Most of liver cancers course through hepatitis and cirrhosis, and more than 80% (50-90%) of primary liver cancers in China occur on the basis of cirrhosis, especially nodular liver cancers often have obvious cirrhosis and poor liver function. Surgery is still the preferred method to improve the long-term outcome of primary liver cancer. Transcatheter hepatic artery embolization chemotherapy, ablation therapy and biologic targeted therapy have become the other three major means of western liver cancer treatment. Chinese medicine treatment can be used throughout the whole course of liver cancer treatment.
According to the course of liver cancer and its symptoms, combined with the discussions of medical texts in past generations, the disease can be classified as “fatty gas”, “accumulation”, “Y”, “dropsy” and “jaundice” in Chinese medicine. “dropsy”, “jaundice”, “vomiting blood”, “blood in stool” and other diseases.
Modern Chinese medicine recognizes that liver cancer is always a disease of positive deficiency and evil actuality, and different stages of the disease have different emphasis on positive deficiency and evil actuality
1.Early stage of hepatocellular carcinoma: the evidence is mainly based on evil, liver qi stagnation, qi stagnation and blood stasis, supplemented by positive deficiency and spleen weakness.
2.Middle stage of liver cancer: the identification of evidence is mostly based on both positive deficiency and evil actuality, spleen deficiency and Qi weakness, blood stasis and phlegm stagnation.
3.Late stage of liver cancer: the evidence shows that there is a great deficiency of vital energy and the disease evil is strong. Qi and blood deficiency, spleen and stomach disharmony, qi stagnation and blood stasis, phlegm and dampness.
Principles of TCM treatment.
Support the righteous: strengthening the spleen and stomach, nourishing the vital energy, nourishing blood, nourishing Yin, moistening the intestines, warming Yang and transforming Qi, etc.
Removal of evil: activating blood circulation, resolving blood stasis, resolving phlegm and dispersing knots, as well as promoting the flow of Qi, resolving dampness, inducing diuresis, reducing yellow, diarrhea, clearing heat and detoxifying toxins, etc.
Chinese medicine treatment.
Early stage: to invigorate blood stasis, soften hardness and disperse nodules, and to remove liver and Qi. The aim is to get rid of the disease.
Middle stage: strengthen the spleen and stomach, move Qi, remove stasis and disperse knots. It also focuses on supporting the righteousness and dispelling the evil.
Late stage: strengthening the spleen and tonifying Qi is the main focus, harmonizing the stomach, eliminating distention, inducing diuresis and reducing yellowing. Care for protecting the righteousness and saving people first.
Identification and typing
1.Liver depression and spleen deficiency or liver qi stagnation
Symptoms: distension and pain in the chest and hypochondrium, more so on the right side, with lumpiness under the hypochondrium, good tachypnea, or with loss of appetite, tiredness and weakness, with a light and dark tongue, with teeth marks on the side, and a thin string pulse.
Treatment: Diversify liver and Qi, harmonize the stomach and strengthen the spleen, resolve phlegm and disperse knots.
Radicals: Chai Hu Dredging Liver San and Six Jun Zi Tang with reduction.
2.Qi stagnation and blood stasis type
Symptoms: Huge mass under the dorsum, stabbing pain or dull pain in the right dorsum or epigastrium, dorsal pain, insomnia and distress, dark or blue tongue with petechiae, thin and astringent pulse.
Treatment: To regulate Qi and activate Blood circulation, resolve blood stasis and eliminate stagnation.
Radicals: Diaphragmatic and Blood Stasis Removal Tang, Plus Reduction
3.Spleen deficiency and blood stasis
Main manifestations: mass under the dorsum, stabbing pain or dull pain in the right dorsum or upper abdomen, dullness, fatigue, abdominal distension, loose stools, vomiting blood or blood in stool, or subcutaneous purpura, pale tongue with petechiae and stasis, weak pulse.
Treatment: Strengthening the spleen and benefiting Qi, regulating blood flow and stopping bleeding, resolving blood stasis and clearing collaterals.
Remedy: tonifying Zhong Yi Qi Tang and Ginseng Ling Bai Zhu San plus reduction
4.Damp-heat type of liver and gallbladder, damp-heat gathering poison
Symptoms: epigastric mass, pain in the right side, distension and fullness of the abdomen, or abdomen as large as a drum, distress in the heart, bitterness in the mouth, bright yellowish skin of the eyes, body heat or hot flashes, dry stools, short, red and yellow urine as thick as tea, purple and dark tongue, yellow thick and greasy coating, slippery pulse.
Treatment: Clearing heat and relieving dampness, dipping fire and detoxicating.
Remedy: Yin Chen Artemisia Tang, Gentian Diarrhea Liver Tang plus reduction
5. Yin deficiency and internal heat, deficiency of liver yin
Symptoms: distension and pain in the ribs, lethargy and weakness, low fever and night sweating, vexation and heat in the five hearts, dull skin, dry mouth without desire to drink, little urination, pale red tongue or vivid red with little or no coating, fine pulse.
Treatment: Nourishing Blood, softening the Liver, cooling the Blood and detoxifying the toxin.
Remedies: Artemisia annua and turtle nail soup, Consistent Decoction plus reduction
6.Spleen and kidney Yang deficiency, internal stagnation of water-drink
Symptoms: epigastric masses, vague pain in the abdominal distension, or abdomen as large as a drum, pale mouth with vomiting of clear saliva, yellowish and dark eyes, fatigue, cold extremities, swelling of the lower extremities, loose stools, scanty urination, pale white tongue and sunken pulse.
Treatment: Strengthening the spleen and tonifying the kidney, warming the Yang and promoting water retention.
Remedies: Wu Ling San, Zhen Wu Tang plus reduction
Key points of identification and treatment.
1. The main disease is in the spleen and stomach, involving the liver, gallbladder, lung and kidney.
2, positive deficiency is dominated by spleen deficiency and qi weakness, which can further develop into lung and spleen deficiency, heart and spleen deficiency, spleen and kidney deficiency, etc. Evil is dominated by qi stagnation, blood stasis, phlegm and water-dampness.
The treatment should take into account the elimination of the evil, do not forget to protect the righteousness, too much bitter cold hurts Yang Qi, also hurts the spleen and kidney; too much attack hurts the spleen and stomach; too much use of blood can lead to bleeding disease.
4. Malignant tumor is a chronic disease, treatment should not be quick, but slow and slow treatment may be effective.
5.The holistic view of TCM treatment: combination of disease identification and evidence-based treatment
At present, the following Chinese medicine preparations are commonly used against liver cancer
1.Elimination of evil is the main focus: Huachansu Tablet/Injection, Eleutherococcus Injection, Anticor Capsules, Anti-cancer Ping Tablets, etc.
2. Combination of supporting the righteous and dispelling the evil: Jinlong capsule, Aidi injection, Huaier granule, Kanglaite injection, Hepatofluo, etc.
3. Support the righteousness and cultivate the root: Jianquan Yi Kidney Granules, Zhengqi Fuzheng Capsules/Pellets, Tonic Zhong Yi Qi Pills, Ginseng and Baijiao San, etc.