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| A preliminary explore on clinical regularity and pathogenesis of TCM based on 44 adult EB viral hepatitis patients |
| Hits 1515 Download times 844 Received:August 30, 2019 |
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| DOI
10.11656/j.issn.1673-9043.2019.06.13 |
| Key Words
Epstein-Barrel viral hepatitis;adult;antiviral therapy;traditional Chinese medicine |
| Author Name | Affiliation | E-mail | | HUANG Ningyu | Accreditation Center of TCM Physician State Administration of Traditional Chinese Medicine, Beijing 100029, China | | | LIU Yang | Affiliated Hosital of Hebei University, Baoding 071000, China | | | YU Hao | Beijing Ditan Hospital Capital Medical University, Beijing 100015, China | | | JIANG Yuyong | Beijing Ditan Hospital Capital Medical University, Beijing 100015, China | | | DU Hongbo | Dongzhimen Hospital Beijing University of Chinese Medicine, Beijing 100700, China | duhongbutcm@126.com |
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| Abstract
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| [Objective] Epstein-Barr viral (EBV) hepatitis is a type of hepatitis with unique clinical features and developing process.[Methods] This study was a retrospective survey of adult EBV hepatitis patients admitted in Beijing ditan hospital from January 2011 to January 2013.[Results] Total of 149 patients were screened and 44 patients were enrolled. The average age is 24.5 years old, the ratio of male to female is 23:21, and the onset time is not regular. Fever, sore throat, tonsil enlargement, fatigue, and swollen lymph nodes are the most common clinical manifestations. EB-IgM is the most commonly used test for the diagnosis of EBV infection and is more sensitive than traditional heterophilic agglutination experiments. The liver damage characteristics of EB virus hepatitis are similar to those of common viral hepatitis, all of which are inflammation of liver parenchyma, but the increase of LDH is more prominent, and more often accompanied by mild cholestasis. The increasing of atypical lymphocytes, lymphocytes, and CD8+ T cells are major features of blood cell changes. Hepatomegaly and splenomegaly are common, especially splenomegaly (31/44). Supporting and liver-protecting treatment are basic therapy, while some patients need antiviral therapy. Most patients had a good outcome. Five patients were cured, thirty seven patients were improved, one patients was unhealed, and one patients was worsened. Some patients may experience chronic and severe viral infections. The average duration of this group of patients was 24 days and the average length of hospital stay was 15 days. The antiviral treatment group had a heavier condition and a longer hospital stay.[Discussion] EBV is a pathogen of liver damage worthy of more attention. Current EB viral hepatitis lacks seasonal distribution characteristics. Fever, lymphadenopathy (or tonsil enlargement, splenomegaly), abnormal elevation of lymphocytes and monocytes are common clinical manifestations of EBV. The increasing of atypical lymphocyte and lactate dehydrogenase (LDH) have special diagnostic value. Though the antiviral therapy for EBV infection is still controversial, the patients with severe condition should receive the nucleoside antiviral drugs. Though the hepatitis process in most patients with normal immunity is self-limited, there are chronic and severe cases. For the EBV hepatitis has typical TCM epidemiological characteristics, it can be treated on the TCM theories and modern pharmacological research. TCM therapy showed certain effect in alleviating gastrointestinal symptoms, accelerating the recovery of liver function and fever. The disease pattern of EBV hepatitis in adults is still unclear and further research is needed in the future. |
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