A. Understanding of the etiology and pathogenesis of primary liver cancer There is no name of “primary liver cancer” in ancient Chinese medical texts, but from the analysis of its pathogenesis and clinical manifestations, it belongs to “liver accumulation”, “fatty gas”, “spleen accumulation”, “gangrene”, “dropsy”, “dropsy”, and “dropsy” in Chinese medicine. “spleen accumulation”, “puffiness”, “accumulation”, “dropsy”, ” Pain in the Throat”, “Jaundice” and other categories. It is recorded in the 56th Book of Difficulties that “the accumulation of liver is called fatty gas, which is under the left or right side of the body, like a cup with a head and foot, and does not heal for a long time”, similar to the swollen and hard masses that may be palpated under both sides of the body when liver cancer is accompanied by splenomegaly. At the same time, the “Difficult Classic 56” also recorded that “the accumulation of the spleen, said gangrene, in the stomach and epigastric, oversized like a plate, does not heal for a long time, makes the limbs do not collect, jaundice”, and the “Introduction to Medicine” explained that “the accumulation of the spleen in the stomach and epigastric, slightly right said gangrene, Yang Qi is trapped by dampness also, making jaundice tired, diet is not for the skin “It is similar to a tumor in the left lobe of the liver, where a mass can be palpated on the right side of the subxiphoid process, accompanied by jaundice and loss of appetite, and its pathogenesis lies in “Yang Qi trapped by dampness”. The Song “Sheng Ji General Record” says “the accumulation of gas in the abdomen for a long time does not differ, firm pushing it can not be moved, pressed its shape like a cup and plate firm knot, for a long time does not itself, people thin body and abdomen large, until death does not disappear”, similar to the signs of liver cancer late stage huge masses. Chao Yuanfang’s “Treatise on the Origin of Various Diseases? It is stated in “The accumulation of the liver” that “the diagnosis of hepatic accumulation, the pulse is stringent and thin, the pain under the two hypochondrium, the evil goes under the heart, the foot and shin are cold, the pain under the hypochondrium leads to the less abdomen”, pointing out that hepatic accumulation can be the main symptom of hypochondrium pain; in “Water Symptoms” it is stated that “there are strong lumps in the abdomen, between the two hypochondrium, swollen and full, swollen all over the body”. This is similar to the consequences of portal hypertension and hypoproteinemia caused by malnutrition in the late stage of liver cancer. In addition, the Hodosan Bureau Formula states that “accumulation in the heart and abdomen …… is as large as a bowl of water, jaundice …… branches full of upper gas, abdominal distension at times, and firm knots under the heart”, and the Finger Fuzzy Quan Sheng Formula? In the chapter on accumulation, it is described that “a lump is formed in the abdomen, which does not move when pressed, does not move when pushed, and moves with slight panting …… and gradually loses weight”, etc., all of which have similarities with the clinical manifestations of liver cancer. The terms “liver accumulation” and “spleen accumulation” in the “Difficult Classic” are not only different in name, but also indicate that this disease contains different pathological mechanisms. Ling Shu. It is pointed out in the “Meridians” that “the veins of the foot of the Turk’yin, …… ring the Yin apparatus, reach the small abdomen, hold the stomach, belong to the liver, contact the gall bladder, go up through the diaphragm, and spread out the wakeful ribs”, so there is no doubt about the relationship between the liver in the sense of modern medicine and the foot of the Turk’yin meridian referred to in Chinese medicine, which resides under the right hypochondrium. The liver in the modern medical sense is an important member of the digestive system, with the functions of taking in, converting, storing and releasing glucose, taking in amino acids to synthesize many proteins (such as albumin, transport proteins, complement and immunoglobulins, and almost all proteins related to coagulation), and participating in the absorption, conversion and metabolism of lipids and vitamins, and its immediate connection to the inferior vena cava, which can transfer all absorbed nutrients to the heart, lungs and the whole body. It is connected to the inferior vena cava and can transfer all absorbed nutrients to the heart, lungs and the whole body, and can also inactivate aldosterone and antidiuretic hormone. “It can also inactivate aldosterone and anti-diuretic hormone. In addition, it can also inactivate sex hormones. Clinically, some patients with chronic liver disease commonly develop liver palms, spider nevi, and abnormal breast development, which are caused by the liver’s inactivation of estrogen, so it is not difficult to understand its connection with the “kidney” (which is responsible for reproductive development) in Chinese medicine. Based on the summary of ancient experience and modern medical research results, combined with his own clinical practice for many years, Dr. Sun pointed out that the etiology of primary liver cancer is mostly attributed to the following conditions: 1) Liver depression and qi stagnation: as pointed out in the Nei Jing long ago, “internal injury from sorrow and anger will lead to qi upward rebellion, and qi upward rebellion will lead to inaccessibility of the six transfusions (acupoints), warmth and qi will not work, blood clotting will not be dispersed, fluid will be astringent and seeping, and the accumulation will all become a result. And do not go, and the accumulation of all into carry on”, Zhang Zihe also said that “the accumulation of also, or because of anger, joy, sadness and fear of the gas”. Therefore, emotional and mental disorders, too much or too little of the seven emotions can lead to the deficiency of the viscera, liver qi stagnation, qi is not smooth, qi, blood and fluid can not run normally, qi stagnation, blood stasis, fluid retention, and accumulation. In addition, according to Sun’s clinical observations, the patient’s depression and fear will increase after the accumulation, which will lead to liver qi stagnation and organ qi deficiency, thus creating a vicious cycle. (2) Spleen and stomach deficiency: Zhang Zihe also pointed out that “spleen deficiency, dampness, cold invasion, dietary disorders, lack of spleen-yang movement, internal accumulation of dampness and phlegm, stagnation of qi and blood, and accumulation of lumps”. Weakness of the spleen and stomach, lack of innate endowment, or excessive consumption of cold, excessive alcohol, excessive fat and sweet, or external dampness and heat, cold and dampness, which do not go away for a long time, will injure the spleen and stomach, deficiency of the spleen and stomach, failure to transport and transform, dampness and turbidity again from within, depression and heat, dampness and heat accumulation, qi and blood, fluid stagnation, phlegm and stagnation of each other into lumps. After the block is formed, the patient is worried and depressed, and the diet is out of order, which also aggravates the deficiency of the spleen and stomach. (3) Qi and Yin deficiency: external dampness and heat, cold and dampness, for a long time, but not go, damage to the spleen and stomach, then the Qi and blood biochemical lack of sources; and dampness evil stay for a long time, depression and heat, dampness is hurt Qi, heat is hurt Yin, Qi and Yin deficiency, deficiency and cause accumulation, accumulation and benefit deficiency, a vicious circle. (4) deficiency of kidney essence: because “liver and kidney are of the same origin” and “spleen is the essence of the latter”, liver and spleen are the same disease, also damage to the kidney. The kidney is the mother of the liver, so if the son is sick and the mother is sick, the kidney essence will be taken away; “the spleen is the essence of the afterlife”, so if the spleen and stomach are not healthy, there will be no source of essence and blood production, so if the liver and spleen are sick together, it often leads to the deficiency of kidney essence, which will not be able to hold the essence, shaking the foundation of the body and making it more difficult to remove the evil toxins. In general, Dr. Sun believes that the disease is located in the organs and is difficult to treat, mostly related to the spleen, liver and kidney. On the basis of profound understanding of the etiology and pathogenesis of the disease, it is pointed out that the overall treatment of primary liver cancer should be based on draining the liver, strengthening the spleen, benefiting the kidneys, and promoting the functions of each organ by supporting the proper administration; supplemented by detoxifying and resolving dampness, promoting the flow of qi and opening up depression, dispelling blood stasis and dispersing knots, resolving phlegm and softening hardness, and eliminating stagnation to eliminate evil. The prescription is Zuo Gui Wan with extra flavor. On the basis of the above main formula, we can add and subtract as appropriate: 1) detoxification and anti-cancer: select vine roots, caoheche, snake tongue herb, septoria, half-sided lotus, etc.; 2) softening and dispersing hard knots: add perforated nail, turtle nail, turtle plate, etc.; 3) promoting qi and activating blood circulation: select Buddha’s hand, citron, betel nut, wide wood fragrance, Chuan Houpu, ground dragon, peach kernel, water saffron seed, lingxiao flower, green calyx plum, August zha, Dan Shen, curcuma, nine fragrant worms, etc.; 4) eliminating blood stasis (5) to resolve dampness and awaken the spleen: add Huo Xiang, Perilla, Cardamom, Coix Seed, etc.; (6) to remove dampness and reduce yellowing: add Artemisia Umbelliflora, Gardenia, Tiger Balm, Money Grass, etc.; (7) for deficiency of kidney energy: add Bone Broken Tonic, Boneset, Mulberry Cuttlebone, etc.; (8) to eliminate dampness and harmonize the stomach: add Ochre, Chicken Neijin, Raw Malt, Jiao Shanzha, Jiao Shenqu, etc.; (9) (9) Nourishing blood and tranquilizing the mind: add Longan, Angelica, He Shou Wu, etc.; (10) Clearing away deficiency heat: add Zhi Mu, Huang Bai, Artemisia, Turtle A, Bai Wei, Yuan Shen, Sheng Di, etc.; (11) Relieving dampness and abdominal fluid: add Chrysanthemum, Han Fang Ji, Daji Pi, Poria, Ze Di, Scapularia, Daji Tang, Gryllolagus (remove head and foot), etc.; (12) Stopping bleeding: add Xian He Cao, Pu Huang Char, Bupleurum, Panax notoginseng, etc.; (13) Diversifying the liver and Qi, and (13) Diversion of the liver and qi, and relieving pain: add Yu Jin, Yuan Hu, Wu Yao, Xiang Shen, Wicker, Xu Changqing, etc. Modern research shows that the main cause of hepatocellular carcinoma in China is viral hepatitis, mainly hepatitis B and C virus infection, which often occurs on the basis of liver cirrhosis, followed by aflatoxin contamination in food, drinking water contamination in rural areas, and bad drinking habits. Therefore, the active prevention of hepatitis virus infection and the active prevention of cirrhosis after infection are two important aspects of liver cancer prevention. The most effective way to prevent hepatitis virus infection is still antiviral vaccination, and it has been confirmed that hepatitis B vaccine has a preventive effect on HBV infection, and hepatitis B vaccination for newborn infants has yielded great social, economic and medical benefits in recent years. However, the active prevention of cirrhosis after infection is still a worldwide challenge. Although many promising advances have been made in recent years in anti-cirrhotic early lesions – liver fibrosis, the clinical application effect is still not very satisfactory, while Chinese medicine has shown certain advantages. Modern research also shows that the decoction extract of peach kernel can effectively prevent the deposition of type I and II pre-collagen in the serum, thus preventing the formation of liver fibrosis, and also promote the decomposition, absorption and degradation of collagen fibers deposited in the liver of patients with liver fibrosis, while the decoction extract of peach kernel can prevent the formation of liver fibrosis by Hawthorn flavonoid extract and saffron seed alcohol extract can also protect the liver by scavenging liver oxygen free radicals and inhibiting lipid peroxidation. Therefore, the combination of these drugs is often used to combat liver cirrhosis and liver cancer, the efficacy is satisfactory, the mechanism needs further study. Fourth, pay attention to psychological guidance and dietary regimen For more than 40 years of clinical practice, it is found that patients with liver cancer are mostly found late, develop rapidly, have difficult treatment, poor efficacy and high death rate, so they have doubts, fears and pessimistic psychology, which should be properly guided. In response to this situation, Dr. Sun pointed out that medical personnel should handle patients’ psychological problems scientifically and carefully from patients’ point of view, give them appropriate sympathy and comfort, encourage them to accept treatment with a positive attitude, prevent accidents, and emphasize that a relaxed mood is beneficial to disease prognosis. Every point of improvement and progress of the patient’s condition should be appropriately affirmed and encouraged, which can improve the patient’s confidence in overcoming the disease and bring into play the patient’s subjective initiative to actively cooperate with the treatment. The diet should be fresh, tasty, hot and cold, easy to digest, nutritious, and can protect the vital energy and improve the immune function, such as eating fresh mushrooms, Lingzhi, fresh carp, milk, etc. to enhance anti-disease ability, eating more high-protein food, forbidding alcohol, eating mutton, scaleless fish, etc.