Perspectives on the characteristics and advantages of Chinese medicine in the treatment of liver cirrhosis

  Cirrhosis is a common chronic progressive and diffuse liver disease caused by different etiologies, which may be asymptomatic in the early stage and may show various manifestations of hepatic decompensation, portal hypertension and multi-system involvement in the later stage. Removing the triggering factors or treating the primary disease is still the most fundamental way and the most effective measure to stop the occurrence and development of liver cirrhosis. With the continuous research, the characteristic treatment of Chinese medicine has shown its good effect. In traditional Chinese medicine, there are internal drugs for clearing heat and detoxifying, regulating qi and activating blood, nourishing yin and benefiting qi, but long-term consumption of tonics or Chinese medicine tends to increase the burden on the gastrointestinal tract and aggravate gastrointestinal symptoms such as nausea, vomiting and diarrhea. Therefore, there are external application of Chinese medicine, Chinese medicine acupuncture point injection, Chinese medicine enema, acupuncture point irradiation and other treatment methods with Chinese medicine characteristics, the following are some examples: I. Chinese medicine umbilical patch The umbilical patch is one of the external treatment methods of Chinese medicine, with a long history. The navel, the point name Shen Que, that is, the place where the divine energy rises and falls, changes and grows, is an important point in the eight channels of the Qi meridian, the Ren channel. The umbilicus and all the meridians are connected, the general pivot of the meridians, the general sink of the meridian, through the eight channels and the whole body meridians, contact the five organs. In view of modern medical research, it is found that the umbilicus is the last closure of the abdominal wall in the process of embryonic development, with the thinnest epidermal stratum corneum, poor barrier function and enhanced permeability, which makes it easier for drug molecules to pass through the stratum corneum of the umbilical skin. The large number of arteriovenous branches and rich venous network of the abdominal wall make this area easier for drug absorption, and it is the ideal site for transdermal drug delivery and slow-release long-lasting drug delivery. Based on the principle of “regulating qi, activating blood circulation, resolving blood stasis, clearing heat and detoxification, nourishing yin and benefiting qi” in Chinese medicine, the umbilical patch is composed of four Chinese herbs, including Lycopodium, Saxifrage, Dilong and Han Fangji. The combination of the four herbs has the effect of regulating qi and eliminating distension, resolving stasis and clearing heat, enhancing the movement of the digestive tract, promoting intestinal peristalsis, accelerating the elimination of endotoxins, and playing a vital role in relieving clinical symptoms. As a transdermal promoter, laurozidone is a typical representative, which is a new type and highly efficient transdermal absorption promoter. Its strong permeation effect, low effective concentration, stable nature, low toxicity, no side effects, can be widely used in transdermal drug delivery system. Laurazepinone also has strong inhibitory effect on a variety of microorganisms. Ice chips is a mixture of lobster and isobornyl, almost insoluble in water, easily soluble in ethanol. It has the effect of aromatic opening, analgesic and anti-inflammatory, and can lead the medicine from the muscle surface to reach the physiology, which has good transdermal promotion effect. Modern research shows that 3% ice chips have the best effect on the sample solution to promote permeation. The combination of laurozidone and ice chips can produce a synergistic effect of drugs and superimpose the permeation-promoting effect. The results of the study showed that Chinese herbal medicine umbilical application can significantly reduce the content of plasma endotoxin, reduce the portal blood flow, and the patient’s abdominal distension, abdominal pain, appetite and stool are significantly improved with high safety and definite efficacy, and there are no obvious contraindications for patients with liver cirrhosis.  Second, Chinese herbal acupuncture point injection: patients with cirrhosis have both erythrocyte immune and humoral immune dysfunction, and when combined with infection, the erythrocyte C3b receptor wreath rate decreases more significantly than the non-infected group, while the immune complex wreath rate is not significantly different, indicating that infection can cause erythrocyte aging or receptor damage, or erythrocyte peroxidation damage, resulting in primary erythrocyte function impairment. Studies have shown that Astragalus has anti-liver injury effects, promotes hepatocyte albumin synthesis, inhibits interstitial collagen cell synthesis, enhances reticuloendothelial system and macrophage phagocytosis, increases lymphocyte conversion rate, induces interferon production, enhances human immunity, prevents hepatic glycogen reduction. Astragalus and its compound preparations have anti-liver fibrosis effects in animal experiments, clinical trials and liver stellate cell experiments. Astragalus injection 2ml was administered bilaterally to the third mile of the foot once every other day for a period of one month for a total of three courses of treatment. The results showed that the patient’s sleep and appetite were significantly improved and the antiviral response was enhanced. The treatment is simple, effective, without adverse effects, and can shorten the hospitalization time and save the treatment cost.  Chinese medicine enemas have a long history and precise efficacy. On the basis of Chinese medicine diagnosis and treatment combined with modern pharmacological research, the Chinese medicine enema formula, which varies from evidence to evidence and from person to person, has shown good efficacy. As there are often different degrees of enteric-derived endotoxemia in liver cirrhosis, and the incidence is positively correlated with the severity of the disease. According to the theory of traditional Chinese medicine, endotoxemia is mostly caused by dampness, heat and toxicity, so traditional Chinese medicine with the effect of clearing heat, detoxifying and laxing the internal organs is often used. The use of traditional Chinese medicine enema can improve the effect of local heat and toxin accumulation, blood stasis and Qi stagnation, as well as the effect of overall regulation. At the same time, Chinese medicine enema formula is based on the diagnosis and treatment of Chinese medicine, according to the patient’s different types of evidence and the use of different treatment principles and drugs, compared with Western medicine has the advantages of strong flexibility and good applicability. Moreover, in the process of disease development of the same patient, the corresponding treatment principles and drugs can be changed in time according to the changes in the evidence, so as to achieve the effect of “eliminating evil without harming the righteous” and “supporting the righteous without leaving the evil”. In addition, there are abundant Chinese medicines to choose and combine, and it has been proved that the side effects are small and the occurrence of drug resistance can be effectively avoided. Therefore, Chinese medicine enema has unique advantages in the treatment of enterogenic endotoxemia of liver disease.  Fourth, liver disease treatment instrument liver area acupuncture point irradiation liver vein starts from the big toe of the foot, up the circumvallosal apparatus, over the less abdominal, cloth thorax, on the top of the top. There are three points in the liver area, namely, the Periodic Gate, the Sun and the Moon, and the Zhangmen, all of which are important points of the Foot Shaoyang Gallbladder Meridian and the Foot Convulsive Yin Liver Meridian. “The DSG-I (Bioinformatics) computerized liver treatment is a new non-pharmaceutical technique for the treatment of liver disease. On the specific acupuncture points mentioned above, through the absorption of infrared information by the acupuncture points, the therapeutic effect can directly reach the diseased places where the internal organs and meridians are out of balance, and play the effect of “returning to the meridians”. Infrared information irradiation technology can automatically extract the biorhythm of the treated person – microcirculatory rhythm to produce energy resonance, which greatly improves the transmission rate of human skin to light waves and increases the absorption rate of energy, making the near infrared wave energy obtained in the liver area area significantly increased, thus making near infrared wave therapy for liver disease a reality. NIR information irradiation technology treatment 1 time (30 minutes), its portal vein blood flow increased significantly, thus can improve the blood circulation of the liver, so that liver cells get sufficient blood, oxygen, and nutrients, significantly improve liver cell metabolism, because the liver blood supply increased, the liver drug concentration can be increased, can better play the drug effect, from the efficacy of promoting liver damage repair treatment liver disease. Near-infrared information irradiation technology for hepatitis and cirrhosis is effective, can significantly improve liver function, reduce liver fibrosis indicators and portal vein pressure, with liver preservation and lower enzymes and anti-fibrosis effect. Research also shows that liver disease treatment instrument cirrhosis patients symptoms and signs improve more obvious, most patients after treatment symptoms significantly improved, signs reduced, such as liver pain, bloating, appetite, physical strength increased, etc., especially for insomnia symptoms improve the extremely significant difference. It is a proven adjunctive treatment that is easy to use, reduces the patient’s pain and improves the quality of life.  These data suggest that Chinese medicine has great potential in the treatment of liver cirrhosis. However, some issues still need to be further addressed, such as: ① finding the right combination of Chinese and Western medical theories in the understanding of anti-liver fibrosis, expanding research ideas, and reaching a consensus on liver fibrosis. ② Study the epidemiological status of liver cirrhosis from the perspective of evidence-based medicine summarizing the TCM evidence, while conducting high-level clinical and experimental research, establishing experimental animal models that are consistent with both the characteristics of liver fibrosis and the TCM evidence, and studying TCM preparations from the cellular and molecular levels. The regulation of immune function and the reduction or elimination of initiating factors may be more important aspects for the efficacy of TCM, but there is a lack of sufficient attention to this.  The pathogenesis of liver cirrhosis is complex, and the identification criteria have not been unified, and the types of evidence are uneven. Therefore, there is a need to analyze the pattern of cirrhosis through prospective epidemiological surveys with large samples, so as to explore and determine the etiology of cirrhosis and the trend of the evolution of the symptoms, and only then can the treatment methods with Chinese medicine characteristics be applied to the clinic more effectively. In the future, there is a long way to go to further refine the characteristic treatment of TCM on the basis of evidence-based treatment. At the same time, on the basis of TCM theory, there will be a broad prospect of combining Chinese and Western medicine with modern technology to improve the preparation and methods of TCM and to promote the absorption of drugs.