1. What do you know about diet? Diet should be diversified. Hepatitis patients don't need to emphasize taboos, and the diet principle is light, digestible and nutritious. Protein is the important material foundation of human body and the "raw material" of immune substances. Eating some eggs, milk, soybean milk, lean meat and fish soup properly is beneficial to the repair, growth and renewal of damaged liver cells, which can shorten the course of disease and reduce the probability of chronic hepatitis. At the same time, we should eat more vegetables, especially green leafy vegetables, pay attention to maintaining weight and prevent fatty liver caused by obesity. Patients with hepatitis should pay special attention not to eat too much sugar, because the three major metabolism of the human body mainly depend on the liver. If you eat a lot of sugar after suffering from liver disease, it will inevitably increase the burden on the liver and induce diabetes. In addition, after you get hepatitis, you should abstain from alcohol, don't drink alcoholic beverages, and avoid taking drugs that damage your liver. For some common diseases, such as colds and coughs, it is advisable to take Chinese herbal medicines or Chinese patent medicines.
2. It is also important to control emotions: patients with hepatitis should pay attention to being optimistic. Traditional Chinese medicine believes that the seven emotions of "happiness, anger, worry, thinking, sadness, fear and surprise" are different emotional responses of the human body to external objective things, so long as they are properly regulated, they will not lead to diseases. If there is a strong or long-term seven emotions stimulation, it will disturb the normal physiological activities of the human body, make the viscera function and qi and blood disorder, and lead to the occurrence or aggravation of diseases. Because "the liver governs anger", patients with liver disease are more irritable, while patients with chronic hepatitis B are chronically ill, nervous and emotionally unstable. Therefore, we should pay special attention to maintaining a good attitude and don't worry too much about the harm of the disease itself, otherwise moping all day will affect sleep and appetite, and even aggravate the condition. In short, a good mood is very important for the rehabilitation of hepatitis patients.
3. Exercise in moderation. Remember: Generally speaking, patients with hepatitis A or hepatitis E who have been cured for more than half a year can participate in strenuous activities. However, even if the symptoms disappear and the liver function is normal, patients with hepatitis B cannot be considered cured. Hepatitis B surface antigen can only be completely cured after it turns negative. At this time, we should also pay attention to the amount of activity. We should try our best to avoid fierce activities such as ball games and participating in sports competitions. Those who have not changed after more than two years of follow-up can only exercise like normal people. In the acute stage of hepatitis and the active stage of chronic hepatitis, reducing physical exertion, reducing liver load and increasing liver blood flow are the key to treatment. In the recovery period, the rest principle is: combination of motion and static, proper exercise. Such as outdoor walking, sunbathing, Tai Ji Chuan. Exercise should be increased gradually, and don't be too tired. Patients should rest for more than 10 hour every day, and in principle stay in bed for half an hour to 1 hour after meals.
In short, adhering to the above principles will definitely improve the quality of life of patients with hepatitis B.
The goals of effective treatment are: ① inhibiting virus replication and eliminating virus; ② Relieve symptoms; ③ diminish inflammation and improve liver function; (4) to prevent progression to cirrhosis and hepatocellular carcinoma; ⑤ Improve the survival rate of patients. At present, there are many methods to treat chronic hepatitis B, including antiviral drugs, immunomodulation, cytokines, anti-fibrosis, antisense oligonucleotides, ribozymes and so on. The definition of effective treatment is that HBV DNA is permanently removed from blood by non-PCR technology, HBeAg turns negative, anti -HBe appears, and ALT value drops to normal. When infection changes from replication stage to integration stage, it usually ends in remission rather than cure. In the United States, interferon and lamivudine are the only drugs approved for the treatment of hepatitis B.
Interferon A recent meta-analysis of 15 studies evaluated the efficacy of interferon. Compared with the untreated control group, the negative conversion rate of HBsAg was 6% higher and that of HBeAg was 265,438 0% higher. The negative rate of HBV DNA was 20% (the detection threshold was 1.5 ~ 30.0 pg /ml or 50 ~ 1 ten thousand copies /ml). If PCR is used, the negative conversion rate of HBV DNA will be reduced. Interferon 5MU daily or 10u three times a week or 1 every other day is a better treatment scheme. The predictor of effective treatment is low viral load (HBV DNA) before treatment.
High-dose interferon is more effective than low-dose interferon, but its side effects also increase. Although the HBsAg negative rate increased significantly after interferon treatment for 4 or 6 months, treatment for 6 months was not more effective than treatment for 3 months. The curative effect of women is better than that of men, and the effective rate of China patients is lower. Among the patients with liver cirrhosis, the patients with severe condition (child-pugh grade B or C) have poor curative effect.
Nucleoside and nucleotide analogues include lamivudine, famciclovir, adefovir, dipivoxil and locavir. They can inhibit HBV DNA replication. In a large-scale randomized controlled clinical trial, patients took lamivudine 100mg/ day orally for *** 12 months, and 16% ~ 32% of patients turned negative for HBeAg, and HBV DNA decreased to.
Combined therapy In some recent studies, interferon (10MU) was given three times a week for *** 16 weeks, and gamasidine was given 100mg daily for 24 weeks, with an effective rate of 29%. In contrast, the effective rate of single drug was 18% ~ 19%, but the difference was not statistically significant.
Antisense oligodeoxynucleotides and ribozyme antisense oligodeoxynucleotides block gene expression through hybridization between antisense strand and antisense strand of HBV DNA. In a recent study, antisense oligodeoxynucleotides inhibited the replication and gene expression of DHBV in Beijing duck for a long time. Ribozyme represents another molecular mechanism to inhibit virus replication. They are antisense oligodeoxynucleotide catalysts that can cleave RNA at specific sites.
The clinical outcome of immunomodulation of acute HBV infection depends on the quality and intensity of host antiviral response. Exactly, HBV in infected hepatocytes may be eliminated by cytotoxic T lymphocytes (CTL), and the possible mechanisms are as follows: ① antigen activated CTL directly kills HBV, leading to the destruction of infected hepatocytes; ② Cytokines secreted by ②②CTL (IFN-γ and TNF-α) can eliminate HBV through noncellular lysis, leading to virus destruction (not destroying hepatocytes), and can eliminate HBV in a large number of hepatocytes by inhibiting virus replication and gene expression. Tolerance is virus-specific, not universal immunosuppression. Many experimental studies show that CD8 ++ and MHCⅰ type ⅰ CTL can clear the virus in infected cells. Therefore, T cell HBeAg epitope vaccine can be used to treat chronic HBV infection.
Thymosin α- 1 can increase the levels of endogenous IFN-α and γ, and also increase IL-2. It can also increase the expression of IL-2 receptor and enhance the proliferation and activity of CD3, CD4, CD8 and NK cells. In HBV infected duck hepatocytes, thymosin α- 1 seems to reduce viral replication, especially at the level of viral protein expression. It is safe, but it needs subcutaneous injection. The results of four studies showed that after 6 months of treatment (1.6mg twice a week), HBeAg and HBV DNA turned negative and ALT decreased to normal in 36% patients. In contrast, only 1 1 1 untreated patients in the control group were effective.
Carefully seek medical advice and choose drugs.
At present, the choice of drugs for treating hepatitis at home and abroad includes three aspects: (1) antiviral drugs; (2) immunomodulators: (3) drugs that promote the repair and regeneration of liver cells.
There are many kinds of drugs for treating viral hepatitis. It is estimated that there are more than 700 kinds of drugs for treating hepatitis in China (including hepatoprotective drugs, antiviral drugs and drugs for regulating immune function). In the treatment of protecting liver function and preventing further necrosis of liver cells, the progress is still remarkable. For example, the mortality rate of severe hepatitis was as high as 80% in the 1960s and 1970s, but it has dropped to about 40% in the 1980s and 1990s, which indicates that the measures to prevent hepatocyte necrosis and promote hepatocyte regeneration have taken a big step forward, but so far there is no specific drug that can radically cure viral hepatitis. However, all kinds of media exaggerated the propaganda of hepatitis treatment, saying that "hepatitis can be cured radically" and "hepatitis * * drugs have the best curative effect" violated the scientific laws, and absurd advertisements were common, such as claiming to be "the king of changing yin", "the bane of hepatitis", "the problem of hepatitis B has been solved", "all the three-yang diseases have turned negative" and "solving the urgent needs of hundreds of millions of hepatitis patients in China".
Recently, many hepatitis experts called on the media to publicize correctly and not to mislead patients into being deceived. It is pointed out that the treatment purpose of hepatitis B is not to make all kinds of virus markers negative, but to prevent hepatitis from developing into chronic and fibrosis. At present, there is no "magic medicine" to eliminate the spread of hepatitis B virus, and there is no provision to take the negative mark of hepatitis B virus as the treatment standard. As mentioned above, although there are many drugs for treating viral hepatitis, especially chronic hepatitis, so far no drug can radically cure hepatitis B virus. For this reason, the author thinks that people with hepatitis B "big three-yang", "small three-yang" and "1.5-yang" or patients with slightly elevated transaminase and hepatitis C transaminase should not ask for help everywhere, such as "the king of turning negative". Our countermeasures are: giving priority to basic treatment, that is, proper rest, keeping optimistic mood, reasonable diet, supplementing enough nutrition and choosing appropriate health food, which has a very good effect on protecting liver function and preventing chronic hepatitis and fibrosis. For those patients with severe hepatitis, it is best to be hospitalized for systematic treatment.