TCM Syndrome Differentiation and Treatment Methods for Chronic Viral Hepatitis

Zhang Liangchen, associate chief physician at Dongcheng Hospital of Traditional Chinese Medicine, goes on to say: Western medicine classifies the disease by virus type, such as hepatitis A, hepatitis B and hepatitis C, while TCM classifies it as liver-gallbladder damp-heat, liver depression with spleen deficiency, spleen-kidney yang deficiency, obstruction of meridians by blood stasis, and liver-kidney yin deficiency. Clinically, most cases of chronic viral hepatitis are of the liver-gallbladder damp-heat type and the liver depression with spleen deficiency type. Everyone knows that hepatitis is contagious, and in reality there is also the phenomenon of carrying the virus without clinical symptoms, which TCM calls the type of healthy qi deficiency with lingering pathogenic qi.

In terms of symptoms, among patients with chronic viral hepatitis, if there is distending pain in the right hypochondrium, nausea, bitter taste in the mouth, fullness and stuffiness in the epigastrium and abdomen, jaundice or no jaundice but dark yellow and reddish urine, yellow and greasy tongue coating, and sticky, foul-smelling stool, it is the liver-gallbladder damp-heat type. If there is distension and fullness in the hypochondriac and rib areas, sallow complexion, a bland taste in the mouth, pale tongue, white coating, poor appetite, thin and loose stool, depression, and stuffiness in the epigastrium and abdominal distension, it is the liver depression with spleen deficiency type.

Jaundiced hepatitis

If there is dizziness and tinnitus, five-center heat, dryness of both eyes, dryness of the mouth and throat, soreness and weakness of the waist and knees, five-center heat, a red and thin tongue with little fluid, insomnia and frequent dreaming, or cracks on the tongue, and scanty or absent menstruation in women, it is the liver-kidney yin deficiency type; if there is aversion to cold and preference for warmth, poor appetite and loose stool, cold pain in the lower abdomen, waist and knees, indigestion of food, and also incontinence of stool, a pale and swollen tongue and edema of the lower limbs, it is the spleen-kidney yang deficiency type; if there is a dark and dull complexion, enlarged and relatively hard liver and spleen, red thread-like spots and erythema, liver palms, spider angiomas, abdominal pain during menstruation in women with dark, clotted discharge, and a dark purple tongue, even with ecchymosis, it is chronic viral hepatitis due to blood stasis obstructing the collaterals.

Zhang Liangchen says: Western medicine treats "the disease of the person", while TCM treats "the person with the disease". That is, Western medicine treats the disease and its symptoms, while TCM treats chronic viral hepatitis by syndrome differentiation, focusing on treating the person, expelling pathogenic qi and supporting healthy qi. Therefore, in the treatment of chronic viral hepatitis, TCM also attaches great importance to medication, dietary therapy, psychology, that is, emotions, and exercise, and, taking into account the characteristic that chronic viral hepatitis easily recurs, conducts treatment in a comprehensive and holistic manner.

Hepatitis B

Chronic viral hepatitis readily damages liver function, so it is best to use integrated traditional Chinese and Western medicine, with complementary advantages, to treat all types of chronic viral hepatitis, timely giving play to the advantages of TCM and Chinese medicinals in protecting the liver, lowering enzymes and reducing jaundice, and in psychological counseling to smooth the emotions, while letting the antiviral treatment of Western medicine make up for the shortcomings of TCM in expelling pathogenic factors. This can relatively quickly reduce liver inflammation and control the progression of the disease. In the antiviral treatment of Western medicine, TCM is still needed to protect the liver and lower enzymes, which can effectively inhibit the virus.

It is a necessity that TCM syndrome differentiation and treatment run through the treatment of all types of chronic viral hepatitis from beginning to end. Clinically, there have long been licorice-based and Schisandra-based formulas with marked effects in protecting the liver and lowering enzymes, as well as some compound Chinese patent medicines, which have become commonly used Chinese medicinals in the integrated traditional Chinese and Western medicine treatment of chronic viral hepatitis. Even in the anti-fibrosis treatment of chronic viral hepatitis, the effect of TCM treatment in reversing liver fibrosis has already been widely recognized. If treated improperly and the disease progresses to cirrhosis, then neither traditional Chinese nor Western medicine can reverse it, but TCM treatment can still greatly improve the patient's quality of life and bring a better prognosis.