Cirrhosis (in the category of accumulation in Chinese medicine) is a chronic progressive, diffuse liver disease caused by different etiologies, which may be asymptomatic in the early stages and may present with various manifestations such as decompensated liver function, portal hypertension and multi-system involvement in the later stages. The disease is complex and difficult to cure. 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 cirrhosis. As research continues to progress, the advantages of TCM specialties are becoming increasingly apparent. Traditional Chinese medicine treatment includes internal medicine such as clearing heat and detoxifying the toxin, regulating Qi and blood, nourishing Yin and benefiting Qi, etc. Some patients taking long-term tonics or Chinese medicine unintentionally increase the burden on the gastrointestinal tract and aggravate gastrointestinal symptoms such as nausea, dullness and diarrhea to varying degrees, therefore, exploring multi-path and multi-target Chinese medicine external treatment has become the hot spot of Chinese medicine characteristic treatment. The introduction of the “meridian qi theory” has, to a certain extent, promoted the development of the characteristic external treatment methods of TCM. The external treatment methods under the guidance of meridian qi doctrine (e.g. external application of traditional Chinese medicine, injection of traditional Chinese medicine acupuncture points, enema of traditional Chinese medicine, irradiation of acupuncture points, etc.) have also been proved to have certain clinical observation value and research prospect in the treatment of chronic liver diseases. Now, we would like to further discuss the relevant Chinese medicine characteristic external treatment methods carried out by our department in recent years. The theoretical basis of TCM special treatment: the doctrine of meridian qi The meridians are the pathways for the body to run qi and blood, contact the internal organs, communicate with the internal and external organs, and run up and down, and are also the pathways for disease and evil to enter and exit; the meridians are the extension of the internal organs, and the qi running in the meridians is meridian qi, which is the category of positive qi of the human body, and meridian qi originates from the internal organs, and the internal organs use meridian qi to communicate with each other, so the change of meridian qi is related to the return of disease. And the meridian qi in each of the twelve meridians have their own distribution rules and characteristics, “Suwen. The skin part of the theory said: “the skin has a division”; “skin, the vein of the part”, “where the twelve meridians and veins, the skin of the part”. The “skin part” is the division of the twelve meridians and their affiliated veins on the surface of the skin, and is also where the qi of the twelve meridians is dispersed. It can be the acupoints of meridians (e.g., the period gate, liver acupoint, foot three miles, etc.); it can also be the convergence of the meridians of the internal organs in a certain part (e.g., the ear, umbilicus, etc.); it can also be the mucous membrane of the skin (e.g., nasal mucosa, intestinal mucosa). Therefore, we can identify the location of the “skin” of the imbalanced meridian qi of the diseased internal organs through disease identification and evidence identification, and use various physical methods (such as acupuncture, moxibustion, massage, etc.) to stimulate the “skin” of the imbalanced meridian qi to adjust the meridian qi of the diseased internal organs, so as to restore the balance of qi and blood of the diseased internal organs. Yin and Yang balance. Covering the meridian qi to pass as important, the meridian qi will be smooth flow of qi, blood, yin and yang, all diseases since removed. The Qing dynasty doctor Wu Shiji believes that “the essence of grass and wood, cooked as soup liquid, take its taste? It’s just to take its gas. …… change the soup liquid into thin paste, from its external and its internal, also take its gas only.” Therefore, with the help of the medicinal qi of Chinese medicine to stimulate the “skin” can also achieve the effect of adjusting the meridian qi of the diseased internal organs of the body. The medicine qi can regulate the meridian qi, the external medicine is the internal medicine, and the dialectical treatment is also the major method of external treatment. Nowadays, the origin of chronic liver disease is closely related to the imbalance of the internal organs’ meridian qi, so the external treatment of clinical evidence should be especially important to dialectical treatment, adjusting the meridian qi, opening all the veins and yin and yang. Chinese medicine clinical exploration and modern research 1, Chinese medicine umbilical application Umbilical application therapy, that is, the selection of the umbilical point of the Shen Que, through the selected Chinese medicine to stimulate the Shen Que point to adjust the body’s internal organs of the meridian qi, restore the balance of qi, blood, yin and yang. The Shen Que point is the main point of the Ren Vessel and is connected to the Du Vessel, which is the boundary between the upper and lower abdomen, and it is the place where the Ren, Belt, and Chong Vessels pass through, and it is the place where the Qi rises and falls and changes. The function of the Shen Que point has been highly esteemed by doctors for many generations, and Wu Shiji of the Qing Dynasty said, “The umbilicus is the moving gas between the kidneys, and the gas passes through all the veins, and the five internal organs, and the internal organs and meridians, and the life makes all the veins and smooth.” In view of modern medical research found that the umbilicus in the process of embryonic development, the last closure of the abdominal wall, the epidermal stratum corneum is the thinnest, poor barrier function, enhanced permeability and other characteristics, drug molecules are easier to pass through the skin stratum corneum of the umbilicus. A large number of arteriovenous branches of the abdominal wall and a rich network of veins make this area easier for drug absorption and ideal for transdermal drug delivery and slow-release long-acting drug delivery. According to the principle of Chinese medicine, “to regulate qi, activate blood circulation, resolve blood stasis, clear heat and detoxify, nourish yin and benefit qi”, the umbilical cord dressing made by our department is composed of four Chinese herbs, including Lycopodium, Sharen, Dilong and Han Fangji. The combination of the four herbs has the effect of regulating Qi and eliminating distension, resolving blood stasis and clearing heat, and plays a vital role in enhancing the movement of the digestive tract, promoting intestinal peristalsis and accelerating the elimination of endotoxins to relieve clinical symptoms. In the process of adjusting the meridian qi through the “skin”, the transdermal facilitator plays a vital role as a medium. Laurazepin, as a new type of highly effective transdermal absorption enhancer, is a typical representative. 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 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. 2. Astragalus acupuncture point injection The cause of accumulation is the deficiency of positive qi, and the formation and evolution of accumulation are closely related to the strength and weakness of positive qi. The “Medical must read? Accumulation” said: “Accumulation of the formation is also a deficiency of the righteousness, and then the evil is entrenched.” Jing Yue Quan Shu? It is also said in the book of accumulation: “People who are deficient in spleen and kidney, and those who are weak and dysregulated, mostly have the disease of accumulation.” . External treatment to regulate the qi deficiency method, especially the selection of acupuncture points and selection of drugs as the key. More than 360 points on the human body is the first to promote the foot three points, cover the foot Yangming Stomach is more gas and blood meridian, foot three points “foot Yangming Stomach meridian” of the main points, acupuncture has to regulate the spleen and stomach, tonic, meridians, support the function of removing evil and can stimulate the biochemistry and operation of blood. The method of acupuncture is afraid that its power is not enough to support the right, so in 5ml syringe with astragalus injection 2ml, with a fine needle as the medium to stimulate the “skin” foot three miles point and through the astragalus medicinal gas to regulate the internal organs of the meridian qi day after day to make it achieve the effect of tonifying the qi, open the meridians and activate the channels, support the right and dispel evil. The “Compendium of Materia Medica” contains “Jie long also, astragalus yellow color, for the long name of the tonic …” cover astragalus “the most tonic of all medicines” also, to the lung, spleen, liver, kidney meridian, especially good at tonic spleen and lung gas, this needle medicine and use the drug gas is connected to the The power of supporting the righteous and dispelling the evil is also very strong. Modern medicine believes that patients with cirrhosis have both erythrocyte immune and humoral immune dysfunction, when combined with infection, the erythrocyte C3b receptor wreath rate decreased 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 is impaired. Many studies have shown that Astragalus has anti-liver damage 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 and prevents hepatic glycogen reduction. Astragalus and its compound preparations have anti-liver fibrosis effects in animal experiments, clinical trials and liver stellate cell experiments. We have used Astragalus injection 2ml of bilateral foot trigeminal injections once every other day for a period of 1 month for a total of 3 courses of treatment. The results showed that it can significantly improve the patient’s sleep and appetite, increase the antiviral response, and no adverse effects, shorten the hospitalization time and save the treatment cost. 3.Chinese medicine enema is the root cause of the deficiency of vital energy in people with accumulation, and the symptoms of heat and toxicity, blood stasis and qi stagnation. As the saying goes, if it is urgent, treat the symptoms; if it is slow, treat the root. The name of accumulation is first found in the “Ling Shu? Five changes”: “people of good intestinal accumulation, …… skin thin and does not luster, the meat is not firm and Nao Ze. This is the case, the intestines and stomach is weak, evil is the evil Qi stay stop, accumulation is injured.” . The accumulation of people’s qi is not smooth, the qi is not smooth, the internal organs are not passable, the internal organs are not passable, the heat and toxicity is embedded, the heat and toxicity is embedded in the transformation of the symptoms. The only way to pass the internal Qi is to use, so the method of enema is the preferred method of external treatment. The bowel gas is not pass people have more heat and toxicity embedded, a single enema can not be the root cause of the cure, when the dialectical selection of clearing heat and detoxification, through the bowel diarrhea of Chinese medicine from the rectal irrigation can get good results. The reason is no more than by “medicine gas” stimulate “skin” to regulate the internal organs of the meridian gas ear. In the clinical evidence, I have prepared my own “intestinal cleansing combination” with the addition of the evidence (raw rhubarb, sliced sapodilla, elm charcoal, dandelion, etc.) 180ml enema, once a day, for one to two weeks. Modern medicine believes that endotoxemia of intestinal origin often exists to varying degrees in cirrhosis, and the incidence is positively correlated with the severity of the disease. Chinese medicine theory believes that endotoxemia is mostly caused by dampness, heat and toxicity, so traditional Chinese medicine is often used with the effect of clearing heat and detoxifying and laxing the internal organs. The use of traditional Chinese medicine enema can improve the local heat and toxin accumulation, blood stasis and Qi stagnation, as well as regulate the whole body Qi to restore the balance of Yin and Yang. At the same time, the 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. 4, liver disease treatment instrument liver acupuncture point irradiation liver main drainage, the main blood collection, the human generation and development of the machine all rely on the liver drainage function, the operation of blood and the transmission of fluid, depends on the smooth regulation of qi, qi depression, blood flow is not smooth. “Dirty disease stop and not enough, the disease does not leave its place”. The Liver meridian starts from the big toe of the foot, travels up the circumvallate apparatus, crosses the lesser abdomen, spreads across the chest, and goes up to the top. The liver area has three points, namely, Zhimen, Riyue and Zhangmen, all of which are important points of the foot Shaoyang gallbladder meridian and the foot Jurgyin liver meridian. As early as in the Ling Shu? The meridians are used to determine life and death, to deal with all diseases, and to regulate deficiency and reality. The twelfth three difficulties>> says: “The meridians, blood and qi, through the yin and Yang, in order to honor the body also.” This summarizes the importance of the meridian system in physiology, pathology and disease prevention. The DSG-I Bioinformatics Infrared Liver Therapy is a new non-pharmacological technique for the treatment of liver disease. On the specific acupoints mentioned above, through the absorption of infrared information by the acupoints, the therapeutic effect can directly reach the diseased places where the internal organs’ meridian qi is imbalanced, and play the effect of “returning to the meridian” and regulating “meridian qi”. Infrared information irradiation technology can automatically extract the bio-rhythm 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 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 of improvement is relatively obvious, most patients after treatment symptoms significantly improved, signs reduced, such as liver pain, bloating, appetite, physical strength increased, etc., especially for insomnia symptom improvement has a very significant difference. It is a proven adjunctive treatment, simple to operate, and to a certain extent reduces the patient’s pain and improves the quality of life. The above information suggests that there is great potential for research and development in the treatment of liver cirrhosis with Chinese medicine characteristics. However, some issues still need to be further addressed, such as: ①Find the combination of Chinese and Western medical theories in the understanding of anti-liver fibrosis, expand the research ideas, and reach a consensus on liver fibrosis. ② Study the epidemiological status of cirrhosis of the liver 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 mitigation 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.