Cholestatic hepatitis

　　Cholestatic hepatitis is caused by various reasons leading to bile secretion disorders in liver cells and/or capillary bile ducts, resulting in partial or complete bile flow obstruction. It often occurs several weeks after the onset of acute hepatitis. Cholestatic jaundice is common in autoimmune hepatitis (cholestatic type), primary biliary cirrhosis, primary sclerosing cholangitis, drug-induced hepatitis, and viral cholestatic hepatitis.

　　Cholestatic hepatitis can lead to liver cirrhosis and liver cancer, posing a serious threat to patients' health and even their lives. Therefore, once the symptoms are detected, timely treatment and active prevention of complications are essential.

　　1. The symptoms are mild while jaundice is deep:Since the liver cell necrosis in cholestatic hepatitis is not severe, and cholestasis is the main symptom, the symptoms are relatively mild, and jaundice can be very deep.

　　2. Deeply yellow urine and light-colored feces:Due to inflammation in the biliary tract system, obstruction occurs, reducing the bile components excreted into the intestines, so the color of the feces is light, resembling clay color, hence the name 'clay-colored feces'. The stasis of bilirubin reverses into the blood, and is excreted by urine, so the urine color is extremely deep.

　　3. Signs and symptoms of cholestatic hepatitis:It is liver enlargement, with an unengorged gallbladder. This is due to liver enlargement caused by cholestasis, and the unobstructed bile excretion leads to an empty gallbladder without bile. The liver enlargement results in increased tension of the capsule, so there is tenderness in the liver area; the stimulation of bile salts causes skin itching.

　　1. Treat acute hepatitis or other liver diseases actively.

　　2. Have a reasonable diet, increase protein supply, ensure vitamin supply. Ensure an adequate supply of fluids. Increase the intake of fresh vegetables and fruits.

　　3. Abstain from alcohol abuse. Avoid excessive diet, especially too much meat and sugars. Be cautious with spicy and other刺激性 foods.

　　1. Cholestatic type:The laboratory examination of hepatitis shows the 'six highs' phenomenon: It is manifested as an increase in serum total bilirubin, mainly due to an increase in conjugated bilirubin (direct bilirubin) (〉70%); alkaline phosphatase (ALP) increases; γ-glutamyl transpeptidase (1-GT) increases; cholesterol (cH) increases; bile acid (TBA) increases; β-globulin increases.

　　2. Cholestatic type:The pathological examination of hepatitis shows microbile duct cholestasis, with obvious bile duct hyperplasia. Under the electron microscope, there is dilation of the capillary bile ducts, formation of bile thrombi in the capillary bile ducts, and pathological changes in microvilli, while liver cell necrosis is not prominent.

　　First, food therapy formula

　　1. Corn Silk and Yin Chen Decoction

　　Add corn silk, Yin Chen, and plantain seed to water, decoct and remove the residue, add an appropriate amount of sugar, take 200ml each time, 3-5 times a day. It is used for cholestatic hepatitis.

　　2. Anti-inflammatory and choleretic tea

　　Add corn silk, dandelion, and Yin Chen to 1000 grams of water, decoct and remove the residue, add an appropriate amount of sugar. Take it warm. Take 3 times a day, 250 grams each time. It has the effects of diuresis, choleretic,清热消炎, and stomachic choleretic.

　　3. Yin Chen Porridge

　　Yin Chen, add water, extract the juice, add glutinous rice, add water, cook until the rice is soft and the soup is thick, add a little sugar, and boil for one more boil. Take 2-3 times a day, 7-10 days as a course of treatment. It is used to treat patients with yellowish body and eyes, yellow urine like strong black tea, nausea, fatigue, red tongue with thick yellow greasy fur.

　　Second, dietary principles

　　1. To promote the repair and regeneration of liver cells, an increased supply of protein should be provided, which should generally account for 15% of total energy intake. It is especially important to ensure a certain amount of high-quality protein, such as animal protein and soy products.

　　2. Ensure the supply of vitamins. B vitamins such as vitamin B1, B2, niacin, and vitamin C play an important role in improving symptoms. In addition to choosing foods rich in these vitamins, it is also possible to take a variety of vitamin preparations orally.

　　3. Ensure an adequate supply of fluids. Drinking more juice, rice gruel, honey water, watermelon juice, and other beverages can accelerate the excretion of toxins and ensure the normal metabolic function of the liver.

　　4. Increase the intake of fresh vegetables and fruits.

　　5. Abstain from excessive alcohol consumption. The main component of alcohol is ethanol, which can be converted into aldehydes in the liver, which have a direct damaging effect on the liver and can cause liver cells to undergo变性 and necrosis. Hepatitis B patients already have liver cell damage, and drinking alcohol further worsens the condition, promoting the progression of the disease towards cirrhosis and even liver cancer.

　　6. Abstain from excessive dietary intake, especially excessive meat and sugar intake. Excessive intake of meat and sugar can convert excess protein and sugar into fat and store it, with the liver being an important storage point. Over time, obesity will inevitably form fatty liver, increasing the burden on the diseased liver and promoting the恶化 of hepatitis B. Hepatitis B patients should arrange a diversified and balanced diet, especially control their weight, eat less animal fat, fried food, salted meat, whole milk, etc.

　　1. Ursodeoxycholic Acid:Relieve symptoms such as fatigue, diarrhea, and itching in patients, can maintain cell membrane stability, reduce liver cell inflammation, improve liver function, increase capillary carbonic acid secretion, promote bile secretion, increase bile flow, and promote the disappearance of jaundice. Take 500mg daily, in divided doses, with no significant toxic side effects. Recently, some people have proposed that UDCA can be used as an adjuvant treatment drug for chronic hepatitis C with IFN treatment.

　　2. Phenobarbital:As an enzyme inducer, it can induce the production of Y protein, enhance its activity, promote the conversion of bilirubin from non-conjugated to conjugated, increase the enzyme activity of the smooth endoplasmic reticulum of liver cells and the activity of Na-K-ATPase on the bile capillary membrane, promote bile acid secretion, increase bile flow, and thus promote bile and jaundice. Take 90 to 180mg daily, in divided doses. This drug has certain liver damage, and those with significant liver function changes should use it with caution. There may be side effects such as fatigue, drowsiness, and rash, which should be observed.

　　3. Adrenal Cortical Hormones:It has a non-specific anti-inflammatory effect, can increase bile flow, promote bile excretion, and thus has a jaundice-reducing effect. The dosage is prednisolone 40mg daily, and the drug is gradually reduced and stopped after 5 to 7 days, with a course of about 1 month. Pay close attention to the occurrence of adverse reactions and use with caution.