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The treatment of viral and toxic hepatitis in Chinese medicine. Oksana Nachataia.

Good day to all! The treatment of HCV infection, as well as toxic and alcoholic hepatitis is very complicated topic. We can say that this is a separate direction in medicine. It is interesting to note that quite literally in my eyes over the last 10-12 years in the relationship between Chinese and Western medicine in this area, there have been quite large changes. A physician who practices TCM now should keep his finger on the pulse, keeping track of current advances in the treatment of hepatitis. On the other hand, the ancient knowledge of TCM does not lose relevance, finding confirmation of its truth in modern studies. The highest analytics approaches the maximum generality. And it cannot but rejoice. During the practice at Tianjin University, I was fortunate enough to study the “middle jiao” treatment system using prescriptions. It is a logically harmonious, systematized principle of selecting Chinese ingredients and their stable combinations for simultaneous targeting of each syndrome, primarily for the liver and spleen in their Chinese sense. This clear algorithm allows you to assign personalized treatment to virtually every patient. As a result, multicomponent recipes are obtained, consisting of individual small stable combinations of ingredients, like a house of “bricks”. In some ways, the principle of their construction echoes with Tibetan medicine, but the basis of this system is the physiology and pathophysiology of BMT in terms of the interaction of organs in the “middle jiao”. Even taken separately, the physiology of TCM is of great interest, since it illuminates the life of the organism from a different angle. But this is by the way. As you know, the physiological connections between the organs of the “middle jiao” (for example, the controlling connections of the “wu xing,” the processes of “raising and lowering”, the distribution of qi, the deposition of blood, etc.) constitute a background, which is then affected by the pathogenic factor that causes hepatitis. According to the views of TCM, there are several factors, such as viruses, alcohol, various hepatotoxic substances. By their nature in Chinese medicine, they all belong to the pathogens “heat and poison,” as they cause a set of concrete specific syndromes in the liver. The main purpose of treating hepatitis of any etiology in TCM is the preservation of the liver – both its structure and function. Usually the basic set of ingredients in the prescription is the same for all situations, since for any hepatitis there is always a certain set of syndromes, both from the liver and spleen, from the blood and so on. Further to this “basic” recipe the ingredients with an emphasis on the main pathogenic factor are added . For example, with hepatitis C, these are plants with more pronounced antiviral properties. In case of toxic hepatitis there are the ingredients that remove toxins from the body. That is, the most important thing is to stop structural changes in liver tissue, the disintegration of hepatocytes, stop the inflammatory process and create a cirrhosis prevention. Not setting the main goal of eliminating the viral agent (with the help of herbs it is extremely difficult to do this), TCM recipes are good at the task of normalizing biochemical parameters, restoring normal liver size, improving well-being. That is, the patient in the process of treatment becomes a virus-carrying condition. For this, there is a certain system for prescribing recipes, taking into account seasonal biorhythms, gender, patient’s age, leading syndrome and other features.

Just 15 years ago, this system was truly a rescue for patients suffering from a persistent viral infection. But then Western medicine made a real breakthrough, learned how to deal with viruses by directly influencing it.(https://www.ncbi.nlm.nih.gov/pubmed/29377464; https://www.mdlinx.com/…/sofosbuvir-vel…/2018/03/29/7508571/) From year to year the drugs became more and more perfect, and now effective and safe drugs are being used, which in most cases solve the problem of eliminating the virus. And, it would seem, the methods of TCM recede into the background. But it is not so. It turns out that by the present moment two medical systems each solve their own task. In the case of viral hepatitis, in particular, hepatitis C, the main goal of TCM is to preserve and improve the liver before antiviral medicines begin treatment, normalize biochemistry, and remove intoxication. The same thing after the treatment – restore the liver tissue, if necessary. In difficult cases, when there is simultaneous infection with two strains of the virus, or there are severe kidney problems, there are contraindications to western treatment, TCM recipes, in my opinion, can be used as “insurance” and additional help for the patient. For cases of toxic and alcoholic hepatitis, as is known, Chinese medicine remains, as before, a pretty good choice to prevent or permanently delay the onset of cirrhosis. Moreover, according to statistics, the number of patients with toxic liver damage does not decrease. Toxic medicines, environmental factors, unhealthy diet contribute to this. (https://onlinelibrary.wiley.com/doi/abs/10.1111/liv.13662) This topic remains relevant. I am glad that more and more TCM recommendations on the way of life for patients with liver diseases find their confirmation in modern studies. This concerns, for example, a diet based on cereals and vegetables, as well as a complete rejection of alcohol – the traditional approaches of TCM in the treatment of hepatitis.(https://www.reuters.com/…/even-light-drinking-may-make-fatt…) Much attention in modern medicine has been given to daily biorhythms, their effect on health. Whereas in Chinese medicine, “the liver is responsible for cycles, for order in the body,” and the first one suffers from sleep and wakefulness, time zones, and the like. Of course, medicine does not stand still, various medical systems enrich each other due to the possibilities of information exchange. Therefore, I wish every success to all specialists and health care practitioners! Many thanks!