Chronic Hepatitis

Chronic hepatitis refers to inflammation and necrosis of liver tissue caused by various factors and lasting for at least 6 months. It encompasses a group of diseases with different causes, symptoms, treatments, and prognoses, but all are characterized by recurrent fluctuations in liver function and varying degrees of inflammation and necrosis in liver tissue. Fibrosis of varying severity is also often present, and the condition may progress to cirrhosis.

TCM Pattern Identification and Treatment Reference

|Common Symptoms

Technical description:

Distending pain in the hypochondrium, low mood and irritability, fatigue and weakness, abdominal distension and loose stools, pale tongue with teeth marks

In plain language:

  • A feeling of distension and pain on both sides below the ribs, which may worsen with movement or pressure. The discomfort may vary in intensity but persist over time.
  • Feeling low, irritable, or emotionally pent up, with low energy and a tendency to be easily affected.
  • Feeling tired and weak, tiring easily during activities and gaining only limited relief from rest.
  • Abdominal fullness and discomfort, along with loose, poorly formed stools and a feeling of incomplete bowel movements.
  • The tongue appears pale, with tooth marks along its edges.

|Treatment Approach

Technical description:

Soothe the liver and strengthen the spleen

In plain language:

  • Help restore the smooth flow of Liver Qi, which may ease chest and rib-side fullness and discomfort, low mood, or irritability.
  • Support the Spleen’s digestive functions, which may help with poor appetite, abdominal distension, loose stools, or fatigue.
  • Promote coordination between the Liver and Spleen and the smooth circulation of qi and blood, with the aim of gradually improving overall energy and physical stamina.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Xiaoyao San

|Common Symptoms

Technical description:

Distending pain in the hypochondrium, dizziness, poor appetite, low mood, wiry pulse

In plain language:

  • A feeling of distension and pain on both sides below the ribs, which may worsen with movement or pressure and vary in intensity.
  • Feeling dizzy or lightheaded, with vision that seems unsteady, especially when standing up or walking.
  • Poor appetite and little desire to eat, even when food is available.
  • Feeling emotionally low and uncomfortable, and easily troubled by one’s emotions.
  • The pulse feels taut and straight under the fingers, like a tightly stretched string.

|Treatment Approach

Technical description:

Soothe the liver and regulate qi

In plain language:

  • Help restore the smooth flow of Liver Qi, which may ease chest tightness, distension beneath the ribs, or low mood.
  • Regulate qi to support digestion and help with poor appetite, belching, or abdominal discomfort.
  • Promote the smooth movement of qi and blood, with the aim of helping the mind and body feel more at ease.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

|Common Symptoms

Technical description:

Dull pain in the hypochondrium, soreness and weakness in the lower back and knees, dizziness, vexing heat in the palms, soles, and chest, red tongue with scant fluids, thin and rapid pulse

In plain language:

  • A dull, persistent ache on both sides below the ribs, often in a relatively fixed area and more uncomfortable with movement or pressure.
  • Soreness and weakness in the lower back and knees, with a feeling of reduced strength when walking or sitting for a long time.
  • Feeling dizzy or lightheaded, with vision that seems unsteady, especially when standing or walking.
  • Heat in the palms, soles, and chest, with restlessness and occasional sensations of internal heat.
  • The tongue appears red, with less moisture on its surface and a slightly dry appearance.
  • The pulse is thin and fast, feeling small and rapid under the fingers.

|Treatment Approach

Technical description:

Tonify and nourish the Liver and Kidneys

In plain language:

  • Support the functions of the Liver and Kidneys, with the aim of easing dizziness, tinnitus, soreness and weakness in the lower back and knees, or low energy.
  • Nourish Liver and Kidney essence and blood, with the aim of supporting steadier energy, clearer vision, and greater physical strength.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

|Common Symptoms

Technical description:

Aversion to cold and cold extremities, fatigue and a weak pulse, cold pain in the lower abdomen, lower back, and knees, poor appetite and loose stools or early-morning diarrhea, edema of the lower limbs

In plain language:

  • Feeling unusually sensitive to cold, with cold hands and feet that are slow to warm up; exposure to cold may worsen the discomfort.
  • Becoming tired easily, with a pulse that feels weak under the fingers.
  • A feeling of cold and pain in the lower abdomen, lower back, and knees, especially with activity or prolonged sitting.
  • Poor appetite and loose, poorly formed stools; diarrhea may occur on getting up in the morning.
  • Swelling in the lower legs or other parts of the lower limbs, with an indentation that remains for a while after pressure.

|Treatment Approach

Technical description:

Strengthen the Spleen and tonify the Kidneys

In plain language:

  • Support Spleen function and strengthen Spleen Qi, with the aim of easing poor appetite, abdominal distension, loose stools, or fatigue and weakness.
  • Support Kidney Qi and strengthen the body’s foundation, with the aim of easing soreness and weakness in the lower back and knees, sensitivity to cold, cold extremities, or fatigue.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Jinkui Shenqi Wan
Yougui Wan

|Common Symptoms

Technical description:

Dull or dusky complexion, or fine red thread-like vessels on the skin; stabbing pain in both sides beneath the ribs; spider angiomas; palmar erythema; enlarged liver and spleen with a firm consistency; dark tongue or purple spots

In plain language:

  • The complexion looks dull or dark, or fine, thread-like red blood vessels may be visible on the skin.
  • Stabbing pain may occur on both sides beneath the ribs, often in a relatively fixed area and more uncomfortable with pressure.
  • Small, spider-like red marks may appear on the skin, with a central spot and fine lines radiating outward.
  • The palms, particularly the thenar and hypothenar areas, appear redder than the surrounding skin.
  • The liver or spleen may be enlarged and feel firm; there may be a sense of fullness or discomfort with pressure.
  • The tongue appears dark, or small purplish spots or patches may be visible.

|Treatment Approach

Technical description:

Dispel blood stasis and unblock the collaterals

In plain language:

  • Disperse stagnant blood, with the aim of gradually easing bluish discoloration, lumps, or stabbing pain.
  • Unblock the channels and collaterals to support the smooth flow of qi and blood and help with numbness, pain, or restricted movement.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Xuefu Zhuyu Tang

|Common Symptoms

Technical description:

Yellowing of the body and eyes with a bright hue, nausea, aversion to greasy foods, poor appetite, distension beneath the ribs and epigastric oppression, dark yellow urine, yellow greasy tongue coating

In plain language:

  • The skin and whites of the eyes look yellow, with a noticeably bright hue.
  • Feeling nauseated, with stomach discomfort and an urge to vomit.
  • Disliking greasy foods and finding them unpalatable.
  • Poor appetite, little interest in food, and reduced food intake.
  • Distension and discomfort beneath the ribs, with a stuffy, oppressive feeling in the upper abdomen.
  • Urine appears yellow and dark rather than clear.
  • The tongue is coated with a thick, yellow, greasy-looking coating.

|Treatment Approach

Technical description:

Clear heat and drain dampness

In plain language:

  • Clear internal heat, with the aim of easing fever, restlessness, or throat discomfort.
  • Help drain excess dampness, with the aim of easing a heavy feeling in the body, poor appetite, or difficulty urinating.
  • Address heat and dampness together, with the aim of helping the body feel more comfortable.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

|Common Symptoms

Technical description:

Yellowing of the body and eyes with a bright hue, epigastric oppression and abdominal distension, dark yellow or reddish urine, yellow greasy tongue coating

In plain language:

  • The skin and whites of the eyes look yellow, with yellowing visible over the body.
  • The yellow discoloration is bright and readily noticeable.
  • The upper abdomen feels stuffy and uncomfortable, with a sensation of fullness.
  • Urine appears yellow to reddish and dark rather than clear.
  • The tongue is coated with a thick, yellow, greasy-looking coating.

|Treatment Approach

Technical description:

Clear and drain damp-heat from the Liver and Gallbladder

In plain language:

  • Clear heat in the Liver and Gallbladder, with the aim of easing a bitter taste in the mouth, restlessness, or red eyes.
  • Help drain dampness in the Liver and Gallbladder, with the aim of easing a heavy feeling in the body, poor appetite, or difficulty passing stools.
  • Promote the smooth flow of Liver and Gallbladder qi, with the aim of supporting overall comfort.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

|Common Symptoms

Technical description:

Yellowing of the body and eyes with a dull hue, no thirst and a bland taste in the mouth, pale tongue with a greasy coating, soggy and moderate or deep and slow pulse

In plain language:

  • The skin and whites of the eyes look yellow.
  • The yellow discoloration looks dull and dark rather than bright.
  • The mouth has a bland taste, and there is no thirst or desire to drink much water.
  • The tongue appears pale, with a thick, greasy-looking coating.
  • The pulse feels soft and slow, or deep and slow, and may be clearer only when pressed more firmly.

|Treatment Approach

Technical description:

Warm and transform cold-dampness

In plain language:

  • Warm and disperse internal cold, with the aim of easing sensitivity to cold, cold limbs, or cold abdominal pain.
  • Address dampness, with the aim of easing heaviness, dizziness, or loose stools.
  • Regulate qi and support the body’s transforming and transporting functions, with the aim of helping the body feel more comfortable and energetic.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Yinchen Wuling San

|Common Symptoms

Technical description:

Sudden onset, rapidly worsening jaundice with a golden-yellow hue, dark yellow or reddish urine, high fever, restlessness and thirst, and in severe cases altered consciousness and delirium; epigastric and abdominal distension; deep red tongue with a yellow greasy or dry coating

In plain language:

  • The illness begins suddenly and progresses rapidly, with symptoms appearing unexpectedly.
  • Yellowing of the skin and whites of the eyes deepens quickly and becomes markedly worse over a short time.
  • The yellow color is striking and golden, and is readily visible.
  • Urine appears yellow to reddish and dark rather than clear.
  • A very high fever develops, causing significant discomfort and may be difficult to bring down.
  • Restlessness and thirst may occur; in severe cases, confusion and delirium may develop.
  • The upper abdomen and abdomen feel distended, stuffy, and uncomfortable.
  • The tongue appears deep red or crimson.
  • The tongue is coated with a yellow, greasy-looking coating, or with a yellow, dry coating.

|Treatment Approach

Technical description:

Clear heat and resolve toxins; cool the blood and open the orifices

In plain language:

  • Clear internal heat, with the aim of easing fever, restlessness, or a sore throat.
  • Address pathogenic toxins, with the aim of easing sores, redness, swelling, or other heat-toxin-related discomfort.
  • Cool the blood to address heat in the blood, with the aim of easing bleeding, rashes, or restlessness.
  • Open the orifices to support clarity of consciousness, with the aim of addressing drowsiness, agitation, or impaired awareness.

|Related Products

The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Follow the product packaging and instructions, and use under the guidance of a physician or pharmacist.

Pien Tze Huang

References

  1. Liver Disease Committee of the Internal Medicine Branch, China Association of Chinese Medicine. TCM Pattern Identification Criteria for Viral Hepatitis (Trial) [J]. Journal of Traditional Chinese Medicine, 1992, 5: 39-40.
  2. Expert Committee on the 2015 Update of the Expert Consensus on the Diagnosis and Treatment of Cholestatic Liver Diseases. Expert Consensus on the Diagnosis and Treatment of Cholestatic Liver Diseases: 2015 Update [J]. Chinese Journal of Liver Diseases, 2015, 7(2): 1-11.
  3. Yu Lecheng, Mao Yimin, Chen Chengwei. Guidelines for the Diagnosis and Treatment of Drug-Induced Liver Injury [J]. Chinese Journal of Hepatology, 2015, 23(11): 810-820.
  4. Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association. Guidelines for the Diagnosis and Treatment of Liver Failure (2012 Edition) [J]. Chinese Journal of Hepatology, 2013, 21(3): 177-183.
  5. Yun-Fan Liaw, Jia-Horng Kao Teerha Piratvisuth, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2012 update [J]. Hepatology International, 2012, 6: 531-561.
  6. AASLD/IDSA HCV Guidance Panel. Hepatitis C Guidance: AASLD-IDSA Recommendations for Testing, Managing, and Treating Adults Infected With Hepatitis C Virus [J]. Hepatology, 2015, 62(3): 932-945.
  7. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Autoimmune hepatitis [J]. Journal of Hepatology, 2015, (63): 971-1004.
  8. Liver Disease Committee of the Chinese Association of Integrative Medicine. Guidelines for the Integrated Traditional Chinese and Western Medicine Diagnosis and Treatment of Liver Fibrosis [J]. Chinese Journal of Liver Diseases (Electronic Edition), 2010, 2(4): 54-59.
  9. Fatty Liver and Alcoholic Liver Disease Group, Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the Diagnosis and Treatment of Alcoholic Liver Disease (2010 Revised Edition) [J]. Chinese Journal of Hepatology, 2010, 18(3): 167-170.