The treatment of viral hepatitis in Chinese medicine attaches importance to the combination of evidence and disease identification. Acute jaundice hepatitis to dampness and heat, more standard solid evidence, focusing on identifying dampness, heat, which is more or less important; acute jaundice hepatitis, focusing on identifying dampness obstruction and qi stagnation; chronic viral hepatitis long course, recurrent attacks, complex pathology, mostly mixed evidence of deficiency, focusing on identifying the deficiency of qi, blood, yin and yang; heavy hepatitis to the predominantly hot and humid venomous, stasis and heat interconnections.
The treatment of viral hepatitis can follow the following principles: ① This disease is the invasion of the evil of dampness, heat and epidemic poison, accumulated in the body, so the basic principle is to clear the heat, dampness and detoxification, and "get rid of all the evil". ② distinguish between real and imaginary, regulate the function of internal organs, the liver should be sparse, the gallbladder should be beneficial, the spleen should be transported, the stomach should be and. (3) The liver is nourished by yin and blood, liver and kidney are of the same origin, and it is more appropriate to pay attention to nourishing the liver and kidney in the body of long-term disease, so as to achieve the purpose of supporting the positive and dispelling the evil. Generally speaking, in acute stage of viral hepatitis, the treatment of symptoms is the main focus, and in chronic stage, the symptoms and root causes should be treated together. Acute hepatitis (liver fever) focuses on clearing heat and detoxification of dampness, in which acute jaundice hepatitis to clear heat and dampness to reduce yellow, no jaundice hepatitis to strengthen the spleen to promote dampness and qi appropriate; chronic hepatitis (liver) when the combination of supporting the right and eliminating evil, such as according to specific evidence to be clearing heat and dampness, strengthening the spleen to promote liver nourishment of the liver and kidneys, activate blood circulation and remove blood stasis, warming and tonifying the spleen and kidneys, etc.; heavy hepatitis (liver distemper) should be reused to cool the blood and remove blood stasis of the products.
I. Liver fever
1. Damp heat of the liver and gallbladder
Symptoms of body and eyes are yellow, yellow and sharp as orange, tiredness and fatigue, dry mouth, bitter mouth, nausea and vomiting, anorexia, epigastric boredom, abdominal distension, right hypochondrium and ribs pain, or accompanied by chills and fever, yellowish and reddish urine, red tongue, yellowish greasy moss, and stringy or sliding number of pulses.
The treatment is to clear away heat and dampness, detoxify the toxin and eliminate the yellow color.
The formula is Yin Chen Artemisia Tang plus flavor, or Ganlu Sterilization Dan plus reduction.
Yin Chen Artemisia Tang: Yin Chen Artemisia 30g, Gardenia jasminoides 15g, Rhubarb 20g, Scutellaria baicalensis 12g, Qian Cao 12g, Dandelion 15g, Banlangen 15g, Radix Paeoniae Lactiflorae 12g, Codonopsis tigrinis 12g, Talcum officinalis 15g, Psyllium Hederacanthum 30g.
Ganlu Disinfectant Dan: Yin Chen Artemisia 30g, Talcum Hederacanthum 15g, Scutellaria baicalensis 15g, Calamus Calamus 15g, Mucuna Pruriens 15g, Phellodendron Bidentata 9g. 12g, shoot Gan 9g, forsythia 15g, mint 12g, nutmeg 12g, patchouli 15g.
Add and subtract heat is heavier than dampness, strengthen the power of clearing heat, gardenia to 20g, add gypsum 15g; dampness is heavier than heat, strengthen the power of dispelling dampness, add poria 15g, poria 15g; chest and epigastric fullness and tightness, accompanied by bowel movement is not refreshing, add the whole piper betel 10g, fagopyrrhenum 10g, Huanglian 12g; nausea and vomiting obvious, add the nausea and vomiting obviously, add the nausea and vomiting obviously. If the nausea and vomiting is obvious, add 12g of Bamboo Roots, 12g of Huanglian; if the abdominal distension is serious, add 10g of Houpu, 10g of Hovenia; if the skin is itchy, add 10g of Bitter Ginseng, 10g of White Fresh Peel; if the dystocia is serious, add 12g of Yanhuosuo, 12g of Neem; if the stomach is dull and hunger is not satisfied, add 12g of Guzha, 10g of Maiba.
2. Dampness obstructs the spleen and stomach
Symptoms of stuffiness of epigastrium, not hungry, epigastric plumping and abdominal distension. The symptoms include nausea, vomiting, poor appetite, hidden pain in the abdomen and ribs, heavy limbs, tiredness and sleepiness, swelling, sticky mouth, yellow eyes, short urine, loose stools, greasy moss, and a moist or slippery pulse.
The treatment is to strengthen the spleen and promote dampness.
The formula is Stomach Ling Tang plus subtractions, or Huo Park Xia Ling Tang plus flavor.
Stomach Ling Tang: Cangzhu 15g, Houpu 12g, Chenpi 15g, Licorice 5g, Ginger 12g, Jujubes 12g, Cinnamon 9g, Atractylodes macrocephala 20g, Zelenyza 20g, Poria 20g, Poria 15g.
Huopu Xia Ling Tang: Huoxiang 20g, Houpu 15g, Faganxia 15g, Poria 20g, Saxifrage 15g, Fructus Cardamomum 15g, Coix lacryma Seeds 20g, Chenpi 15g, wood 12g.
Add jaundice, add Yin Chen 30g; nausea and vomiting, add Acorus calamus 12g; abdominal distension with swelling, add 15g of abdominal skin, 15g of psyllium; poor nutrition, add 15g of chicken Neijin; loose stools, add 12g of white lentils, 12g of lotus seed meat.
3. Cold and dampness trapped in the spleen
Symptoms of the body and eyes Yellowish, dark color, or no jaundice, stuffy epigastrium, fear of cold, preferring warmth, loose stools, pale tongue, fat tongue, white slippery moss, slow and weak pulse.
Treatment: Strengthening the spleen and stomach, warming the middle and removing dampness.
The formula is Yin Chen Juxue Tang plus subtractions.
In Chen 20 to 30g, epimedium, dry ginger, licorice 6g each, Poria, zedo 20g each, Huo Xiang, thick Park, atractylodes 10g each, fried grain buds, fried malt, chicken gold 12g each.
Add and subtract if there is no jaundice, In Chen can be reduced to 15g; with nausea and vomiting, add ginger 12g; coercive rib pain, add Chenpi 12g, 12g of huosuo.
4. > 4. Liver depression and qi stagnation
Symptoms of coercion and distension of the epigastric region, chest tightness, good breath, depression or irritability, do not want to eat or drink, or nausea and vomiting, or bitter mouth like vomiting, or nausea and aversion to oil, dizziness, stringy pulse, moss white slippery; women's menstrual disorders, dysmenorrhea, or menstrual period of the breasts for distension.
The treatment is to dredge the liver and regulate qi.
The formula of Chai Hu Shu Hepatosan is added and subtracted.
Bupleurum Chinense, Xiangshu, Citrus aurantium, Rhizoma Ligustici Chuanxiong, Paeonia lactiflora, Gardenia jasminoides, Semen xia 10g each, Psoria vulgaris 30g, Poria cocos, Atractylodis Macrocephalae 15g each, Ginger, jujube 6g each.
Addition and subtraction of coercion and pain fixed and not moving, add Yanhusuo 15g, Salvia divinorum 15g, nerd, anorexia oil, add hawthorn 15g, Huoxia 12g, belching and bitter mouth, add Scutellaria baicalensis 12g, make Semen xia 12g; Irritability, add gardenia 12g, scutellaria baicalensis 12g; insomnia, add fried jujube nut 15g, lily of the valley 15g.
5. Liver and stomach disharmony
Symptoms gastric distension and discomfort, two hypochondriacs, belching and swallowing of acid, nausea, vomiting, aversion to grease, loss of appetite, fatigue and tiredness, pale red tongue, thin white moss, pulse string.
Treatment: dredge the liver and stomach.
The formula Four Reversed San is added and subtracted.
Bupleurum Chinense 15g, Paeonia lactiflora 15g, Citrus aurantium dulcis 12g, licorice 5g.
Addition and subtraction of epigastric distension, belching, add 12g of Xiangshu, 9g of Houpao, 12g of Shenqu; nausea and vomiting, aversion to grease and fatigue, plus the system of half-summers 10g, patchouli 12g, 15g of hawthorn.
Second, the liver
1. Swelling and pain, painful when pressed, stuffy epigastric region, nausea and anorexia, nausea, yellowish color of body and eyes, yellow urine, sticky and bitter mouth, fever and thirst, or drinking without much, constipated or grayish-white stools, sleepy limbs, fatigue, red tongue, yellowish and greasy tongue fur, and stringy or stringy and slippery pulse.
The treatment is to clear away dampness and heat, cool the blood and detoxify the toxin.
The formula of Yin Chen Si Yi San is added and reduced.
Yin Chen 30g, poria 20g, Poria 20g, Atractylodes macrocephala 15g, Zedoaria japonica 15g.
Add and subtract fever, add Scutellaria baicalensis 15g, Gentiana longifolia 15g, Gardenia jasminoides 15g; coercive distension and pain, add Uljin 12g, Chaihu 12g, Citrus aurantium 12g; constipation, add rhubarb 6g, Citrus aurantium 10g; nausea and vomiting, add Semen xia 10g, Huo Xiang 12g, Fructus cardamomum 12g.
The formula is to clear away dampness and heat, cool the blood and remove toxins.
2. Liver depression and stagnation of Qi
Symptoms of hidden pain in the two coils, lumps under the coils, abdominal distension, epigastric plaque and loose stools, belching frequently, tongue with thin white or yellowish coating, and a thin pulse.
Treatment: dredge the liver, regulate qi and relieve depression.
The formula is to add and subtract Chai Hu Shuo Liver San.
Bupleurum Chinense 15g, Paeonia lactiflora 15g, Rhizoma Ligustici Chuanxiong 12g, Radix et Rhizoma Glycyrrhizae 12g, Citrus aurantium 12g, Radix et Rhizoma Glycyrrhizae 5g.
Add and subtract dystocia is very bad, add Yu Jin 12g, Yan Hu Suo 12g, distension of the abdomen and loose stools, add Atractylodis macrocephala 12g, yam 15g, Atractylodes cynanchum 12g, Poria 12g; belching is added, add 9g of ochre, 9g of Echinacea, agitation, plus 12g of green peppermint
3. Liver depression and spleen deficiency
Symptoms of coercion and rib distension and pain, chest tightness too breath, mental depression, temperament impatience, food reduction, mouth pale and tasteless, epigastric plumping and abdominal distension, worse in the afternoon, less breath and lazy, limbs lazy, yellowish color, loose stools or eat grain, every time because of eating cold, greasy and indigestible food and aggravation, tongue pale moss white, pulse sinking string.
Treatment: dredge the liver, regulate qi and blood, strengthen the spleen and detoxify the middle.
The formula is Easy San or Chai Shao Liu Jun Zi Tang.
Bupleurum Chinense, Citrus aurantium dulcis, Jiaojiao, Xiangshu, Buddha's hand, raw malt, raw grain buds 10g each, white peony, Poria cocos, Codonopsis pilosula 15g each, 30g of Chinese yam, baked licorice 6g.
Add and subtract dystocia pain is obvious, add 12g of neem, 12g of yujin; dystocia pain is fixed, the pain is like pins and needles, you can add safflower 6g, yanhuisuo 12g; epigastric platitudes abdominal bloating is very big, add 12g of Buddha's hand, 12g of sand nut, 12g of sand nuts, 12g of wheat germ, and so on. 12g, 12g of raw malt; tiredness and fatigue, add 18g of Radix et Rhizoma Ginseng.
4. Yin deficiency of the liver and kidney
Symptoms of right hypochondriac pain, lumbar and knee pain and weakness, limb constriction, tendon vigilance, dizziness, tinnitus like cicadas, dry eyes, dry mouth, dry pharynx, insomnia and dreaming, tidal fever, or five distracting heat, spermatorrhea in men, menstruation, menstruation of women, menstruation is small, the tongue is thin, the tongue is red, less fluids, cracked, flowers, or little moss, or bright red without moss, or the tongue is red. or little moss, or glossy red without moss, with a thin and feeble pulse.
The treatment is to nourish blood and soften the liver, nourish yin and tonify the kidney.
The formula is always decoction or nourishing water to clear the liver drink.
5. Liver stasis
Symptoms: tingling in the dorsal area, lumps under the dorsal area, pain worsened by pressing, dark color, or red silk, enlarged liver and spleen, hard texture, spider nevus, liver palms, women's menstrual abdominal pain, menstrual fluid dark with lumps, dark tongue or petechiae, pulse is dull, thin and astringent.
The treatment is to activate blood circulation and eliminate blood stasis, disperse knots and clear the channels.
The formula of Blood Palace and Blood Stasis Tang or Diaphragm and Blood Stasis Tang is modified.
Wuling Lipid, Ligusticum Chuanxiong, Radix Paeoniae Alba, Peach Kernel, Safflower, Ulmus, Mudan Pi, Rhubarb 10g each, Wu Yao, Yan Hu Suo, Zelan, Xiang Guan, Xie Cao, Citrus Aurantium, Hovenia Hedys 15g each, Cannabis Pterygosperma, Frying Fritillariae, Yi Mucus Gratiae 12g each.
Addition and subtractionWhite rib stabbing pain is obvious, add Neem Zizi 15g; liver and spleen enlargement is obvious, add Ostrea gigantea 15g, Xia Kucuo Cao 15g; epistaxis is added, add Bai Mao Gen 15g, San Qiu Gen 15g. For epistaxis, add 15g of Radix et Rhizoma Gastrodiae, 10g of Panax notoginseng Powder (to be taken); for those with phlegm, add 12g of Semen Armeniacae, 12g of Pericarpium Citri Reticulatae; for those with deficiency of qi and yin, and tiredness and low energy, add 15g of Panax Ginseng, 15g of Astragalus Membranaceus.
6. Blood stasis, heat and phlegm obstruction
Symptoms of jaundice with deeper jaundice, which does not recede over the past few months, with mild self-consciousness and itchy skin, or with burning sensation, and small hemorrhage and petechiae after scratching, or distension of the right side of the liver. The liver is enlarged, with a slight feeling of fatigue, dryness of the mouth and throat, deep yellow urine, light or gray stool, dark red tongue, little moss, and a strong pulse.
The treatment is to clear away heat and dampness, remove blood stasis and eliminate phlegm.
The formula is Artemisia Inophyllata Tang with added flavor.
In Chen, money grass, red peony, danshen each 30g, gardenia, Citrus aurantium, rhubarb, yujin each 10g, Zhu Ru, the ground dragon each 12g, the whole piper betel 25g, Huanglian 6g.
Add and add phlegm is very bad, add the system of half-summertime 15g, 15g of bamboo lee; coercion rib pain is severe, add Yanhuisuo 15g, mudanpi 15g.
7. Cold and damp stasis
The symptoms of jaundice is deeper, more severe, the pulse is strong. p> Symptoms of deep jaundice, dark color, stagnation, skin itching, bleeding spots and petechiae after scratching, or discomfort in the right side of the body, cold limbs and cold, low food and epigastric plumpness, yellow and cold urine, pale or gray stools, pale tongue, white slippery texture, and a slow pulse.
The treatment is to warm the middle and strengthen the spleen to eliminate dampness.
The formula is to add and subtract Yin-Chen-Ju-Shi Tang.
The formula is 30g each of Yin Chen and Qian Cao, 10g each of Rhizoma Atractylodis Macrocephalae, Radix et Rhizoma Atractylodis Macrophyllae, Radix et Rhizoma Gentiana, 10g each of Rhizoma Atractylodis Macrophyllae and Radix et Rhizoma Polygalae, 25g each of Radix Paeoniae Alba and Radix et Rhizoma Salviae Miltiorrhizae, 15g each of Poria, and 6g of Radix et Rhizoma Glycyrrhizae.
Addition and subtraction: If the skin itching is severe, add 15g of Radix et Rhizoma Phellodendron, 15g of Rhizoma Atractylodis Macrophyllae; If the skin is very cold, add 15g of Cornus officinalis, 15g of Radix et Rhizoma Polygalae.
Symptoms of yellowish staining of the whole body, dark color, mental depression, cold limbs, weakness, loose stools, or complete grain, the whole body can be seen in the red silk, epistaxis, skin ecchymosis, or vomiting blood, or abdominal distension, the pulse is exposed, the tongue is pale, moss is thin, and the pulse is thin.
Treatment: warming the kidney and strengthening the spleen, promoting dampness and eliminating yellow.
The formula of Radix et Rhizoma Polygoni Multiflori Soup combined with Zhenwu Tang is added and subtracted.
In addition, if there are 30-60g of Yin Chen and Qian Cao, 15g of ginseng, Atractylodes macrocephala, Poria, Achyranthes bidentata, Ze Xie Diarrhea, and Daxing Pi, 10g of Radix Polygoni Multiflori and 10g of Radix Cinnamomi, and 6g of Radix et Rhizoma Glycyrrhizae Praeparata, the addition of 20g of Rhizoma Polygoni Multiflori and 20g of Radix Polygoni Multiflori is indicated if there are pain in the ribs and coats of arms and if there are enlargement of liver and spleen, and if the pain is very great when pressed.
Symptoms: Clearing heat and resolving dampness, detoxifying and eliminating yellow.
Prescription: Yin Chen Artemisia Tang combined with Ganlu Sterilizing Dan plus subtractions.
Yin Chen 60g, Scutellaria baicalensis, Huang Huanglian, gardenia 10g, forsythia 20g, Panax quinquefolium, plantain, Salvia miltiorrhiza 30g, Bamboos, Chrysanthemum, Acorus calamus, Mouton, Bei Mu, Sagittaria japonica, rhubarb, Citrus aurantium, 12g, talcum powder 15g.
Add and subtract fever does not go down, add goat's horns 15g; abdominal distension, urinary shortness, go to the Sagittaria japonica, mother of pearl, add Poria,
2. Poison into the camp blood
Symptoms of body heat at night, jaundice rapidly deepening, short and red urine, movement disorders, lethargy, or delirium, tremors of the hands and feet, vomiting, abdominal distension, epistaxis, subcutaneous petechiae, or can smell the "liver stench", the tongue is reddish-red, moss is yellow and dry, the pulse is thin and stringy. The tongue is reddish-red, the moss is yellow and dry, and the pulse is fine.
The treatment is to clear the camp, cool the blood and detoxify the toxin.
The formula is Rhinoceros Horn San plus subtractions.
Buffalo horn tip 30g, Yin Chen 30g, gardenia 20g, Huanglian 15g, ascending hemp 15g.
Addition and subtraction of faint delirium and delirium, plus service Angong Niuhuang Pill 1 pills; trembling hands and feet, plus goat's horns 15g, Croton 15g; frequent vomiting authors, go to the ascending hemp, plus Bamboo Root 15g, reed root 15g; vomiting epistaxis, plus Comfrey 15g, the living groundnut 15g, leucocephalos 15g; constipation or constipation of stools or the bowels of the body, add the blood and detoxification. 15g; for constipated or sticky stools, add 6g of rhubarb.
3. Epidemic internal closure
Symptoms: high fever that does not subside, severe jaundice, confusion, restlessness or frenzy, closed stools, abdominal distension like a bulge, smell of "liver stench", rapid narrowing of liver turbid boundary, vomiting epistaxis, red tongue, yellowish and dry black moss, thin and numb pulse. The pulse is fine and numb.
Treatment: detoxification and opening of the orifices.
The formula Angong Niuhuang Pill is used alternately with Zhi Baodan.
Add and subtract the two stools are not generic rhubarb 15g, Poria 20g, vervain 20g decoction retained enema; if you see thick and greasy tongue, then change to Calamus Tulip Gold Soup Plus Reduction (Yin Chen 30-60g, calamus, tulip gold, Huo Xiang, cardamom kernel 15g each, forsythia, moutanpi, gardenia, slippery stone, bamboo, chrysanthemums, each 10g, blended with 10g of bamboo leach, 10g of ginger juice, 9g of Yushu Dan),. Another service to the treasure Dan 1; if the jaundice does not go away for a long time, add danshen, zeilan, Tianji Huang each 15g.
4. Evil trapped in the positive off
Symptoms and symptoms of delirium tremens, shortness of breath, "liver stench" is difficult to smell, the face of the dirt and zygomatic red, sweating and viscous, incontinence of the two stools, or epistaxis, vomiting blood, abdominal distension, abdominal wall of the blue veins exposed, pale tongue and white, pulse rapidity, the tongue is pale and white, the pulse is rapid. The tongue is pale, the moss is white, and the pulse is rapid and stalked or slightly fine.
Treatment: Clearing away heat and removing toxins, supporting the uprightness and consolidating detachment.
The formula is to add and subtract ginseng and sorghum soup.
30g of ginseng, 15g of epiphyllum, 20g of atractylodes, 15g of dry ginger, 15g of mealybugs, 30g of chennai.
Add and subtract the above medicines should be thickly decocted, and frequently filled. If the tongue is dry and the mouth is parched, and the yin is exhausted and the yang is dead, the combination of Shengmingshan can be used.