Emphasis on standardized diagnosis and treatment of viral hepatitis

Overview of Viral Hepatitis Viral hepatitis is a group of systemic infectious diseases caused by a variety of hepatitis viruses, with liver damage as the main cause. According to the pathogenetic classification, there are 5 types identified, i.e., type A, B, C, D and E. From the epidemiological and prognostic point of view, basically can be divided into two categories, one including type A and type E, which is characterized by, mainly through fecal-oral transmission, often seasonal peaks, can cause outbreaks of epidemics, and generally do not change into chronic; the other category includes type B, C and D, which is characterized by, mainly through the bloodstream, no obvious seasonal, mostly disseminated, and is more likely to become chronic. Due to the promotion of planned immunization against hepatitis B vaccination, the number of children suffering from hepatitis B has decreased significantly in recent years in big cities and more developed areas, and the rate of children carrying hepatitis B virus is around 2%. Standardized Diagnosis of Viral Hepatitis The clinical manifestations of all types of viral hepatitis are similar, with fatigue, loss of appetite, anorexia, hepatomegaly, abnormal liver function, and jaundice in some cases, which manifests yellow urine and yellow eyes. Clinical diagnosis of viral hepatitis can be categorized into acute hepatitis, chronic hepatitis (mild, moderate, severe), severe hepatitis/hepatic failure, sludge hepatitis, and hepatitis cirrhosis. Susceptible persons infected with viral hepatitis should first go to the local infectious disease hospital or regular hospital infectious diseases department for a clear diagnosis, through the infectious disease specialist’s professional consultation and examination, the doctor will be based on the epidemiological data, clinical manifestations, laboratory and imaging tests to make clear whether the patient is suffering from viral hepatitis at the fastest possible speed, of which the most basic and important tests are liver function, hepatitis viral pathogenesis and ultrasound, which can facilitate the early treatment. Timely diagnosis is conducive to early treatment and early recovery. It is worthwhile to pay attention to the PCR method to detect HBVDNA is a molecular biology method, it is a special instrument will be a very small amount of HBV DNA expansion of millions of times, high sensitivity, but there are often false positives, can not be detected as the only basis for the diagnosis of hepatitis B HBVDNA positive. Such as HBVDNA quantitative unit 5 × 106copy / ml is the copy number / ml of the meaning of the copy number is the use of DNA signal amplification technology, by the computer to calculate the content of hepatitis B virus nucleic acid in the blood, copy number is a molecular biological quantitative unit, not a simple unit of quantity, can not be simply understood as the blood contains 5 million per milliliter of the hepatitis B virus, the copy number is high, only that the HBV nucleic acid content is high. Standardized treatment of viral hepatitis Patients with viral hepatitis should eat high protein (patients with hepatic coma should limit protein intake), low fat, high vitamin food, carbohydrate intake should be moderate, not too much, in order to avoid fatty liver. Avoid overeating during the recovery period. Absolute prohibition of alcohol, drinks containing alcohol, nutrients and drugs. In the early stage of acute hepatitis, hospitalization or local isolation treatment and bed rest should be provided; activities should be gradually increased in the recovery period, but overwork should be avoided to facilitate recovery. General treatment and symptomatic supportive therapy, jaundice patients should use anti-yellowing drugs, obvious symptoms and jaundice should be bed rest and should be hospitalized. Acute hepatitis C advocates the early use of interferon, the course of treatment for 24 to 48 weeks, and can be added with ribavirin at the same time, which is conducive to the early clearance of hepatitis C virus. During the recovery period, the amount of activity can be increased gradually, but overwork should be avoided. Work and study can be resumed after 1~3 months of normal liver function. Chronic hepatitis should be treated according to the specific conditions of patients, taking antiviral, adjusting immunity, protecting hepatocytes, improving liver function, anti-fibrosis and psychological and other therapeutic measures. Attention should be paid to individualized treatment. Commonly used drugs are glucose, vitamins, drugs to promote liver detoxification function for hepatic tylenol, reduced glutathione, hepatic le and thiopronin; to promote energy metabolism drugs for adenosine triphosphate, coenzyme A, compound phospholipase; yellow-reducing drugs for potassium magnesium menthylate, ursodeoxycholic acid, traditional Chinese medicines such as yinmai huang, bitter huang, danshen injections; enzyme-lowering drugs for schizandra chinensis, bifidobacterium bisabolate, bisabolol, psoralen, pituitary herb, Hepatitis Spirit, Bittersweet, Compound Sambucus Root Preparation, Glycyrrhizin, Glycyrrhizin, Compound Glycyrrhizic Acid Monoamine, and Silymarin, etc.; Modulation of body immunotherapy includes Thymosin (peptide); Antiviral drugs are α-interferon (regular or long acting), nucleoside analogs (such as Lamivudine, Atrifovir, Entecavir, and Tibivudine); Antihepatic Fibroblastic Drugs include Salvia miltiorrhiza, Cordyceps Sinensis, Kernel Extracts, and Gamma-interferon, colchicine, etc.; severe chronic hepatitis requires attention to the use of branched special therapies such as liver anamnesis, human serum albumin, and normal human fresh plasma. Antiviral therapy for chronic hepatitis B/C is the key to treatment, which can keep HBV DNA/HCV-RNA negative and alanine aminotransferase (ALT) normal, abort or reduce necroinflammation in the liver, prevent liver fibrosis and/or hepatic dysplasia from occurring, avoid the re-activation of ALT and the resulting hepatic dysplasia, prevent cirrhosis and/or hepatocellular hepatocellular carcinoma, and ultimately prolong the survival and long-term effects. prolonging survival long-term effects. It is worthwhile to pay attention to the fact that before using antiviral therapy, liver puncture biopsy, viral genotype and viral mutation should be performed, which is an excellent guide to predicting the efficacy of the treatment, the dosage of the drug and the course of the treatment, so as to achieve the target, and the drug should not be blindly administered based on the simple pathogenicity examination (e.g., hepatitis B two-half pairs, hepatitis C antibody). The principle of treatment of severe hepatitis/liver failure is based on comprehensive treatment with supportive and symptomatic therapies to promote hepatocyte regeneration and prevent and treat various complications. Specific treatment for basic therapy, thymosin (peptide) immunotherapy, hepatocyte growth promoter and prostaglandin E1 application, the prevention and treatment of complications of artificial liver support system application of sloughing hepatitis early treatment with acute jaundice hepatitis, can be added with S-adenosylmethionine, jaundice persists without receding, and there is no contraindication to adrenocorticotropic hormone can be used to try prednisone orally or intravenously dexamethasone, the need for gradual withdrawal of the drug. Hepatitis cirrhosis can refer to the treatment of chronic hepatitis and severe hepatitis, oral compound turtle shell soft liver tablets, Anluo Huafu Pill drugs, with hypersplenism or portal hypertension can be selected for intervention or surgical splenectomy treatment. In order to better standardize the diagnosis and treatment of viral hepatitis, it is necessary to do the following work: 1, conscientiously carry out and implement the “Infectious Disease Prevention and Control Act” promulgated in August 2004, and do a good job in admitting and treating viral hepatitis patients in hospitals, to prevent their cross-infection in the society. 2. Formulate whether treatment and health care programs for hepatitis B virus carriers, and set up a network system for hepatitis B virus carriers by local infectious disease hospitals. 3.Increase the professional review of liver disease advertisements, and the local medical associations should be responsible for the review. 4.Establish the access mechanism of liver disease specialists to eliminate the phenomenon of blind diagnosis and treatment of liver disease by some so-called liver disease specialists and charlatans. 5. Increase the popularization of liver disease knowledge and improve the health education knowledge of liver disease patients. 6. The treatment of liver disease by traditional Chinese medicine should follow the principles and methods of evidence-based medicine, and should not boast of its high therapeutic value.