Hepatitis

Hepatitis
Most called viral hepatitis, caused by hepatitis viruses, can be divided into three types: Type A, Type B and non-A non-B hepatitis. People are susceptible to the disease. Clinically, the major symptoms are poor appetite, hepatalgia and fatigue. Fever and jaundice may occur. liver function test shows various degrees of hepatic damage.
DIAGNOS1S
l Epidemiologic information: The epidemic condition and a history of close contact with a hepatitis patient, or a history of blood transfusion or receiving blood preparations or immunization injections should be noticed.
2. Clinical features
(l) The onset of the disease is insidious and slow. The patients complain of fatigue and anorexia. Some have jaundice, but most of them belong to mild hepatitis. Only ten percent of the patients have typical manifestations or jaundice.
(2) Patients with hepatitis A often manifest pyrexia, shorter course and rapid recovery; patients with hepatitis B usually have a chronic course and remain HB virus carriers for a long time.
A few of them may progress to cirrhosis. The severity of the clinical features of Non-A Non-B hepatitis is between those of hepatitis A and hepatitis B. And its incubation period can be long or short.
3 Physical signs: The liver becomes enlarged, and tender on palpation and is painful on percussion. There is a mild changes of liver texture. Hepatic face, vascular spiders and liver palms may be present in chronic active hepatitis. A few patients suffering fronm fulminant heptitis may have skin petechiae, epistax is and ascites, or even hepatic coma, indicating poor prognosis.
4. Laboratory examination
(1) Liver function: In patients with acute hepatitis, the SGPT is marked elevated up to several hundreds units, even more tyhan one thousand units. In icterohepatitis, the icterus index and the one-minute bilirubin fixed quantity are increased. In severe and chronic active hepatitis, metabolism of protein is disturbed resulting in the change of ratio of serum albumin to globulin.
(2) The detection of specific antigens and antibodies: It is available to detect the HAAg in filtrate if stools and the anti-HAV of the IgG and IgM class in the diagnosis of hepatitis A. Three antigen and antibody systems, that is HbsAg, HbcAg and HbeAg with their antibodies, can be detected, which is valuble in the diagnosis and in predicting the severity, infectivity and prognosis of the hepatitis B. Non-A Non-B hepatitis can only be diagnosed by using the exclusive nmethod.
(3) In chronic active hepatitis, tests for cellular immunity humoral immunity and autoimmunity may be performed to evaluate the host immune mechanisms and severity of the disease so as to give a relevant treatment.

What is the Significance of Hepatitis C?

Hepatitis, especially hepatitis C, is currently the most prevalent infectious disease in the U.S. More than 4.5 million Americans have been infected with hepatitis C, and almost 3 million currently carry the hepatitis C virus. More than 30,000 new cases are diagnosed each year.
Hepatitis C is an insidious, stealthy virus that mutates while hiding within liver and other organ cells, making it very difficult for the body's immune system to eradicate it. Additionally, hepatitis C tends to progress slowly over many years (20 to 30), resulting in as many as 75 % of infected patients having few noticeable symptoms until they reach an advanced chronic stage. Hepatitis C results in 8,000 to 10,000 deaths annually. It is also the leading cause for liver transplants in the U.S. Without effective treatment, this figure is expected to triple within the next 10 to 20 years.
As the disease progresses, blood tests indicate elevated liver enzyme levels (ALT, AST), that are indicative of liver damage and inflammation. As the course of the disease gradually disrupts crucial liver functions, it progresses to cirrhosis (scarring), which, in a small portion of patients, can then lead to hepatocellular carcinoma, a type of primary liver cancer.
Although the severity of hepatitis C is much less than HIV infection, four times as many people are infected with HCV than HIV. Hepatitis C causes more morbidity (sickness) than mortality (death). It has a much slower disease course, therefore, we have more time to treat and alter its course. Since it affects the lives of so many people, there is a great need to develop effective treatments that can fight this disease. Conventional treatment could not offer effective way to control the situation so far. Is there any alternative way or complementary method to deal with it better? Traditional Chinese Medicine can be an effective way to do so.

What are the clinical implications of the natural history of Hepatitis C?

The statistical data on the natural history of hepatitis C is based on the National Institutes of Health's Consensus Statement on Managing Hepatitis C. From the data, we can see that hepatitis C progresses very slowly, which gives us time to treat and alter its disease course. In the acute stage (first six months), about 15% of patients will be able to resolve the infection spontaneously and recover completely. This means that the body has the mechanism (the immunity) to fight off HCV. The remaining 85% of infected persons will develop a chronic infection, though the majority of them (75%) will be stable. If the liver inflammation is well under control, this stability will last a very long time. About 25% of chronically infected patients will develop cirrhosis, but the majority of them (75%) will be stable. We can treat these people to partially reverse their fibrosis and keep them stable. Only 25% of those who have cirrhosis will progress to liver failure or liver cancer that will require a liver transplant. Overall, this population is only 5% of the total patients. This means that hepatitis C is much less serious than HIV and causes more morbidity (sickness) than mortality (death).
On August 19, 1999, the New England Journal of Medicine published the article "The Prevalence of Hepatitis C Virus Infection in the United States, 1988 Through 1994." This survey was done by the Centers for Disease Control and Prevention in Atlanta and found that "The overall prevalence of anti-HCV was 1.8%, corresponding to an estimated 3.9 million persons nationwide (95% confidence interval, 3.1 million to 4.8 million) with HCV infection.... Seventy-four percent were positive for HCV RNA, indicating that an estimated 2.7 million persons in the United States (95% confidence interval, 2.4 million to 3.0 million) were chronically infected...." According to this report, at least 2.7 million Americans carry HCV, making it the most common infectious disease in the U.S.A. This is a conservative estimate; the actual number may be higher. The most interesting thing to emerge from this report is that about 1.2 million people who were once infected no longer have any signs of the virus. These people eradicated the virus through their own disease-fighting power, i.e., and their immunity. This further confirms that our body has the ability to eliminate the HCV. Previous data found only 15% of the patients can spontaneously eradicate the virus; now this proportion has increased to 26%. This is an encouraging figure. If we can help the other 74% restore their immune function, they might be able to do the same.

What is the ideal strategy for treating chronic Hepatitis?

¡¤ Eradicate the virus or suppress replication of the virus.
¡¤ Control liver inflammation and halt disease progression.
¡¤ Suppress fibrosis and promote re-absorption of fibrotic tissue.
¡¤ Promote regeneration of liver cells and restore liver function.
¡¤ Convert Chronic Active Hepatitis into Chronic Persistent Hepatitis, then effect a clinical and
histological cure.

Right now, we (both Eastern and Western Medicine) still have not been able to find an absolute cure. Thus, a comprehensive approach is needed to treat chronic viral hepatitis, including proper herbal treatment, rest, and nutrition. By doing this, we can halt progression of the disease and restore general health while the "patient" has plenty of time as the cure is being sought.

How can one distinguish between chronic active and chronic persistent Hepatitis?

¡¤ Disease Course Over 6 months,
Hepatitis Symptoms:
¡¤ Fatigue, anorexia, stomach distention, loose stool Multiple Few
Physical Signs:
¡¤ Enlarged & hardened liver and spleen, jaundice, bleeding, grayish complexion, liver palm, spider moles, ascites and edema Obvious Mild
Additional Signs:
¡¤ Joint pain, skin rashes, fevers, thyroid inflammation, vasculitis, ulcerative colitis, Sjogren's syndrome, nephritis glomerular Often Few
Liver Function Tests
¡¤ ALT Greater than 150 Less than 150
¡¤ Gamma-globulin elevated not elevated
¡¤ Bilirubin total greater than 1.5 less than 1.5
¡¤ Pt Time prolonged not prolonged
¡¤ Auto-immune ANA, AMA (+) negative
Histology necrosis, inflammatory cell infiltration in portal areas, lobe invasion, connective tissue hypertrophy, fibroblastic activities no necrosis, mild inflammation, no lobe changes, signs of healing, no worse on long term follow-up

What are the conventional treatments available for Hepatitis C?

Presently, the FDA-approved conventional treatment is Alpha Interferon (IFN). The response rate is low and long-term remission is uncommon. Approximately 30 to 40% of patients treated with IFN for a six-month to one year period show normalization of liver enzyme levels, as well as a reduction of viral load and of inflammation diagnosed by liver biopsy. Unfortunately, this improvement is usually short-lived, as 70% of patients suffer relapse within a few months after IFN treatment is discontinued. Thus, only 15 to 20% of patients treated with IFN can expect remission for an unspecified time.
Additionally, the side effects of IFN can be quite severe: persistent "flu-like" symptoms, fatigue, muscle aches, depression, headache, dizziness, general malaise, insomnia, poor appetite, nausea & vomiting, bone marrow depletion, white blood cell dropped , anemia, hair loss, irritability, and even auto-immune diseases, such as hyperthyroidism. It has become evident that the side effects of IFN can be even more detrimental than the disease. So there number of patients have no choice to discontinue the treatment before the course finished.
A new combination therapy, Rebetron, has recently been approved by the FDA. It is a combination of IFN and ribavirin, a nucleoside analogue (in the same family as AZT) developed in the late 1980s. It showed poor results when used alone for hepatitis C, though when combined with IFN in clinical trials, the combination therapy showed about a 50% sustained HCV suppression after the therapy stopped. However, it is much too soon to say that this is a good combination. Nucleoside analogue is a chemotherapy that is very hard on the liver. The side effects of Rebetron can be dangerous. In addition to the IFN side effects mentioned above, ribavirin may produce birth defects and severe anemia that can lead to heart attack or stroke in those with risk factors. Psychiatric problems, such as suicidal tendencies, have also been reported.

What are the shortcomings of conventional treatments for viral Hepatitis?

¡¤ Conventional treatments might not be consistent with the first principle of medicine: DOES NO HARM. Some of its side effects may be even more harmful than the disease itself.
¡¤ Most patients have suffered with the disease for over 20 to 30 years. At this stage, pathogenetic factors can have more profound effects on disease progression than the etiologic factor (the HCV). But conventional treatment is focused solely on the etiologic factor and does not address complicated chronic liver disease.
¡¤ Conventional treatment interferes with immune function and can even cause autoimmune diseases, thereby further compromising the patient's health, since a healthy immune system is required for fighting the HCV.
¡¤ Conventional treatments can only bring 20-40% patients' PCR of the HCV load down to an "undetectable" level in the blood. "Undetectable" is not synonymous with "total eradication", and upon checking the liver for these responders, most patients will still have HCV in their liver. Relapse may happen at a later time.
¡¤ With conventional treatment, many patients become sicker, weaker, depression.

What can we to do for them, who could not stand the side effects from the conventional treatment or the ones who, have no positive response.

Hepatitis C problems that conventional medicine has not addressed:

¡¤ What can be done for the 60 - 70% non-responders?
Since the efficacy of the IFN treatments is only about 15 to 25%, and the response to combination treatments is about 30 to 40%, a lot of patients treated with conventional medicine will not have a positive response. What to do for them?
¡¤ What can be done for those contraindicated for IFN and Rebetron treatments?
The contraindicated conditions include: de-compensated cirrhosis, persistently normal ALT, active alcohol or illicit drug use, history of severe depression, cytopenias (low white blood cell count), hyperthyroidism, renal transplant, and convincing evidence of autoimmune disease. It should be noted that most patients with these conditions are in great need of treatment.
¡¤ What can be done for those who can't tolerate the side effects of conventional treatment?
Because of the side effects of IFN and Rebetron treatments, about 20 to 40% of patients have to reduce their dosage, and 10 to 15% have to stop treatment completely. These people will not be aided by conventional medications for hepatitis C.
¡¤ What can be done for those who have positive response, but rather high relapse after the response period?
For those who do respond to IFN and Rebetron, how long the response lasts is another question that needs to be answered. Side effects and high cost prevent the usage of IFN and Rebetron as long-term maintenance treatments. What to do next?
¡¤ What can be done about the pathological damage that has already been done by chronic hepatitis C?
The clinical symptoms are signs of liver damage and conventional treatments do not offer any solutions to the years of accumulated damage that Hepatitis has caused.

Is there an alternative way to treat viral Hepatitis?

Due to the limited treatment protocol within conventional medicine, many patients are searching for alternatives. Traditional Chinese medical protocols using combinations of antiviral, liver-protective, and anti-inflammatory by Chinese herbs or acupuncture (all relatively nontoxic) appear to halt the progression of the disease in many cases. It would be easy to research the efficacy of such therapy and compare it with the conventional regimen if experts were aware that the alternatives exist, and were open-minded about integrating them into their practices.
In China, doctor have a great deal of experience treating hepatitis with traditional medicine (one-third of the world's hepatitis carriers are in China). There are many studies show that Chinese herbal regime and acupuncture have a much higher sustained response rate than the Western drug interferon, is more affordable, and has no serious side effects.

Why use Traditional Chinese Medicine to treat viral Hepatitis?

In TCM, this disease belongs to the categories of "huang dan" (jaundice), 'ganyu" (stagnation of liver qi), "xie tong" (hypochondriac pain)'.

A third of all hepatitis cases worldwide (of which 30 million are hepatitis C) are found in China, with viral hepatitis being the most prevalent infectious disease-11% of the Chinese population are HBsAg positive, and more than 100 million are HBsAg carriers. Every year, 10 million new cases are diagnosed and thus, Chinese doctors treat most of the world's hepatitis patients.
Because China is a developing country, expensive drugs, such as IFN and ribavirin, are not readily available, nor are they affordable. Therefore, Chinese doctors are mainly dependent on Chinese medicine to treat viral hepatitis. Chinese doctors employ an integrated approach in the treatment of hepatitis C and B. they use Western medicine's diagnostics together with Chinese medicine's constitutional differentiation and herbal and /or acupuncture treatments. Chinese herbal and acupuncture treatments suppress the HCV and HBV, regulate immunity, normalize liver enzyme levels, heal inflammation of liver cells, clear jaundice, improve the microcirculation of the liver, prevent fibrosis, and partially reverse cirrhosis.
A survey was done in China to compare Western and Chinese medicine for treating chronic viral hepatitis. It questioned 200 doctors from large city teaching hospitals and medium-sized city hospitals, as well as rural primary-care practitioners. Among them, 90 were Western medicine practitioners, 80 were TCM practitioners, and 30 were practitioners of integrative Chinese and Western medicine( ICWM ). All 200 doctors agreed that TCM and ICWM produce better therapeutic results in treating chronic viral hepatitis than does Western medicine.

How does Traditional Chinese Medicine approach chronic viral infections?

Chinese medicine's approach is termed literally translated as dispelling the infectious agent by supporting the normal function of the body. Following this principal, Chinese medicine has developed therapies to regulate the immune system. Chinese medicine is a constitutional medicine and purports that the body itself is the major healing force. Drugs and procedures can help to heal, but they cannot replace the healing function of the body.
In the case of viral hepatitis, Chinese medicine first focuses on the normalization of liver function and the restoration of overall health. With improving health, the body's immune function is strengthened. Further, with the help of anti-viral herbal remedies, the HCV is suppressed and kept at bay, causing no further harm.

What is Acupoint Injection Therapy ( AIT ) ?

Acupoint injection Therapy (AIT) is a combination of Chinese herbs , vitamins and acupuncture points. We select certain Chinese herbs and suitable dosages of vitamins directly inject into certain acupuncture points to treat different diseases or disorders. The benefits are: more powerful and more effective than any single way. This is a combination way to get acupuncture, Chinese herbs and vitamins effectively combine together. In addition, this is a safe and convenient way to practice.

How Acupoint Injection Therapy can effectively treat hepatitis C:

Acupoint injection Therapy : We select certain Chinese herbs and suitable dosages of vitamin B1, B12, B6, or even vitamin C to inject into certain acupuncture points. The benefits are:
1. To protect the liver from further damage by the virus, detoxify the liver, promote nutrition and oxygen to the liver--which is very important for tissue recovery and to improve liver function.
2. To strengthen the immune system ability to defend against and kill the virus and to reduce inflammation.
3. To improve the patient general condition, solve multiple disorders at the same time without involving chemical drugs, and furthermore to protect the liver from previous drug damage.
One graphic example of the latter benefit was seen with a patient who suffered from advanced ascites and edema, for which he had to take large daily doses of Lasix; with acupoint treatment the patient was able to reduce the drug gradually until he could stop it altogether. Reasons: 1). Stimulating the special acupoints BL-23, SP-6, SP-9, RN-4, BL-25 can reduce ascites. 2). Ascites and edema can be reduced by further stimulating these acupoints with certain herbs and vitamins. 3). Improving the digestive system to absorb more nutrition and protein so that albumin levels can be improved. As a long-term consideration, this will very much benefit the cirrhosis patient, for at this advanced stage of disease chemical drugs will be much more harmful than for a patient with a normal liver.
Another case, patient suffered hepatitis C as well as diabetes (FBS 263), kidney damage (BUN 31), heart enlarge, severe lung infection for two months with very bad cough. After AIT for two weeks, patient felt much improved. 3 months later, blood test and x-ray showed all of them improved without drugs involved.
4. AIT is safe, more effective, and has no side effects, which is very important for chronic disease.
5. This therapy has potential applications for both the prevention and treatment of chronic hepatitis, cirrhosis and their complications.

Did you ever treat hepatitis C, how is the results?

Since 1989, I have treated several cancers and many hepatitis B patients with Acupoint Injection therapy (AIT). Cancer patients have many complications and co-infections, AIT offer a good option to the patients who refused conventional therapies. Cancer conventional therapies resulted in drug-induced liver, kidney, heart, stomach and blood counts, damage. All these damage responded favorably to AIT treatment. Some patients even got completely response to AIT within 3 months. Hepatitis B even got easier controlled by AIT than cancer did. The effective clinical results our patients obtained encouraged me to treat more complicated cases, hepatitis C & B, cancer, TB and even AIDS patients. We can’t say we healing all the patients, but we really did help a lot of patients by AITthan we expected before. Of course we did treat hepatitis C patients and all of them got well response. Hepatitis C

How can we believe alternative medicine can be a good option for hepatitis C?

Doctors of conventional Western medicine respond differently to Traditional Chinese Medicine. In the case of hepatitis C, doctors are often frustrated by the lack of effective treatments to offer their patients. A few of them has great foresight and sagacity, have begun to advocate integrative medicine. Many doctors have listened to their patients' positive accounts of their experiences with Traditional Chinese Medicine and have begun to look at this alternative.

As a clinician and I respect good clinical outcomes. Medical science is an application science, and the final judgment is the clinical outcome. Doctors should respect the clinical results and not reject the medicine because it is based on a different theoretical system. Especially for hepatitis C, the treatment results are measured by lab tests, not just the patients' feelings. "Feeling better" may be considered a placebo effect, but lab tests that indicate normalized enzyme levels and decreased PCR of HCV are undeniably objective, hard data as evidence.

Some helpful philosophy:

Many patients worry that they are carrying a virus and have not been cured. Although their liver functions are normalized and they have a normal or near-normal quality of life, they feel uneasy that they still have HCV in their body. we tell them that everybody carries certain viruses in his or her body. It is abnormal not to have viruses in our bodies. Some viruses have names and can be tested; some have no names and can't be tested. Viruses were the first living things on Earth and are one of the major causes of mutation. In millions of years of evolution, the human body has adopted mechanisms to deal with viruses. Given enough time, it will learn how to coexist with a newly invading virus. Gradually, our immune system can control it, keep it at bay, and prevent it from further harm.
Worrying can only weaken the immune system and make the virus stronger. From the experiences of many of our HIV patients, we have seen that coexistence with the virus is possible. After coexisting for a sufficiently long time, the virus becomes less harmful and finally becomes harmless, while at same time our body becomes stronger and can control the virus better.

Conclusion to introduction:

Although Chinese herbal treatments may not be a cure for chronic liver diseases at least according to the conventional medical definition they present alternatives for hepatitis C patients. More importantly, our protocols cause no serious side effects and actually benefits the body during treatment, not harm it.. Thus, they can definitely improve overall health and halt the progress of chronic hepatitis.
Proper treatment enables patients to have much more time to wait for an absolute cure in the future. Therefore, for chronic hepatitis, the sooner herbal treatment is given the better the results.

Goal of treatment:

Chronic viral hepatitis, especially hepatitis C, is a complicated liver disease. Liver damage is mainly caused by inadequate immune response. HCV replication alone causes little direct damage. Simply eliminating HCV is insufficient to heal the damage already done by the chronic disease over 20 to 30 years. Effective treatment should address both pathogenic and etiologic problems. our Chinese herbal treatment protocol for hepatitis C is just such a comprehensive and systematic approach. It consists of eight treatment objectives:

¡¤ Control of liver inflammation and normalization of liver function, i.e., lowering or normalizing ALT level.
¡¤ Lowering and stabilizing of the viral load ( PCR )at a low level (below one million per milliliter) or eradication of the HCV.
¡¤ Regulation of immunity to help achieve the two above-mentioned goals.
¡¤ Improvement of microcirculation in the liver in order to promote liver regeneration.
¡¤ Facilitating bile secretion and excretion.
¡¤ Lowering portal vein pressure, and prevention and reversal of fibrosis.
¡¤ Maintenance of normalized liver function and halting liver-disease progression (after liver inflammation is well under control).
¡¤ Treatment of hepatitis C-related symptoms and complications, such as fatigue, insomnia, joint pain, skin rashes, diabetes, and infections, thus improving the patient's overall health.
¡¤ Control of liver inflammation and normalization of liver function, i.e., lowering or normalizing ALT level.
This requires the improvement and normalization of enzyme levels and the healing of inflamed liver cells. The herbal remedies listed below are necessary for most patients, especially those with elevated ALT and AST levels. These enzymes are normally found inside the liver cells, though they leak into the bloodstream when liver cells are inflamed. This is especially true of ALT, which exists mostly in liver cells and has more specificity for monitoring liver inflammation than AST does. Moreover, ALT responds to herbal treatment much faster than AST. AST exists in the heart and muscle, as well as the liver, and is less specific to liver inflammation and responds to treatment more slowly than ALT does. In order to control liver inflammation, three consecutive normal ALT readings within one year must be seen, and each reading should be two to three months apart. Hence, this part of treatment should last at least one year. This group of herbal remedies can also help maintain normal enzyme levels for those patients with a normal ALT level.

For more details, please go to Hepatitis C , Hepatitis B