Understanding alcoholic hepatitis

  According to incomplete statistics, the incidence of alcoholic liver disease is increasing year by year, and the degree of its pathology is proportional to the total amount of alcohol consumed. Alcoholic liver disease is an important type of alcoholic liver disease and fatty liver disease with insidious and high incidence, which can evolve into alcoholic hepatitis and even cirrhosis with continued development. From 2000 to 2004, the incidence of alcoholic liver disease accounted for 2.4%, 2.7%, 2.8%, 3.4% and 4.3% of other liver diseases in the same year; patients with alcoholic liver disease in China have serious liver damage, of which 28.8% are alcoholic hepatitis patients and 37.4% are alcoholic cirrhosis patients. Currently, there are limited treatments for alcoholic liver disease other than the “four-step comprehensive therapy”, so prevention is the main focus of alcoholic liver disease. This includes abstaining from drinking alcohol, improving nutrition, preventing liver damage, and stopping or reversing the progression of liver fibrosis. Experts recommend the following aspects of prevention and treatment in daily life: 1. Moderation of alcohol consumption: moderate alcohol consumption is good for health, but the key is to grasp the amount of alcohol consumed. Alcohol has a strong toxicity to liver cells, 95% of alcohol directly affects the metabolic function of protein and fat, thus reducing the detoxification capacity of the liver, leading to alcoholic fatty liver. Once the appearance of alcoholic liver no matter which phase belongs to the disease in the course of treatment and disease recovery, must be absolutely prohibited from drinking alcohol.  2, reasonable diet: should be more vegetarian, cereal-based, coarse and fine with, should be light, avoid greasy, rich in nutrients, easy to digest as the principle, more meals, avoid cold, sweet and greasy, spicy and hot and phlegm-assisted damp products. Eat more vegetables and fruits, often eat dairy, beans, light and less salt diet, and pay attention to the supplement containing vitamin B, C, K and folic acid more food, such as fresh fruits and vegetables. You can take polyene-phosphatidylcholine drugs to reduce the damage of alcohol to the liver through antioxidant effects; you can also take glycyrrhetinic acid preparations, silymarin, reduced glutathione and other drugs to improve liver function.  3, regulate the mood: for alcoholic liver or normal people, it is necessary to maintain a good psychological state, so as not to aggravate the disease due to psychological stress and mental factors, which will affect the whole recovery process of the disease and the treatment effect.  4, work and rest: for healthy people to pay attention to exercise, balance the body fat, timely and reasonable metabolism. For patients with alcoholic liver disease, they should pay attention to rest, so that they can live in moderation and work and rest in the right amount. In the recovery process should be based on the severity of the disease and the physical strength of different, choose the appropriate exercise methods.  5, early detection and early treatment: early detection and treatment of alcoholic patients can prevent the occurrence of alcoholic liver disease. Regular visits to the hospital for liver function as well as physical examination should be done, especially for people who have been drinking alcohol for a long time and have a history of liver or digestive system diseases.  6, the role of schisandra: adjuvant treatment of chemical liver injury. It can be used to treat alcoholic liver, alcoholism, fatty liver, and can be used for the prevention and maintenance of patients with regular alcohol consumption and liver disease.  Who drink alcohol is prone to alcoholic liver a. Patients with hypertension, cardiovascular and cerebrovascular disease: moderate drinking helps the circulation of blood, but too much may induce cardiovascular and cerebrovascular accidents. Alcohol can make the brain excited, emotional, vasodilatation, induce blood pressure, arrhythmia, accelerated heartbeat and other adverse symptoms, serious can cause vascular spasm, acute heart attack or vascular rupture, cerebral hemorrhage and even sudden death.  Second, liver disease patients: drinking too much alcohol hurts the liver the most. The liver is the body’s largest chemical plant, more than 95% of alcohol intake into the body through the liver metabolism. The normal human liver’s daily capacity to metabolize alcohol is about 1 gram per kilogram of body weight, a 60-kg person, the daily intake of alcohol should be limited to less than 60 grams. People with liver disease have poorer metabolic function of the liver itself than normal people, and if they drink alcohol in an uncontrolled manner, it can lead to aggravation of the disease or even accidents.  Third, patients with gastrointestinal diseases: excessive alcohol consumption, the damage to the body is multi-system, multi-organ, can cause indigestion, gastritis, gastric bleeding, alcoholic pancreatitis, pancreatic necrosis, etc.. Therefore, patients suffering from gastric ulcer, gastritis, enteritis, nephritis and other diseases should not drink alcohol, and people with hemorrhoids should not drink alcohol. If you must drink to the point, try to eat some dishes or food before drinking, do not drink on an empty stomach, both easy to get drunk, but also easy to hurt the stomach.  Fourth, diabetics: some studies have shown that there is a U-shaped relationship between alcohol consumption and diabetes, moderate drinking can reduce the onset of diabetes, excessive drinking will aggravate diabetes. Excessive alcohol consumption can cause disorders of glucose metabolism, leading to impaired pancreatic function, causing an increase in blood glucose concentration and aggravating the symptoms of diabetes. For people with diabetes, it is best to drink dry red wine without sugar, not strong white wine, not to drink on an empty stomach, and not to drink heavily. If it is really hard to be generous, you can add some plain water or mineral water to the wine to wash it down, thus reducing the alcohol and calorie content.  Five, snoring people: sleep snorers originally had a narrow upper airway, alcohol has a direct paralyzing and relaxing effect on the upper airway muscles when sleeping after drinking, then the original narrow upper airway will be repeatedly collapsed and blocked, and frequent sleep apnea will occur. Such people are prone to dry mouth after waking up due to lack of oxygen at night, drowsiness during the day, difficulty in concentration or memory loss; temper also becomes irritable and irritable, and symptoms such as increased blood pressure in the morning and increased urination at night, and the chance of hypertension, angina, arrhythmia, stroke and other cardiovascular and cerebrovascular events are greatly increased, which is the “sleep apnea syndrome” after drinking. This is the “sleep apnea syndrome”. In addition, after drinking a lot of alcohol, the brain becomes slow to wake up to asphyxia and hypoxia, and the asphyxia time is prolonged, especially in the second half of the night, which is more serious, and sudden sleep death may occur.  Preventive measures for alcoholic liver I. Strengthen health education Make full use of radio, television and movies and other propaganda media to vigorously carry out public health education and improve the quality of health for all people, especially health education for primary and secondary school students, college students and their parents light on the prevention of alcoholism should be strengthened to reduce alcoholism among young people.  Second, strengthen the training of medical personnel Hingson et al. surveyed 271 cases of alcoholics and found that only 70 cases (25.8%) actively sought medical attention and 201 cases (74.2%) did not. Among those 70 cases, only 31 (45%) were asked by doctors about their drinking history, 18 (25.7%) were advised to drink less or were informed about the dangers of alcohol consumption, and 2 (3%) were treated for alcoholism, indicating that medical personnel are not sufficiently aware of the seriousness of alcoholic liver disease and that there is an urgent need for them to be trained about the prevention and treatment of alcoholism.  Third, early detection and treatment Early detection and treatment of alcoholic patients can prevent the occurrence of the disease. At present, there are two methods to screen alcoholic patients: (a) In-person questioning or questionnaire screening: The most common method is the CAGE questionnaire survey, 1. Do you feel you need to reduce your drinking; 2. Do you feel offended by criticism of your drinking; 3. Do you feel guilty about your drinking; 4. Do you drink alcohol first thing every morning when you wake up. A positive answer of 1, 2 or more points for each question suggests a drinking-related disease. The sensitivity of this method is 75%-90%, and the specificity is 77%-96%. In addition, there are “two-question screening” and other in-person questioning screening methods, most of which are derived from CAGE.  (ii) Laboratory screening: an increase in mean red blood cell volume (MCV) combined with an increase in serum glutamyl transpeptidase (GGT) can confirm the diagnosis of 90% of alcoholics.  (i) Health warning labeling law; (ii) Increase in the price of alcoholic beverages; (iii) Increase in the legal drinking age; (iv) Prohibition of drunk driving law, etc.