I. Ancient Chinese medicine understanding of liver diseases.
Accumulation, bulging, obstruction, fetish, jaundice, liver accumulation, fullness, etc.
The common TCM basic symptoms of primary liver cancer (single evidence) include 8 basic symptoms in two parts: actual evidence and deficiency evidence.
The actual symptoms include qi stagnation, blood stasis, heat and dampness, while the deficiency symptoms include qi deficiency, blood deficiency, yin deficiency and yang deficiency.
1. Qi stagnation: ① distension and fullness in the chest and epigastrium, ② pain without a fixed location, ③ depression or sighing, ④ belching or erratic flow, ⑤ pulse string.
2. Blood stasis: ① accumulation of lumps under the dorsum, ② pain that does not move, ③ dull face or blue nail, ④ liver palm or spider mole or exposed veins, ⑤ purple tongue or petechiae, petechiae or varicose veins under the tongue and astringent pulse.
3. Heat evidence: ① fever, ② thirst or bitterness or bad breath, ③ dry stool or yellow urine (red), ④ red tongue or yellow coating, ⑤ pulse count.
4. Dampness: ① abdominal or chest water or lower limb edema, ② yellow staining of body and eyes, ③ heavy head and body, ④ greasy or slippery coating, ⑤ slippery pulse.
5. Qi deficiency: ① fatigue, ② dullness or fullness after eating, ③ loose stools, ④ pale and fat tongue or pale tongue with teeth marks, ⑤ weak pulse.
6. Blood deficiency: ① white face or atrophy or pale lip and nail color, dizziness and blurred eyes, ③ palpitations or little sleep, ④ pale white tongue, ⑤ thin pulse.
7. Yin deficiency: ① dry mouth, ② night sweating, ③ hot flashes or fever in the hands and feet, ④ tender red tongue or little or cracked or peeling moss or no moss, ⑤ thin and counted pulse.
8. Yang deficiency evidence: ① cold fear and cold limbs, ② clear and long urine, ③ frequent nocturia. Yang deficiency can be diagnosed when any one of these is seen on the basis of Qi deficiency.
The basic types of primary hepatocellular carcinoma (recurrent evidence) are summarized into five types: liver depression and qi stagnation type, spleen qi deficiency type, liver-blood stasis type, liver-biliary damp-heat type, liver-kidney yin deficiency type.
Liver depression and qi stagnation type: clinical manifestations of drowsiness and pain in the ribs, depression, or sighing, or impatience and irritability, with a light red tongue with a thin white coating and a string or thin pulse.
Localization of liver symptoms: abnormal sensation in the hypochondrium or less abdomen, with a string pulse.
Qualitative symptoms of qi stagnation and qi depression: distension, swelling and pain, stuffiness, hidden pain, scurrying pain.
Stasis of liver and blood: clinical manifestations include stabbing pain and refusal to press on the masses in the hypochondrium, dark face, enlarged liver, liver palm, spider mole, abdominal pain during menstruation in women, dark lumpy menstrual fluid or delayed menstruation, dark red tongue or petechiae, thickened veins at the base of the tongue, thin or astringent pulse.
Qualitative symptoms of liver: abnormal sensation in the hypochondrium and lesser abdomen, depressed mood, and stringent pulse.
Qualitative symptoms of blood stasis: purple tongue or petechiae with petechiae, skin and nails are wrong, mouth and lips are dark, face is dull, nails are purple and dark, pulse is astringent.
Spleen qi deficiency type: clinical manifestations are weakness, poor appetite, distension of the epigastrium and abdomen, loose and unpleasant stools, or swollen limbs or ascites, pale and fat tongue with teeth marks on the edges, smooth or moist pulse.
Qualitative symptoms of spleen: discomfort in the stomach and abdomen, yellowish face, diarrhea.
Qualitative symptoms of Qi deficiency: abdominal distension after eating, pale tongue with tooth marks on the side, slow pulse.
Damp-heat type of liver and gallbladder: clinical manifestations include yellowing of the body and eyes with distinct color, or without jaundice but with a red tongue, yellowish greasy coating and a slippery pulse, nausea or even vomiting, distension or pain in the ribs, yellow urine, and a dry and bitter mouth.
Qualitative symptoms of liver and gallbladder: abnormal sensations in the hypochondrium or lesser abdomen, depression, stringy pulse, liver palm or spider mole, and elevated jaundice index.
Qualitative symptoms of dampness: orange color or yellow sclera, or yellow skin, elevated jaundice index, greasy coating.
Qualitative symptoms of heat: red tongue, yellow coating, counted pulse, yellow urine, dry and bitter mouth.
Yin deficiency of liver and kidney: clinical manifestations of dull pain in the ribs, soreness and weakness of the waist and knees, dizziness, dizziness, tinnitus like cicada, little sleep, dreaminess or insomnia, emaciation, afternoon hot flashes or night sweats, spermatorrhea in men and menorrhagia or menorrhagia in women, red tongue with little fluid, fine or fine pulse.
Localized symptoms of the liver: abnormal sensations in the hypochondrium or lesser abdomen, depression, stringiness of the pulse, liver palms or spider nevus, elevated jaundice index, dizziness, dizziness.
Localized symptoms of kidney: abnormal manifestations such as lumbar or knee tenderness, changes in reproductive behavior such as spermatorrhea in men and menstruation or menorrhagia in women, tinnitus.
Qualitative symptoms of yin deficiency: emaciation, thin tongue, thin pulse, afternoon hot flashes, night sweats, and peeling moss.
IV. Treatment of primary liver cancer
1.Strengthen the spleen and benefit the qi, dredge the liver and regulate the qi, invigorate blood circulation and remove blood stasis, clear heat and detoxify.
2, softening and dispersing nodules, harmonizing the stomach and eliminating conduction, nourishing the liver and kidney.
3. Clearing the liver and gallbladder, tonifying the kidney and strengthening the spleen, nourishing Yin and clearing heat, benefiting Qi and nourishing Yin, and promoting the flow of dampness.
V. Commonly used prescriptions
Yiguan decoction, Yiyao san, Gentian diarrhea of the liver, Artemisia annua soup, Ginseng lingbaijiao san, Sijunzi tang, diaphragm down and eliminating blood stasis, Chaihu dredging the liver, tonifying Zhong Yiqi tang, Xiao Chaihu tang, Xiang Sha Liujunzi tang, Yin Chen Wu Ling san, Haifu and eliminating blood stasis tang, Zhi Bai Dihuang tang, Huang Lian detoxification tang, Si Wei San etc.
Commonly used herbs
Strengthening the spleen and benefiting the qi: princely ginseng, codonopsis, astragalus, licorice, atractylodes, yam.
Diversifying the liver and Qi: Chai Hu, Citrus Aurantium, Augusta, Neem, Chen Pi.
Promoting blood circulation and resolving blood stasis: Salvia miltiorrhiza, Radix Angelicae Sinensis, Radix Paeoniae Alba, Curcuma longa, Ulva lucidum, Peach kernel, Salviae Miltiorrhiza.
Drainage of water and dampness: Poria cocos, Coix seeds, Yin Chen, Poria ling, Zelenia, Plantago ovata, Daggerbark
Clearing heat and detoxifying the toxin: Gardenia jasminoides, Semen Armeniaca, Rhubarb, Serpentine, Gentiana, Phellodendron, Scutellaria
Nourishing Yin and replenishing blood: turtle nail, wolfberry, white peony, raw groundnut, rehmannia, cornelian, turtle plate, sage