loss of appetite are gone , jaundice over the peak period , the symptoms disappeared completely. At this time , the liver is still strong internal changes to completely recovered , must fully recuperate .Early acute hepatitis , some patients with abdominal pain , there is no consciousness in patients with abdominal pain , liver light pressure with your fingers , only tenderness , enlargement of the liver is also often the symptoms.
( Three ) without jaundice, hepatitis and jaundice hepatitis high concentrations :
In the past, it was thought necessary acute hepatitis , jaundice , and because of jaundice , before a diagnosis of hepatitis.Without jaundice, hepatitis , and its symptoms are not lighter than jaundice hepatitis , cirrhosis or become chronic morbidity , but also about equal. Without jaundice, hepatitis , just feel gastrointestinal discomfort, no hepatitis symptoms " may delay the intensive period of convalescence and chronic greater risk ."Some acute hepatitis , jaundice, acute hepatitis concentrations exceed normal jaundice , and disappear slowly, so symptoms. Serum bile pigment over twenty milligrams , restoring normal need six to eight weeks , the symptoms are not necessarily more severe , chronic possibility is not necessarily bigger.
From the above that: the treatment of acute hepatitis Liver gallbladder method to be used in hepatitis and liver Liver Powder Pill , to get good results.

Hepatitis C treatment is to cure

Had previously heard of viral hepatitis , liver function in patients with high and low , all over seeking doctors, even taking the expensive Chinese and Western medicine , it seems null and void . Watched from hepatitis , cirrhosis to liver cancer , how many friends and family away from us . Since the virus and rapid development of genomics since chronic hepatitis C has been considered incurable diseases.
Taipei City Hospital Yang Hospital District medical director said that , C-type hepatitis infection may be due to blood transfusion or blood contact with infected body fluids , in the past due to post-transfusion infection ratio of about 10 to 15% , but in the routine screening of blood donors detection of hepatitis C virus antibodies has been substantially reduced . Most are sporadic infections, such as intravenous drug users , the use of non- disposable needles to inject , hospital colleagues and family members of patients with chronic hepatitis C or sexual partners , more opportunistic infections . In Taiwan, the general public in the blood of hepatitis C virus antibody positive rate of about 2 to 4%, but the high prevalence areas up to 40 to 60%.
The natural history of viral infection , according to route of infection , the virus characteristics , clinical symptoms and different immune responses in patients . Generally, infection, young, female, nonwhite , less exposure to the virus , such as the immune response is good, as well as in patients with clinical symptoms , and less progress to chronic hepatitis, however , infection with genotype first type of immune dysfunction of the patients progressed to higher rates of chronic hepatitis .
Get acute hepatitis C natural clearance rate, caused by the transfusion of approximately 15 to 25 % of sporadic about 30 to 53 percent , and its duration can be to no active chronic hepatitis and liver function repeatedly to the level of performance of patients with chronic hepatitis . Not active chronic hepatitis patients required to detect hepatitis C viral load , and even liver biopsy assess fibrosis and, if more than the first phase of fibrosis should be considered for treatment , no fibrosis , clinical observations can be. As liver function in patients with chronic hepatitis high and low volatility , the current evidence-based medicine that such treatment is successful, there are 75 to 80% can be cured , it should be considered active treatment.
In general , genotype 1 and 4 type on with a combination of interferon -based antiviral drugs less effective . Therefore, patients should be checked before treatment would face treatment tolerance , liver disease severity , the number concentration of the virus , genotype and treatment if there are some viruses or biochemical reactions - in the fourth week of rapid viral response measurements , such as no or almost no virus volume , and in twelve weeks time also undetectable viral load , only 24 weeks of treatment can be, but the amount of virus in the twelfth week if not less than 100 times the pre-treatment viral load ( representing a decline of 2 logs), will consider withdrawal, but decreased 2 logs , they will have to treat a total of 48 weeks . Patients as smoothly throughout the course of treatment , the final amount of virus to be detected again , and the amount of tracking the virus every six months , at least 2 to 3 times None of the above , be considered cured.

Hepatitis treatment

Hepatitis and hepatic fibrosis prevent liver cancer alternative : Gycyrrhizin
1 . Promote liver function (GPT, GOT, TB) returned to normal, liver histology (Histology) improved.(2) reduce liver cancer incidence rate 50 ~ 60% (Cancer 1997, Oncology 2002 ─ 15 years of long-term studies ) .3 patients with interferon invalid , you can still reduce the rate of liver cancer 49% (Dig. Dis. And Sci. 2006).

Efficacy against Hepatitis B :
Within four weeks of liver function improvement rate chart
Significantly reduce the inflammation of the liver index , the effective rate of 78% or more:109 chronic hepatitis B patients , the use of four weeks , a significant improvement in liver function .ALT levels ─ the effect of 51% , effective 78%.AST levels ─ the efficiency 59% , effective 83%.TB value ─ the effect of 36% , effective 64%.( Reference : Hepatology research 2000.)



Within eight weeks of liver function improvement rate chart
194 chronic hepatitis B patients , the use of eight weeks with different doses (100mL, 40mL).ALT values ​​<1 .5x="" .="" 74="" 79="" br="" uln="" were="">ALT levels <40 .="" 57="" 58="" br="" iu="" l="" were="">─ improved symptoms of hepatitisJaundice disappeared, spirit, appetite , sleep quality improved.Eliminate fatigue , bloating disappear.─ safe, no side effects, long-term use90% of patients had no adverse effects occurThe effect ─ ALT, AST, TB (Total bilirubin) <1 .5="" br="" disappears.="" jaundice="" normal="" times="">Effective ─ including the aforementioned lower values ​​less than 50% improvement in symptoms in patients .( Reference : Hepatology research 2000, 2002.)






Efficacy against Hepatitis C :
Reduced rate of liver cancer fifteen years
─ cirrhosis, liver cancer incidence by 50 to 60%403 CHC patients , the use of Glycyrrhizin up to 15 years , proven to reduce cirrhosis (Cirrhosis) and the incidence of hepatocellular carcinoma (HCC).F1 reduced the incidence of liver cancer patients 50% (6% vs. 12%, n = 193, p = 0.040).F2 reduced the incidence of liver cancer patients 53% (15% vs. 32%, n = 128, p = 0.005).F3 decreased incidence of liver cancer patients 21% (40% vs. 51%, n = 74, p = 0.071).High-risk group ( > 50 years old , F3) if the ALT value control less than 75 IU / L, which reduced the incidence of hepatocellular carcinoma 66% (n = 31, p = 0.057).( Reference : Oncology 2002.)


Reduced rate of liver cancer fifteen years
─ also effective than interferon ?Analysis of chronic hepatitis C , interferon treatment group of 1191 , the use of Glycyrrhizin treatment group were 453 .Interferon (IFN) treatment group compared with the control group, the incidence of liver cancer decreased 33% (n = 1191, p = 0.14).Glycyrrhizin treatment group, the incidence of liver cancer compared with the control group decreased 60% (n = 453, p = 0.044, Multivariate analysis using time ≧ 10 years , 1970 ~ 1984 Kenji Ikeda, MD)( Reference : APASL 2002.)




Main Ingredients:Each mL of Glycyrrhizinate monoammonium 2.04mg ( equivalent Glycyrrhizin 2.0mg), each ampoule 20mL.

Dose:Intravenous injection , once a day , every 2 to 3 ampoules , continuous injection of 2 to 4 weeks. If ALT unable fell 60 IU / L or less, increase to once a day , every five ampoules , for 2 to 4 weeks , the maximum daily dose of 5 ampoules .

Maintenance dose:If ALT dropped 60 IU / L or less, 2 to 3 times per week , every 2 to 3 ampoules ; and increase or decrease the dose according to the disease .

Indications:Maintenance of normal liver function , drug allergy, food allergy ; applicable chronic B, C hepatitis patients .→ interferon (IFN) combined class nuclear drugs (NRTI, ex: Lamivudine or Ribavirin) ineffective treatment (Non-responder) or re- recurrence (Relapser).→ intolerable side effects of interferon or class of nuclear medicines for patients (Side effects)→ expected poor efficacy (CHC Genotype1, 4, 5, 6) of the patients with chronic hepatitis C→ disease considerations can not use IFN + NRTI therapy such as :
Decompensated liver disease ( if jaundice, ascites , hepatic coma ) .Autoimmune diseases such as : rheumatoid arthritis , psoriasis , autoimmune hepatitis.Immunosuppressants user .Elderly ( > 50 years ) .Depression, anxiety , insomnia.Alcoholic hepatitis .Hematopoietic function problems .Kidney disease .Anemia.Diabetes.Cardiovascular disease.Thyroid dysfunction .

Side effects:Safe, almost no side effects, however still need to pay attention to pseudo- sexual aldehyde tallow alcohol hyperparathyroidism (Pseudo-aldosteronism) resulting from sodium retention , hypokalemia , hypertension , clinical manifestations of lower extremity edema, poor muscle strength , muscle pain, headaches, other side effects such as : tiredness , abnormal sensation , skin rash.