(6) Treatment of pediatric chronic hepatitis

A great amount of experiences have been accumulated in the treatment of liver disease with TCM.  Although the TCM formulas are numerous, but basically, they concentrate into the following principles:

•           anti-inflammation and detoxification,
•           soothing of liver and elimination of stagnation,
•           clearance of wetness-heat,
•           softening and reduction of liver and spleen.

The representative formula, Yinchenhao Tang with addition and subtraction, is one used commonly in clinical practice with good results.  Application of this formula (one parcel daily) usually alleviated clinical symptoms and causes retraction of the enlarged liver.  When the liver is normal (lower margin of liver 1.5 cm above costal margin in percussion), continuation of the TCM therapy for 4-6 weeks cam eliminate the wetness-heat inside the body.  Treatment is stopped at the attainment of clinical cure.

In the course of application of TCM formulas according to the child’s constitution, one can add or cancel some drugs in the formula.  Experience in clinical application indicates that if the diagnosis is correct, no matter the symptoms belong to respiratory system or digestive system, there is no need to use too many TCM or WM drugs to deal with the symptoms.  The symptoms from different systems caused by hepatophilic virus can similarly be eliminated rapidly.

Help children to take TCM drugs is not a hard job

Many people think that children are difficult to accept TCM drugs because of its bitterness.  But, in fact, there is absolutely nothing to be afraid of, because human beings can gradually get accustomed to taste.  Numerous clinical cases prove that after several trials of administration, children can gradually take the medicine by themselves.  In some cases, we can add some sugar beforehand to correct the taste.  For the avoidance of vomiting and lowering of drug effect, one can divide the drug taking into several times until the child is accustomed.

Tips for the Prevention of re-infection

It should be noticed that experience from numerous clinical cases indicated that clinical cure in children suffering from chronic hepatophilic virus disease can be obtained only by systemic therapy.  But after clinical cure, children must be taught to conform to personal hygiene habits because it is only when stress put on personal hygiene that prevention of relapse of disease is possible.  Some children suffering from repeated attacks of hepatomegaly should be put under consideration whether they have or not close contact with family members who are carriers of hepatitis virus or they are or not in a virus contaminated environment or whether their food are in a sanitary control or not.  If the possible source of infection is detected, the change of some insanitary habits or avoidance of contact with hepatitis virus may be effective in the prevention or re-infection.

Be cautious about the following:

• Do not let the child and family members have communication of body fluids such as feeding with chewed food, wet kissing, get contact with adult’s menstrual blood, feces or urine.
• If some family members are carriers of hepatitis virus, these members should strictly conform to personal hygiene regulation to avoid spread of the infection.
• If the employment of house maids, one must pay attention to their health condition.  If they have hepatitis or hepatomegaly, they must be treated as well.
• For infants and children, one must send for a doctor to treat conditions such as malnutrition and under development, anomaly of bone development (rickets), secondary obesity, or obstinate eczema, acne, aphthae, repeated nasal hypersensitivity, epistexis, frequent common cold, trachitis or asthma, frequent wetness-heat abdominal pain, constipation, diarrhea, nausea vomiting, gastric disease, hematochezia and insomnia.  If family members have history of liver disease, one should be on the alert of chronic hepatitis.
• Adopt strict hygienic habits on food and drinking, teach them “do not eat uncooked food”, “do not eat contaminated food” and “do not eat deteriorated food”.

translated by Professor ZHENG Hua En in July 2005