Hepatitis

　　Hepatitis is inflammation of the liver, which can be caused by various factors such as viruses, bacteria, parasites, chemical toxins, drugs and toxins, immune factors, and alcohol. The pathogen invades the liver, causing liver cells to be destroyed and liver function to be damaged. The following is a specific introduction to the etiology of the disease:

　　1. Hepatitis viruses

　　Hepatitis A virus (HAV) is a small ribonucleic acid (RNA) virus with a non-enveloped icosahedral symmetrical spherical particle shape, with a diameter of 25-29nm, containing a single-stranded positive chain RNA genome; Hepatitis B virus (HBV) is a DNA virus composed of a 42nm envelope (HBsAg) and core (HBcAg), with the core consisting of DNA, DNA polymerase, HBcAg, and HBeAg; Hepatitis C virus (HCV) can be transmitted through blood; Hepatitis D virus (HDV) is a defective RNA virus with a diameter of 35-37nm, with an HBsAg envelope; Hepatitis E virus (HEV) is a new etiological agent of enterically transmitted hepatitis, previously known as enterically transmitted non-A, non-B hepatitis virus.

　　2. Alcohol

　　Alcohol has a significant toxic effect on the liver, and the extent of liver damage is proportional to the alcohol content, which can induce alcoholic hepatitis.

　　3. Taking liver-damaging drugs

　　Many drugs such as tetracycline, erythromycin, rifampicin, rifampin, methyldopa, diclofenac, sulfonamides, anesthetics, and others can exacerbate liver damage. Aspirin, paracetamol, and other drugs commonly used for antipyretic and analgesic purposes also have toxic effects on the liver.

　　4. Overdose of medication

　　Large doses of medication or long-term use of a certain medication can lead to the accumulation of medication, causing liver damage.

　　5. Poisoning

　　Pesticides, insecticides, rodenticides, chemical reagents, and other toxic substances may damage liver tissue and induce liver inflammation.

　　Long-term untreated hepatitis may also lead to the following diseases:

　　1. Hepatic diabetes

　　The clinical manifestations are similar to type 2 diabetes, because the liver's ability to inactivate insulin is reduced, which promotes the increase of insulin; in addition, the inactivation of glucagon in the liver is reduced, and the insulin receptors on liver cells are reduced, leading to resistance to insulin, so even though insulin levels are high, blood sugar remains high; at the same time, C-peptide is less affected by the liver, so C-peptide is not high.

　　2. Fatty liver

　　The mechanism of production is not yet clear, characterized by generally good condition, mild to moderate elevation of ALT, increased blood lipids, and fatty liver waveforms visible on B-ultrasound examination. Diagnosis is based on liver biopsy pathological examination.

　　3. Liver cirrhosis

　　The development of chronic hepatitis into liver cirrhosis is the result of liver fibrosis. The mechanism has not been fully elucidated. It is also seen in subacute, chronic severe hepatitis, and asymptomatic HBsAg carriers with insidious onset.

　　4. Liver cancer

　　HBV, HCV infection is closely related to the onset of the disease. It is common for patients with chronic active hepatitis and liver cirrhosis to develop liver cancer. It can also be seen in patients with chronic HBV infection that develop liver cancer without going through the stage of liver cirrhosis. The mechanism of occurrence is currently believed to be related to HBV-DNA integration, especially X gene integration. The transactivation of oncogenes by HBxAg plays an important role. In addition, carcinogens such as aflatoxins have a certain synergistic effect.

　　In the early stage of hepatitis, symptoms such as loss of appetite, poor digestion, bloating after eating, lack of hunger, aversion to greasy food, and nausea and vomiting after eating, and fatigue after activity may occur. Next, I will specifically introduce the common symptoms of this disease.

　　1. Loss of appetite

　　Loss of appetite is a common symptom in most hepatitis patients, especially in patients with jaundice hepatitis, which is more severe. Hepatitis patients have a large number of liver cells destroyed by hepatitis virus, which reduces the function of bile secretion, affecting the digestion of fats, hence the aversion to greasy food. During hepatitis, gastrointestinal congestion, edema, and reduced peristalsis affect the digestion and absorption of food. In addition, since the metabolic products cannot be detoxified by the liver, they stimulate the central nervous system, leading to loss of appetite, nausea, aversion to greasy food, and symptoms such as loss of appetite in acute viral hepatitis.

　　2. Fatigue and weakness

　　This is one of the early manifestations of hepatitis patients. Mild cases may not be active, while severe cases may be bedridden, even after sufficient rest, fatigue cannot be eliminated. The reason is that the patient has a loss of appetite, digestive and absorptive disorders, leading to insufficient energy in the human body; secondly, due to the liver cell damage caused by the virus, the liver produces and stores less glycogen; in addition, the lack of vitamins, electrolyte disorders, and the reduction of acetylcholinesterase in the blood caused by liver cell damage affect the normal function of nerves and muscles, resulting in an unexplainable general weakness.

　　3. Jaundice

　　Patients with jaundice hepatitis all have the symptom of yellow urine. Initially, the urine color is light yellow, deepening day by day, becoming as dark as tea or soybean oil; followed by yellowing of the skin and sclera. Normally, the lifespan of human red blood cells is 120 days, and the destroyed red blood cells release hemoglobin, which, after a series of transformations, is affected by the liver cell damage caused by hepatitis virus, affecting the metabolism of bilirubin, causing an increase in bilirubin in the blood, yellowing of the skin and sclera, and an increase in bilirubin excreted in urine compared to normal, hence the deepening of urine color.

　　4. Fever

　　Acute jaundice hepatitis is often accompanied by fever in the early stage, usually between 37.5~38.5 degrees Celsius, with rare cases of high fever, generally lasting for 3~5 days, while the fever in non-jaundice hepatitis is much lower than that in jaundice hepatitis. The cause of fever may be due to liver cell necrosis, liver dysfunction, reduced detoxification and excretion function, or sepsis caused by the virus.

　　5. Liver area distension and pain

　　Hepatitis patients often experience pain in the liver area, involving the upper right abdomen or right back, with varying degrees of pain, such as distension, dullness, or pricking pain, which worsens during activity and varies in duration; sometimes the pain is relieved when lying on the left side. The reason is that the hepatitis virus causes liver enlargement, increasing the tension of the liver capsule; inflammation involves the liver ligaments and surrounding tissues; in addition, the virus often affects the gallbladder and biliary tract during hepatitis, causing inflammation of the gallbladder and its surrounding tissues.

　　6. Spider angioma and liver palm symptoms

　　Spider angioma is a special type of capillary dilation, which often appears on the face, neck, and chest, and can also appear in other parts. It is characterized by small vascular tumors with a diameter of less than 2mm in the central part, extending many capillaries around it with branches, looking like a red spider lying on the skin. If the center is pressed with a pencil tip, the spider angioma will disappear because the blood flow of the spider angioma is from the center point to the peripheral capillary branches. If the center is pressed, the blood flow is blocked, and the spider angioma disappears due to ischemia. Liver palms refer to the appearance of patchy congestion or red spots and plaques on the skin of the hypothenar eminences of the thumb and little finger, or after pressure, they turn pale. Spider angioma and liver palms are important signs of chronic hepatitis and liver cirrhosis.

　　Hepatitis is a common infectious disease, and it is necessary to be vigilant, with early detection and early treatment.

　　1. Vaccine

　　Since hepatitis is a viral infectious disease, like other viral diseases, it can be prevented by vaccination. The hepatitis vaccines currently in use are for hepatitis A and B.

　　2. Abstain from alcohol

　　Alcohol can damage liver tissue, so to protect the liver, one must abstain from alcohol.

　　3. Low-fat diet

　　Fatty liver can affect liver function and often coexists with obesity and diabetes. To stay away from fatty liver, it is necessary to start with dietary regulation. Controlling fat intake is essential, but the total amount of sugary foods should also be controlled, including rice and noodles, because excessive sugary foods can also be converted into fat in the human body.

　　4. Avoid contact with pathogens

　　Hepatitis A and E are transmitted through the digestive tract, so preventive measures should focus on dietary hygiene, washing hands before and after meals, not drinking unboiled water, and not eating raw aquatic products. Hepatitis B and C are transmitted through blood, so it is advisable to avoid blood transfusions and the use of blood products such as albumin and globulin. In family life, if there is a hepatitis B or C virus感染者 in the family, it is also important to avoid contact with blood.

　　Hepatitis is a general term for liver inflammation, which can be caused by various factors such as viruses, bacteria, and parasites. Generally, the following examinations are required for this disease:

　　1. Blood routine

　　The total white blood cell count in the early stage of acute hepatitis is normal or slightly elevated, generally not exceeding 10×10^9/L. During the jaundice period, the total white blood cell count is normal or slightly low, with an increase in lymphocytes and occasionally atypical lymphocytes. In severe hepatitis, the white blood cell count may rise, with a decrease in red blood cells and hemoglobin. Hepatitis cirrhosis with hypersplenism may have the 'three less' phenomenon of decreased platelets, red blood cells, and white blood cells.

　　二、尿常规

　　尿胆红素和尿胆原的检测是早期发现肝炎的简易有效方法，同时有助于黄疸的鉴别诊断。肝细胞性黄疸时两者均阳性，溶血性黄疸时以原为主，梗阻性黄疸以尿胆红素为主。深度黄疸或发热患者，尿中除胆红素阳性外，还可出现蛋白质、红、白细胞或管型。

　　三、肝功能检查

　　1、血清酶测定

　　(1)丙氨酸氨酶：反映肝细胞功能的最常用指标。ALT在肝细胞损伤时释放入血流。血清ALT升高，对肝病诊断的特异性比天冬氨酸氨酶(AST)高，因为其他脏器中ALT含量比AST低得多。重型肝炎患者可出现ALT快速下降，胆红素不断酶升高、胆分离现象，提示肝细胞大量坏死。

　　(2)天冬氨酸转氨酶：在肝病时，血清AST升高与肝病严重程度呈正相关。急性肝炎时如果AST持续在高水平，有转为慢性肝炎的可能。

　　(3)乳酸脱氢酶(LDH)：肝病时可显著升高，但肌病时亦可升高，须配合临床加以鉴别。

　　(4)Y谷氨酰胎酶(Y―GT)：肝炎和肝癌患者可显著升高，在胆管阻塞的情况下更明显，YGT活性变化与肝病病理改变有良好的一致性。

　　(5)胆碱酯酶：由肝细胞合成，其活性降低提示肝细胞已有较明显损伤，其值愈低，提示病情愈重。

　　(6)碱性磷酸酶：当肝内或肝外胆汁排泄受阻时，组织表达的ALP不能排出体而回流入血，导致血清ALP活性升高。

　　2、血清蛋白

　　主要由白蛋白、α1、α2、β及Y球蛋白组成。在急性肝炎时，血清蛋白质和量可在正常范围内。慢性肝炎中度以上、肝硬化、重型肝炎时出现白蛋白下降，Y球蛋白升高，白/球(A/G)比例下降甚至倒置。

　　3、胆红素

　　急性或慢性黄疸型肝炎时血清胆红素升高，活动性肝硬化亦可升高且消退缓慢，重型肝炎常超过171vmol/L。一般情况下，肝损程度与胆红素含量呈正相关。直接胆红素在总胆红素中的比例尚可反映淤胆程度。

　　4、凝血酶原活动度(PTA)

　　PTA高低与肝损程度成反比。

　　肝病患者在日常生活中应该多注意饮食，宜以清淡为主且合理搭配，粗细搭配合理膳食，遵循肝病调理的方式方法。接下来给大家推荐几种有助于缓解肝炎的食物，患者不妨一试。

　　1、牛奶

　　含优质蛋白质、人体易吸收的乳糖与乳脂、多种维生素、丰富的钙与磷及多种微量元素，是肝炎患者理想的天然美食。

　　2、鱼类

　　其蛋白质与人体的蛋白质结构相似，易于消化和吸收。

　　3. Honey and Bee Milk

　　It is mainly composed of glucose and fructose, which can be directly absorbed by the human body. It also contains a variety of inorganic salts and trace elements, which are easily absorbed and have high utilization rates.

　　4. Eggs

　　The yolk contains a wealth of fat, including neutral fat, lecithin, and cholesterol. Hepatitis patients can consume eggs reasonably, with no more than 2 per day being recommended.

　　5. Mushrooms

　　Rich in amino acids and vitamins, it also has antibacterial, anticancer effects and the function of invigorating the spleen and stomach.

　　6. Eat more vegetables and fruits

　　Vegetables and fruits can provide sufficient vitamins and fiber, and also help promote digestive function.

　　7. Cordyceps sinensis

　　Cordyceps sinensis can improve and restore liver function. In recent years, the clinical use of Cordyceps sinensis has shown certain effects on improving liver function. According to research, cordycepin and cordyceps polysaccharides can enhance the phagocytic function of liver cells, cordycepic acid, SOD, and vitamin E can prevent liver tissue fibrosis, anti-lipid peroxidation, and at the same time, due to the enhanced immune function of Cordyceps, the detoxifying function of the liver is enhanced, thus effectively protecting liver cells.

　　There are many types of hepatitis, and treatment needs to be based on the specific type. The following are some basic principles for treating hepatitis, which patients should refer to.

　　1. Antiviral treatment

　　In China, the hepatitis B virus (HBV) is an important pathogen of chronic severe hepatitis. Antiviral treatment will help control the condition. The treatment method for early acute hepatitis is the application of interferon, which is administered subcutaneously or intramuscularly.

　　2. Immunoregulatory therapy

　　Including immunosuppressants and immunostimulants.

　　3. Treatment for intestinal toxins

　　During severe hepatitis, there is a disorder of intestinal flora, which is the main mechanism for the production of endotoxins. Therefore, it is very important to apply microecological preparations or lactulose to regulate intestinal flora, reduce the absorption of blood ammonia and other toxins, and prevent complications such as infection.

　　4. Anti-inflammatory, antioxidant, protect liver cells, promote regeneration

　　Glycyrrhizin preparations have a relatively clear anti-inflammatory effect and are now routine drugs for hepatitis treatment. After application, they can reduce liver cell inflammation and necrosis, which is conducive to controlling the condition.

　　5. Symptomatic Treatment

　　Patients with nausea, aversion to oil, and vomiting should be treated with glucose and vitamin C, vitamin B.