Secondary Treatments
     Hepatitis C has such a diverse range of symptoms that it is difficult to imagine a form of treatment that would not have a potentially useful role.

The other branches of TCM

     Acupuncture, acupressure, Qi Qong and massage can play a very useful role in the treatment of hepatitis C, particularly when combined with herbal treatment. The relief of excessive heat, correction of yin deficiency and stagnant liver Qi, the balancing of common liver-spleen disharmony, blood purification, the promotion of strong elimination and the development of a relaxed state of mind in the patient are regarded as being very important objectives.

Western Herbal Medicine
     Undoubtedly has many useful plants such as milk thistle seeds, burdock root, dandelion root, globe artichoke (for the liver); cat’s claw and golden seal for the bowel; gingko for peripheral circulation; dandelion leaf for fluid retention; and echinacea for the immune system. On the whole, Western herbal medicine is not able to provide the same level of sophistication as Chinese herbal medicine, although some herbalists are now combing both ingredients and strategic approach. One formulation, suggested by Peter de Ruyter, of Sydney, Australia, for patients trying to counter progressive liver disease who cannot obtain an individualised prescription, is as follows:
     Baical Scullcap 15%
     Astralagus 15%
     Bupleurum 5%
     Silybum 15%
     Schisandra 20%
     Licorice 15%
     Echinacea 15%
     Made up as a herbal tincture, 3ml, 3 x daily before meals, diluted in water.
     De Ruyter suggests that normalisation of liver function may be achieved by taking Picrorrhiza tablets; ½ tablet twice daily until function is restored, followed by ½ tab daily for two months. Brian McKenna suggests that freeze dried milk thistle is a good way of normalising ALTs and ASTs.
     Depending on the symptomatic profile of the patient, there are a range of approaches which may be taken depending upon the judgement of the practitioner. For instance, Malcolm Simmonds produces a range of preparations including some for lower bowel problems, common in HCV patients.

Amino Acids, food supplements, vitamins and minerals
     HCV patients have an established pattern of glutathione deficiency. (26) The glutathione precursor, N-Acetyl Cysteine, is likely to be extremely useful in the management of many chronic hepatitis C patients. Not only does it counteract the deficiency, which is linked to accelerated progression of liver disease and increased free radical damage, but it also acts against oncogenesis, is hepatoprotective, and enhances overall immune function. Other amino acid supplements, such as methionine, taurine, tryptophan, glutamine and proline may also address various symptoms. (27)
     Simple food supplements, such as chlorella – which contains a wide range of amino acids – may be useful additions to a therapeutic regime. Whilst an overactive immune system may be unhelpful for patients, a healthy and balanced immune function is vital; patients with immunosuppressive conditions such as HIV, and those on immunosuppressive drugs, such as steroids, suffer from higher viral loads and accelerated disease progression. This indicates that immune function should be supported as it does have a modulating effect on HCV replication. To this end vitamins such as C and minerals such as zinc and selenium may be very useful. Conversely, patients should be made aware that all immunosuppressants, be they prescription or recreational drugs, or elements in the diet, such as saturated fats and sugar, are potentially hazardous.

Exercise, diet and fasting
     Exercise may be a very useful tool in the encouragement of lymphatic drainage and the counteraction of circulation problems, although patients with lymphatic cancer should not take exercise. Lymphatic drainage techniques, such as the use of alternating hot and cold packs of castor oil placed over the liver, and lymphatic drainage aromatherapy massage are likely to be very helpful. (Note that although lymphatic cancer is rare, lymphoproliferative disorders are common.)
     Diet should ideally be modified to eliminate all alcohol – very moderate occasional consumption may be harmless, but patients should be informed that accelerated progression of liver disease to cirrhosis and cancer is definitely linked to alcohol consumption. (29) Coffee may also cause problems, and is regarded as being ‘hot’ in Chinese medicine. Substitution with dandelion coffee or green tea (highly eliminative), will be a positive change.
     Fats and sugars, pastries, hot and spicy food should be reduced. Additives, pesticides, fluoridised or chlorinated water, household drugs such as paracetamol, aspirin and ibuprofen may pose additional problems to patients. The consumption of fresh fruit and vegetables, preferably organic, and low-fat high-protein foods should be encouraged.
     Fasting for hepatitis C patients is controversial with doctors advising strongly both for and against. Some routines may benefit some patients, although those with pronounced liver disease should not undertake water-only fasts. The following regime may be beneficial:
     Start the day with a large glass of prune juice; follow up with half and half organic apple juice and distilled water; use camomile enemas if headaches appear. Continue for only 36 hours if new to fasting. Continue for up to 3 days if experienced. Break the fast with steamed organic apple and cinnamon. Add stewed vegetables slowly. Leave heavy protein and carbohydrate until last.
     Although the eliminative effects of fruit juice fasts may be most useful, the regenerative impact of vegetable juice fasts may also be helpful. A cocktail of broccoli, bok choy, celery, lettuce, capsicum and a small amount of carrot is advised by Peter de Ruyter.
     Liver flush regimes, such as the half and half olive oil and lemon juice cocktail first thing in the morning, should be adjusted for hep C patients; only a small dash of olive oil should be used, with most of the blend being made up of lemon juice.
     Anything at all which helps the patient to cultivate a relaxed approach to life is to be encouraged. There are many ways in which an anxious state of mind can make a patient’s prognosis worse.

Further Information
     Further details are contained in ‘The Hepatitis C Handbook’. This is not an exhaustive list of therapeutic approaches to hepatitis C; the author would welcome any contribution from practitioners or patients with further experience or expertise.

Further Reading & Resources
     The Hepatitis C Handbook by Matthew Dolan, Catalyst Press, 1997; ISBN 0 9529509 0 1. Order through local book shop or call the distributors, Central Books on 0181-986 4854 direct; in America, contact PJ Communications, New York, (212) 714 6076.
     The Hepatitis C Support group: Write to PO Box 13036, London NW1 3WG
     The Gateway Clinic, Old South Western Hospital, Landor Road, London SW9 9NU 0171-346 5441.

http://www.positivehealth.com/permit/Articles/Nutrition/hepc.htm

Applying Chinese Medicine

Hepatitis C Help

Self-Care

• Moxibustion
• Acupressure/Massage
• Exercise
• Daily Journal
• Dietary Recommendations
• Supplements

Moxibustion

The following description of moxibustion is an excerpt from The Chinese Way to Healing: Many Paths to Wholeness, Berkley Pub Group, 1996.

Moxibustion uses burning herbs, placed on or near the body, to stimulate specific acupuncture points. This warms the Channels and expels Cold and Dampness; creates a smooth flow of Qi and Xue ; strengthens Yang Qi ; prevents disease and maintains health.

For hundreds of years, moxibustion has been partnered with acupuncture. According to the Chinese text, Introduction to Medicine, “When a disease fails to respond to medication and acupuncture, moxibustion is suggested.”

There are two basic forms of moxibustion: The cone and the stick. You can use both of them for self-care at home.

The moxa cone is made by compressing the herb mixture, known as moxa wool, into a cone about the size of the upper part of your thumb. The cone is then burned on the body. One of the most common applications is to the navel, where it is effective in relieving abdominal pain, diarrhea, and easing excessive sweating, cold limbs and a flagging pulse. When moxa cones are burned on other parts of the body, the effect is to ease disharmonies in Channels and Organ Systems associated with those points.

Moxa Cone

The following directions are for using the moxa cone. Never place the moxa directly on your skin!

1. Make three cones.
2. Place each one firmly on a slice of dry aconite about an eighth of an inch thick and set within arm’s reach. Aconite is a special herb your practitioner can give you. It’s toxic if ingested, but perfectly safe when used with the moxa cone. You may also use a slice of fresh ginger about 1/8th of an inch thick that you have pierced with four or five small holes.
3. Lie Down.
4. Place a piece of clean cotton somewhere on your torso so you can retrieve it quickly if need be.
5. Put two tablespoons of salt in your navel and tamp down until smooth and flat. (If you have an "outie", the Chinese texts suggest taking a long, wet noodle and forming a circle around the navel to contain the salt.)
6. Pick up the cone and attached piece of aconite.
7. Light the cone — from the top if you want it to burn cooler and more slowly; from the bottom (don’t light the aconite) if you want it to burn hotter and more rapidly.
8. Place the aconite/moxa mound on top of the salt.
9. If, as it burns, it becomes too hot, gently lift the moxa and aconite, slip the piece of cotton cloth over the salt and set the aconite and moxa back in place.
   (NOTE: The ginger tends to spread the heat more than the aconite because it is damp and it doesn’t offer as much insulation, so be especially careful not to burn your skin.
10. Let the moxa burn down. If it still feels too hot, remove the aconite and cotton and let the salt cool. Repeat three times. When you're done, save the aconite; brush off the salt.
11. To place moxa cones on other points, skip the salt and use a piece of cotton topped with a slice of ginger or aconite. Never place the moxa directly on your skin!

Moxa sticks, the size of a baby cigar, are available pre-rolled. When lit, they are used like wands, by circling their burning end over various acu-points. This method is particularly effective for treating painful joints and chronic problems such as dysmenorrhea, hernias, and abdominal pain.

Moxa Stick

The following directions are for using the moxa stick

1. Mark the acu-points you want to heat with a small dot.
2. Light the wand and let it burn until it begins to smoke.

For chronic hepatitis, you may use the following points at home as well as in the clinic with a practitioner. Please have a practitioner show you the location of these points so you can do it properly. I use these in clinic whenever there are increased AST and ALT levels.

Chronic hepatitis special points:

• –.75 from Du Channel T10/T11/T12
• UB 18/19/20

Additional points for various conditions include:

• For Dampness and treating digestive problems associated with Cold, use Ren 12 — halfway between the navel and the tip of the sternum is effective in dispelling cold and Dampness
• For weak energy and lack of appetite, use St36, Sp6
• With nausea, moxa Ren 12, Ren 14, and Sp6

Acupressure/Massage

You may use the following points to perform self-acupressure:

• For nausea, press P6 and Ren 12
• For weak energy, massage St36, Sp6, and Sp4 For loose stools and abdominal cramping, massage St37, St25
• Abdominal massage is helpful to harmonize the Large and Small Intestine, Liver, Spleen, Stomach, and Gallbladder. To increase the massage’s effectiveness, warm the abdomen first with a hot pack or ginger compress. You may also massage using a warming oil infused with cinnamon (see references listed below for complete self-massage instructions).

Exercise

Qi Gong exercise to strengthen Liver. See Kenneth Cohen’s books and articles. For simple beginning Qi Gong exercise by Larry Wong, Quan Yin Healing Arts Center’s Qi Gong teacher, see The Chinese Way to Healing: Many Paths to Wholeness.

Daily Journal

For one to two weeks before going to visit a Chinese medicine practitioner or for your own benefit in general, keep a daily journal and record the following.

• Everything you eat and drink and when
• Any bodily symptoms and the time of day they appear
• Your physical activities and how long you do them
• Sleep patterns
• Digestion and patterns of elimination and urination
• Your emotions and when they arise
• Intake of drugs, prescription or recreational, alcohol, nicotine products
• Mental clarity or lack of clarity

Dietary Recomendations

• Eat cooked foods--it helps the digestive system to digest more easily. Depending on your condition, you may want to eat some raw foods occasionally or daily. This would depend on your general Chinese differential diagnosis. Do not eat foods directly out of the refrigerator.
• Drink warm or hot drinks--drinking cold fluids puts out the digestive fires which are important to assimilation of nutrients. Do not drink cold drinks directly out of the refrigerator.
• With Heat syndromes, avoid hot or warm foods such as ginger, garlic, turkey, chicken, mutton, shrimp, and heavy oils. Eat an increased amount of raw vegetables, juices and fruits (no more than 33%)
• With excess Dampness, fried foods and dairy products should be completely avoided. Limit tofu and when eaten should always be cooked, preferably with ginger and garlic. Eat carrots, barley, rice, corn, aduki beans, mustard greens, chicken, potatoes, alfalfa, and rye.
• Avoid alcohol
• Limit intake of coffee, chocolate and other highly caffeinated foods
• Drink green tea — it has liver protective and anti-cancer effects. However, with anxiety and depression, this should be limited if you are caffeine-sensitive (the above are not complete lists — see references below for complete lists of foods for various conditions and Chinese diagnoses — also, a practitioner can give you dietary advice)

Daily Supplements

As recommended for a general immune health program, modified for chronic viral hepatitis.

• Lactobacillus acidophilus, refrigerated powdered type (use as directed).
• Multivitamin, multimineral supplement. Powder capsule form is best for digestion. Sometimes B complex vitamins can make some people with hepatitis nauseated. Make sure it supplies selenium and chromium
• Essential fatty acids. One tablespoon per day of organic flax, raw sesame, or evening primrose oil to promote prostaglandins. Helps decrease muscle aching and fibromyalgia symptoms. Should be refrigerated type to avoid rancidity
• Low dose Carotenoids at 5000 to 10,000 units per day (Do not take Vitamin A)
• Vitamin E — 400 to 1200 I.U. per day — can help cell-mediated immune function, skin problems, memory loss
• Vitamin C — if you can tolerate it, you can take up to six grams per day. Take to bowel tolerance — meaning until too much gas or loose stools, then back off until comfortable
• Additional supplements as recommended by a nutritionist or qualified practitioner

http://www.docmisha.com/applying/hepatitis_help/04self_care.html