Talk about the understanding and treatment experience of cirrhosis
Liver cirrhosis is one of the common clinical diseases, and according to its clinical manifestations, it can be included in the evidence of “dropsy” and “accumulation” in Chinese medicine. As a common disease, cirrhosis poses a great danger to human health and has its own special clinical characteristics. Today, Chinese medicine should also recognize it as an independent disease, which is conducive to finding a systematic and more effective treatment method. Now we will talk about the understanding and treatment experience of this disease according to our clinical practice.
I. Pathological analysis of common symptoms
From the clinical manifestations of patients with cirrhosis, most of them have poor nutritional status, sallow complexion and thin body, which means that the body is deficient in vital energy and imbalance of yin and yang. Distension and pain in the epigastric and hypochondrium, belching and uncomfortable, is qi yu; irritability, insomnia and dreaminess, sore mouth and tongue, dry stool and red urine, is fire yu; dullness and generalized evil, chest stuffiness and distension, heavy and sleepy body, loose stool and urine, or ascites, is damp yu; abdominal distension and uncomfortable after eating, belching and rotten gas, bad smell of food, thick and greasy tongue coating, is food yu stagnation. All of the above manifestations are depression as a disease. On palpation, the liver is hard and painful, the abdominal wall veins are varicose, the lower esophagus and gastric fundus veins are varicose, and there is a history of vomiting blood and black stool, which are all blood stagnation. Although there are many clinical symptoms of liver cirrhosis, there are only three pathological changes.
(a) Depression, the depression of qi, fire, dampness and food, which is the key.
(2) Stagnation of blood stasis, which is the result of the unresolved development of all depressions.
(3) deficiency, the deficiency of vital energy and the dysregulation of yin and yang, which is the result of the injury caused by all the depressions and the dysfunction of the internal organs.
Among the three, “depression” is the fundamental pathology, and the mechanism runs through the whole process of occurrence, development and change of cirrhosis. The disease is born from this, and the disease is even from this.
Overview of common Chinese medicine treatment methods
Comprehensive information, Chinese medicine on the treatment of liver cirrhosis have the following views.
(a) The disease has been prolonged for a long time, the vital energy is already a large deficiency, although the symptoms are numerous, it is difficult to attack from the actual evidence, must be supplemented to slow the figure. According to the different symptoms, or spleen, or kidney, or nourish blood, or benefit the qi, the main focus is to nourish the right, the right can be sufficient since the evil.
(2) The disease belongs to the original deficiency and the standard real, the original deficiency can be slow to figure, the standard real must be urgent to attack, with the boat car pill, Gansui powder, ten dates soup and so on first to expel its water, until the standard real has been removed and then to support the right. Or the method of tonifying and diarrhea may be adopted.
(3) Emphasizing that blood stasis is the main cause, we advocate that stasis should be eliminated, and we should use Xie Yu Blood Soup with Rhubarb, Tao Ren, ? (c) Emphasizing that blood stasis is the main cause, he advocates using Lower Stasis Blood Soup, with Rhubarb, Tao Ren, ?
(4) In addition to Blood stasis, there are also signs of Damp-Heat retention, and advocates invigorating Blood, promoting Qi and clearing Damp-Heat.
If the eyes are red and thin, the five hearts are irritable and hot, and the urination is red and the stool is knotted, the liver and kidney should be nourished and the lower element should be filled.
Segmental therapy for liver cirrhosis
All of the above are clinically used methods, but they lack systematic and comprehensive. The author believes that although the symptoms of cirrhosis are complex and numerous, as long as the three main pathological mechanisms of “depression”, “stasis” and “deficiency” are grasped, the main and secondary factors are distinguished, and the main approach is to dredge the liver and regulate depression, with
Phase I: Dredging the liver and regulating depression.
This stage aims to dredge and regulate qi to relieve depression. The medicines used are Chai Hu, Scutellaria baicalensis, Radix Paeonia lactiflora, Cicada molasses, Ginger Huang, Almond, and Jiao Mai Bud. Although the main purpose is to regulate depression, it depends on the location of the depression. Heat depression should be cleared, fire depression should be sent, gas depression should be sparse, damp depression should be opened, food depression should be eliminated, and stagnation should be passed. All the different depressions, how to determine the? Must refer to the tongue and pulse to determine its location.
Second stage: activating blood circulation and removing blood stasis.
This method should be applied after regulating the depression, and the depressions are gradually relieved before using products that invigorate the blood and resolve stasis to smooth the flow of blood. However, it is not purely used to remove blood stasis, but should still be used to regulate the qi and release liver heat. If the qi is unblocked, the blood stagnates and moves, and if the liver heat is discharged, the depression does not come back. The medicines used are Dampi, Gardenia, Red and White Peony, Yujin, Almond, Cyperus, Fucus, Whitehead, and Jiao Sanxian.
The third stage: nourishing blood and activating blood circulation as well as softening and resolving blood stasis.
This method should be applied after the last two methods. All the depressions have been resolved, blood and qi gradually attain smoothness, the function of the viscera gradually restored, diet and sleep are normal, but the remaining liver hardness is not eliminated, it is appropriate to use this method to nourish the blood and invigorate the blood, regulate the qi flow, and at the same time, salty cold to soften the hardness and eliminate stasis, in order to slowly eliminate the hardness and soften the liver. Medicines such as: turtle nail, oyster, angelica, raw earth, Chuanxiong, white peony, yujin, almond, spineflower, motherwort, cyperus. This is based on Siwu Tang to nourish the Blood and invigorate the Blood, with the addition of Yu Jin, Yi Mu Cao and Xi Cao to strengthen the function of invigorating the Blood and resolving blood stasis. Clinical application can also be combined with pills such as Turtle Nail Decoction Pill to regulate the treatment.
Phase IV: Adjustment of Yin and Yang for balance.
This method is actually the principle of late treatment. However, the above rules should also be applied in conjunction with each stage of treatment. Those who are deficient in Yang should support their Yang, those who are deficient in Yin should take care of their Yin, those who are deficient in Qi should benefit their Qi, those who are deficient in Blood should regulate their Blood, those who are deficient should be tonified, those who are solid should be diarrhea, those who are cold should be heated.
The purpose of the above four stages of treatment is to: first open its depression is qi flow blood smooth; followed by blood circulation to remove blood stasis, salty cold to soften the hardness of the blood stagnation is feasible, liver hardness can be soft, evil go is also restored. If the hands will be salty to soften the firmness or throw tonic, gluing the qi, aggravate the depression, but to retain the evil. If the ascites is more prevalent or the deficiency has been extreme, and when the first water to treat the symptoms or urgently to support the positive, often in the method of change, valuable in the clinical evidence weighing.
Fourth, the life conditioning of cirrhosis
Clinical treatment of liver cirrhosis is not satisfactory, often because of over-reliance on drug treatment, but do not pay attention to life conditioning. Life conditioning should mainly focus on the following aspects.
(a) careful diet: food should be light, vegetarian food is the main, eat less and more meals. Try to eat less fat and high-protein food, and eat more fresh vegetables, to keep the bowel movement smooth. The purpose is to reduce the burden on the digestive organs and liver. Clinically, patients and their families often emphasize one-sidedly on increasing nutrition, reluctantly eating {nutritious food, resulting in loss of appetite, bloating, abdominal fullness, abdominal discharge, thick and greasy tongue, in order to increase the burden on the gastrointestinal and liver, although the nutrition is high, but not absorbed, into a leak two, more than the loss, food accumulation in the middle, but increased liver damage.
(B) more activities: the purpose is to make the flow of Qi and blood, exhale the old and take in the new, in order to facilitate recovery. Liver patients are often easily fatigued, reluctant to move, especially with ascites, often bed rest is the main. Long-term bed rest and stagnation of qi and blood are not conducive to functional recovery. There are many ways to move around, especially walking is the easiest and most suitable. I advocate that patients with cirrhosis walk not less than two hours or ten miles a day, once in the morning and once in the evening, in order not to make excessive fatigue can be carried out intermittently.
(C) Yi Yi Zhi: cirrhosis of the liver for a long time, long treatment, resulting in patient discouragement, depression, lack of confidence in the cure, often can not adhere to the system treatment. Therefore, it is necessary to comfort the patient with a wide range of words to help build up confidence. At the same time, family members should also be advised to create a good living environment for the patient, so that his mood is happy, do not go against his will, so that his anger and sadness, aggravating the disease.