Articles

Liver Disorders

Related Health Condition

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Introduction

Hepatitis A is a common contagious disease induced by hepatitis virus A (HAV). It is mainly manifested in tiredness, poor appetite, nausea, vomiting, fever, and usually, jaundice.

Etiology/Pathogenesis

According to traditional Chinese medicine, the fundamental cause of hepatitis A lies in congenital defect or various degrees of deficiency in the heart, lung, spleen, and kidney, and pathogenic warmness and heat, dampness as well as blood stasis are its superficial causes. The battle waged between the vital energy and the pathogenic factors and their interactions form the pathological basis for different types of hepatitis. In the case of extreme consumption of qi and impairment of yin by dampness and heat pathogens, severe symptoms of yang-deficiency and yin-exhaustion will occur.

Primary Treatments with Chinese Medicinal Herbs

Yin Chen Hao Tang

Ingredients: Yin Chen (Oriental Woodworm), Zhi Zi (Gardenia), Da Huang (Rhubarb)

Clinical Application:
Jaundice-type Hepatitis: Yin Chen Hao Tang was used to treat 50 cases of acute jaundice-type hepatitis. Modifications were made according to symptoms. After 3 courses of treatment, 47 cases recovered, 2 cases improved, and 1 case did not respond to the treatment, with a total effective rate was 98%. (1)

A modification of Yin Chen Hao Tang was used to treat 122 cases of juvenile jaundice-type hepatitis. The results: 100 cases recovered, 20 cases significantly improve, and the remaining 2 cases improved, with a total effective rate of 100%. (2)

Hepatitis A: 180 cases of juvenile hepatitis type A were treated with a modification of Yin Chen Hao Tang. The modifications of the formula were as follows: for patients with fever, Chai Hu (Bupleurum) and Huang Qin (Scutellaria) were added to the basic formula; for patients suffering from nausea and vomiting, Sha Ren (Glehnia Root) and Huo Xiang (Agastache) were added; for patients with epigastric fullness, Hou Bu (Magnolia Bark) and Zhi Qiao (Aurantium Fruit), etc., were added; for patients with poor appetite, Jiao San Xian (a mixture of Mai Ya (Malt), Shan Zha (Crataegus), and Shen Qu (Medicated Leaven)) was added; for patients with yellowish urine, Mu Tong (Akebia) was added; and for patients with high levels of glutamine transferanse, Wu Wei Zi (Schizandra) was added in large dose. One dose of the formula was administered daily (spread out in frequent takings throughout the day). The results: 5 cases recovered after 3 doses, another 56 cases recovered after 7 doses, and the remaining 119 cases recovered after 12 doses. (3)

Zhang treated hepatitis A with his self-formulated formula, Hepatitis A Decoction. Based on the classic formula Yin Chen Hao Tang, Zhang’s formula consisted of Yin Chen (Oriental Wormwood), Zhi Zi (Gardenia), prepared Da Huang (Rhubarb), Ban Lan Gen (Isatis Root), Dan Shen (Salvia), Shan Zha (Crataegus), Pu Gong Ying (Dandelion), Han Lian Cao (Eclipta), Yi Yi Ren (Coix), Bai Zhu (White Atractylodes), and Tai Zi Shen (Pseudotellaria Root). These herbs were decocted in water for oral administration (200ml each time, twice a day). The results: most symptoms of the digestive tract improved within 3 days, food intake increased significantly, fever was speedily brought under control, and the yellowish-brown pigmentation of the sclera and the dark yellow color of the urine abated gradually; half a month into the treatment, the liver was no longer palpable in most patients with hepatomegaly; 15 to 35 days into the treatment, the patients’ normal liver function completely recovered; on average, bilirubin disappeared within 20 days and glutamic-pyruvic transaminase (GPT) returned to normal or nearly normal in 20 days. (4)

Hepatitis, other than Type A or B: 42 cases of hepatitis of neither type A nor type B were treated with Yin Chen Hao Tang. The results: 13 cases recovered, 26 cases improved, and the remaining 3 cases did not respond to the treatment, with a total effective rate of 92.86%. (5)

Hepatitis E: A modification of Yin Chen Hao Tang was used to treat 20 cases of jaundice-type hepatitis infected by hepatitis virus E. The modified formula consisted of Yin Chen (Oriental Woodworm), Zhi Zi (Gardenia), Long Dan Cao (Gentiana Root), Jin Yin Hua (Lonicera Flower), Fu Ling (Hoelen), Ze Xie (Alisma), Da Huang (Rhubarb), Ji Nei Jin (Membrane of Chicken’s Gizzard), Ban Lan Gen (Isatis Root), and Shan Zha (Crataegus). One dose of the formula in decoction, divided into three separate administrations, was taken daily. The results: all 20 patients recovered after being treated for 1-2 months. (6)

Other Treatments with Chinese Medicinal Herbs

Jia Gan He Ji

Peng et al. treated 42 cases of hepatitis A with a formula called Jia Gan He Ji and 15-amino acid, with another 42 cases treated with only 15-amino acid serving as the comparison group. The formula consisted of Yin Chen (Oriental Wormwood), Shan Zhi (Gardenia), prepared Da Huang (Rhubarb), Dan Shen (Salvia), Shan Zha (Crataegus), Bai Zhu (White Atractylodes), and Chen Pi (Citrus). The herbs were decocted in water for oral administration (100ml each time, twice a day). Six weeks constituted one course of treatment. Patients of both groups received a daily IV injection of 250ml 15-amino acid. The study measured the patients’ alanine aminotransferase (ALT) and total bilirubin (TBIL I) levels throughout the treatment, and found that it took patients of the treatment group a significantly shorter time to be clinically recovered than it did patients of the comparison group; also, relative to the comparison group, it took a shorter time for the treatment group to recover from their abnormal ALT and TBIL I values (P

Jia Gan Ning

Sun used Jia Gan Ning formula (Decoction for Relieving Hepatitis A) to treat 150 cases of acute icterohepatitis A. A total of 300 icterohepatitis patients were randomly placed into a treatment group (n=150) and a control group (N=150). The treatment group was treated with Jia Gan Ning decoction, which consisted of Yin Chen (Oriental Wormwood), prepared Da Huang (Rhubarb), Fu Ling (Hoelen), Zhi Qiao (Aurantium Fruit), Che Qian Cao (Plantain), Jin Qian Cao (Glechoma), Ban Lan Gen (Isatis Root), Hu Zhang (Giant Knotweed Rhizome), Zhi Zi (Gardenia), Gan Cao (Licorice), and Mai Ya (Malt). The herbs were decocted in water and taken one dose a day. The control group was treated with Vitamin C, Kalii Aspartas et Magnesis, etc. (IV injection), and generic hepatinica (oral administration). The results: 100% of both groups recovered; on average, it took 11.5 days for icterus to completely subside in the treatment group, and 30 days in control group; and on average, the liver function recovered in 16.2 days in the treatment group, and it did so in 30 days in the control group. (7)

Yin Zhi Wu Cao Tang

Liu treated 40 cases of acute icterohepatitis with Yin Zhi Wu Cao Tang. The formula consisted of Yin Chen (Oriental Wormwood), Bai Hua She She Cao (Oldenlandia), Jin Qian Cao (Glechoma), Bai Jiang Cao (Thlaspi), Di Jin Cao (Herba Euphorbiae), Che Qian Cao (Plantain), Fo Shou (Finger Citron), Zhi Zi (Gardenia), Xiang Fu (Cyprus) and Hou Pu (Magnolia Bark). Modifications were made according to the patients’ symptoms. The results: 36 cases recovered(symptoms disappeared and two successive examinations of the liver function showed normal results) and 4 cases improved (main symptoms disappeared or were significantly relieved, the size of the hepatomegaly and splenomegaly reduced and the liver function basically recovered). (8)

Other Treatments

Qiao treated 25 cases of severe icterohepatitis with both traditional Chinese medicine and Western medicine. The Chinese medicinal herbs used were Yin Chen (Oriental Wormwood), Ji Gu Cao (Herba Abri), Tian Ji Huang (Japanese St. John’s Wort), Chi Shao (Red Peony), Dan Shen (Salvia), Fu Ling (Poria), Bai Zhu (White Atractylodes), Chen Pi (Citrous Peel), Shan Zha (Crataegis), Mai Ya (Malt), Shen Qu (Medicated Leaven), and Ji Nei Jin (Membrane of Chicken’s Gizzard). Modifications were made according to the patients’ symptoms. One dose of the formula in decoction was administered orally daily. were decocted in water for oral administration of one dose a day. The Western medicines used were 15-amino-acid injection, an "energy mixture", etc. The results: 11 significantly improved, and 11 cases improved, and the remaining 3 cases did not respond to the treatment. (9)

Acupunture & Acupressure

Liu adopted otopoint pressure therapy to treat 56 cases of infantile acute icterohepatitis, including 45 cases of virus hepatitis A, 9 cases of hepatitis B, and 2 cases of mixed type (A and B) hepatitis. These patients were randomly divided into a treatment group (26 cases) and a control group (30 cases). In the treatment group, all patients received treatment on these otopoints: Gan (MA-SC 5), Pi (MA-IC), Jiao Gan (MA-AH 7), Nei Fen Mi (MA-IC 3), Yi (MA-SC 6), Dan (EX-LE 6), and Wei (MA-IC). In addition, depending on the patients’ symptoms, they also received supplemental treatment as follows: treatment on San Jiao (MA-IC 4) for excessive dampness, and on Er Shen Men (MA-TF 1) and Pi Zhi Xia (MA-AT 1) for severer abdominal pain. Details of the treatment: after routine sterilization, vaccaria seeds were adhered to the otopoint areas using small pieces of adhesive plaster. Moderate pressure was applied to these areas (e.g., with a thumb) both clockwise and counterclockwise 3 times a day. The two ears alternated in receiving the treatment every other day, and five sessions constituted one course of treatment. Patients in the control group were treated with a Western medicine. The results: after 2 courses of treatment, of the treatment group and the control group, respectively, 16 (61.54%) and 14 cases (46.67%) recovered, 9 and 15 cases improved, and 1 case in each group did not respond to the treatment. (10)

References

  1. Ren Jian Cai. Treating 50 cases of acute jaundice-type hepatitis with a modification of Yin Chen Hao Tang. Shanxi Journal of TCM. 1998;14(3):19.
  2. Ma De An, et al. Treating 122 cases of jaundice-type hepatitis with a modification of Yin Chen Hao Tang. Journal of Gansu College of TCM. 1996;13(4): 9-10.
  3. Li Zhi Qiang. Treating 180 cases of juvenile hepatitis type A with a modification of Yin Chen Hao Tang. Henan Journal of TCM. 1994;(3):46.
  4. Zhang Jin Fa. TCM treatment of 70 cases of acute hepatitis A. Gansu Journal of Traditional Chinese Medicine. 1997;10(5):16.
  5. Sun Yi Ling, et al. Treating 42 cases of hepatitis that is neither type A nor type B. Journal of Practical TCM. 1999;13(1):54-55.
  6. Zhang Yun Shan, et al. Treating 20 cases of jaundice type hepatitis infected by hepatitis virus E. Hebei Journal of TCM. 1996;18(4):11.
  7. Sun Jiu Guang. Treating 150 cases of acute icterohepatitis A with Jia Gan Ning. Hebei Journal of TCM. 1998;20(3):163.
  8. Liu You E. Treating 40 cases of acute icterohepatitis with Yin Zhi Wu Cao Tang. Journal of TCM Science and Technology. 1999;6(5):285.
  9. Qiao Shi Zhong. Treating 25 cases of severe icterohepatitis with both traditional Chinese medicine and Western medicine. Journal of Integrated Medicine for Liver Diseases. 1998;8(4):242-243.
  10. Liu Xiao Ying. Treating 56 cases of infantile acute icterohepatitis by otopoint pressure therapy. Journal of Integrated Medicine for Liver Diseases. 1997;7(2):104-105.