Study on the intervention effect of beneficial Qi, cooling blood and detoxifying herbs on the variation of hepatitis B virus Subject Description: Study on the intervention effect of beneficial Qi, cooling blood and detoxifying herbs on the variation of hepatitis B virus Hepatitis B, a daunting name. Chronic viral hepatitis B is a common disease that seriously endangers human health, and China is a high incidence area of viral hepatitis with an average incidence of 120-140/100,000. Among them, hepatitis B is particularly prominent. China’s hepatitis B virus infection rate is as high as 57.63%, that is, at least 600 million people have been infected with this virus. The rate of hepatitis B surface antigen positivity is nearly 10%, about 130 million people, about 1/4 of them will develop chronic liver disease, some patients can develop liver cirrhosis, and even evolve into liver cancer. It is understood that patients with this disease often develop clinical changes of heavy hepatitis, and individual patients will develop fat metabolism disorders in the late stage of disease and recovery. At present, there are about 30 million patients with chronic viral hepatitis B. Every year, 237,000 people die from hepatitis B-related diseases, and 156,000 of them die from liver cancer. Therefore, it is especially necessary to strengthen the prevention and treatment of chronic viral hepatitis B. Why is it difficult to treat hepatitis B The currently applied anti-hepatitis virus drugs are first of all only a virus inhibiting drug, not a virus clearing drug, and to achieve complete clearance, it must rely on the body’s immune response. At the same time, viral mutation and drug resistance are difficult to avoid. There is another issue worthy of attention, the application of antiviral drugs must grasp the indications, in chronic hepatitis B patients to consider the patient’s immune status, if the patient is in the immune clearance period, the effect may be better, in addition to active cirrhosis, cirrhosis decompensation virus in the replication state, as well as organ transplant patients, or other patients using immunosuppressive drugs, it is more suitable for the application of nucleoside In addition, nucleoside antiviral drugs are more suitable for patients with active cirrhosis, cirrhosis in a replication state, organ transplant patients, or other patients using immunosuppressive drugs, while pregnancy and children should be strictly controlled indications, closely observed applications, and selected carefully. In the application of antiviral drugs, the long-term efficacy of the drug application can be predicted based on the short-term efficacy of the application, and if the short-term efficacy is poor, it should be discontinued or replaced as soon as possible. Xu Chunjun reminded that there are a considerable number of patients whose application effect is not very satisfactory. For the application of antiviral drugs must pay attention to the indications, long-term dosing, special patient applications, determine the efficacy of the application and drug resistance issues, etc., Xu Chunjun and his group carried out a study on the intervention of beneficial Qi and cool blood detoxification class of Chinese medicine on hepatitis B virus mutation, and initially proved that Chinese medicine can significantly improve the clinical symptoms and laboratory indicators of patients with chronic viral hepatitis B, which is worth further in-depth discussion. Expert review: Chronic viral hepatitis B is a major infectious disease that seriously affects people’s health and life in China. It is believed that the ideal endpoint of antiviral therapy is the disappearance of hepatitis B surface antigen or serological conversion and HBV clearance, but it is often difficult to achieve, and there is no reliable therapeutic endpoint for current antiviral drugs, especially nucleoside analogues, and the hepatitis B virus is prone to multiple mutations. Therefore, strengthening the prevention of chronic viral hepatitis B and optimizing treatment regimens is a major issue that needs to be addressed. It is imperative to expand the ideas and means of Chinese medicine in the diagnosis and treatment of chronic viral hepatitis B series of pathological processes, and to bring into play the strengths of Chinese medicine to improve the efficacy. There is a famous saying in Huainanzi: “A good doctor always treats the disease without disease, so there is no disease; a sage always treats the disease without disease, so there is no disease.” “Treating the untreated disease” is an important prevention and treatment idea in Chinese medicine. The “cure” here does not simply refer to medical treatment, but also contains management, organization, governance, research and other content. To “cure the disease before it happens” means to take measures in advance to prevent the occurrence and development of diseases. Its meaning can be understood at three levels: “Preventing diseases before they occur,” “Preventing microscopic diseases and preventing gradual changes,” and “Preventing both diseases and changes. This requires people to prevent diseases in general, to pay attention to prevent minor diseases from becoming major ones, and to prevent further deterioration of diseases when they come, so as to take the initiative of health. In their research on the intervention effect of Chinese medicine on the mutation of hepatitis B virus, they have adhered to the concept of “prevention of mutation from both diseases” and responded to all changes with no change. We know that viruses are always mutating, especially under the effect of drugs, they are more resistant. Humans can go to the sky and the earth, but the common cold has always troubled us, which is the trouble of a hundred different viruses. The multi-targeted action of Chinese medicine can reduce the possibility of virus mutation, and at the same time, the regulation of autoimmunity by Chinese medicine can help to improve the patient’s constitution and prevent the aggravation of the disease. Chronic viral hepatitis is mostly classified in Chinese medicine as “jaundice”, “dysesthesia”, “accumulation”, “bulging” and “tumor”. “depression”, “deficiency labor” and other categories. The Committee of Hepatobiliary Diseases in Internal Medicine of the Chinese Society of Traditional Chinese Medicine has suggested that the Chinese medical name for viral hepatitis should be “liver fever”. They randomly assigned 138 patients to three different treatment groups in a 1:1:1 ratio according to a random number table, and the basic conditions and liver function before treatment were comparable among the three groups. In the combination group, oral heprotinin 100 mg/day was administered, plus Chinese herbal medicine to benefit the Qi and cool the blood and detoxify the toxin; in the Chinese herbal medicine group, Chinese herbal medicine to benefit the Qi and cool the blood and detoxify the toxin was applied alone; in the western medicine group, heprotinin 100 mg/day was administered orally. The duration of treatment was 12 months in all cases. The results showed that there were 12 cases of viral mutations in the western medicine group and 5 cases in the combined group, all of which appeared 12 months after the drug administration. It showed that the herbal medicine of benefitting Qi, cooling Blood and detoxifying blood had good intervention effect on lamivudine-induced hepatitis B virus mutation, which was not significantly different from the conventional antiviral western medicine. Expert comment: According to a conservative estimate, the intervened patients treated with TCM alone or combined Chinese and Western medicine account for 30%-40% of all patients at present, and occupy a very important position in treatment. Looking back at the development of traditional medicine, every major breakthrough in theory and identification system has heralded a leap in the theory-guided practice of Chinese medicine, which in turn has promoted the development of Chinese medicine. Chinese medicine’s thinking on liver treatment has been described in great detail from the “Inner Path” to the present day in terms of the etiology, diagnosis and treatment of jaundice, bulging, and dysmenorrhea that occur in liver disease, and it has been applied clinically in a proven manner that is very much in line with clinical needs. Complementary Chinese and Western is the right way to go “No treatment is perfect, and all have its advantages and shortcomings.” Xu Chunjun said that we must not overemphasize the role of TCM, nor can we completely deny the role of TCM. In the process of using TCM treatment, we should pay particular attention to the universality of clinical diseases, but also take into account the specificity of the patient, although there is the “effect does not change the formula”, but also to specifically analyze the relationship between the identification of supporting the positive and eliminating the evil. We firmly abandon the principle of using the same medicine, and adhere to the principle of adapting to the situation according to the person. It is a big misconception in clinical practice to emphasize the identification of disease and ignore the essence of identification in TCM. There are many kinds of proprietary Chinese medicines, and the instructions of each medicine indicate the main evidence of Chinese medicine and the types of diseases in modern medicine, and the correct application method should be the combination of disease and evidence. Hepatitis B is not scary, what’s scary is to have a disease and seek medical help. Choose the right treatment method to stay away from the disease. Expert comments: Traditional Chinese medicine has a long history of several thousand years, and clinical practice has confirmed that it is conclusive and effective in the treatment, prevention and health care. The treatment of diseases in TCM is macroscopic and comprehensive, and its formation and development process is very different from the way of thinking and research methods of modern Western medicine. In recent years, some scholars believe that TCM has failed to keep up with the development of advanced science and technology, and the diagnosis and clinical efficacy of the four diagnostic methods of TCM still lack conclusive scientific experimental basis. Therefore, the inheritance and development of traditional Chinese medicine is the current theme. The development of traditional Chinese medicine has become the trend of development of traditional Chinese medicine, combining Chinese and Western medicine and facing the contemporary era. According to the pathogenesis of Chinese medicine, the cause of viral hepatitis B is twofold: internal because of the deficiency of positive qi, which is the essence of the disease, and external because of the invasion of dampness, heat and epidemic toxin, which is an important condition of the disease; the pathogenesis is complicated, firstly, because of the unique pathogenic characteristics of the evil of dampness, heat and epidemic toxin, such as dampness is heavy, lingering and difficult to heal, as well as the failure to treat acute hepatitis, mistreatment, the depletion of positive qi over time, and the dysfunction of the internal organs of the body. Many factors make the disease chronic in some patients. Damp-heat and epidemic toxin in the blood, blood stasis and phlegm, and deficiency of both qi and yin are the main pathogenesis of liver cirrhosis in hepatitis B. Damp-heat and epidemic toxin in the blood and diffusion of the three jiao can lead to chronic heavy hepatitis, and damp-heat and epidemic toxin, phlegm stasis and blockage, and local yin and yang are the internal mechanisms of liver cancer formation. In the whole process of disease development, the deficiency of positive energy is always present. The internal organs of the disease involve the liver, spleen and kidney. In the acute stage, dampness, heat and epidemic toxicity are the main causes; in the chronic stage, imbalance of qi and blood is the main cause; in the advanced stage, deficiency of positive qi is the main cause. Therefore, benefiting Qi and cooling Blood to detoxify is the main treatment for this disease. According to modern pharmacological research, the herbs of Qi benefit, such as Astragalus membranaceus and Radix et Rhizoma prince ginseng, have significantly enhanced cellular and humoral immunity and enhanced phagocytosis of the reticuloendothelial system, while the drugs of Blood cooling and detoxification, Radix Paeoniae and Radix et Rhizoma bitter ginseng, have significantly inhibited the immune response. The combination of the two can maintain a coordinated immune regulation, enhance the body’s immune surveillance, prevent the production of viral mutations and can protect liver cells.