Nourishing Yin and invigorating Blood for the treatment of cirrhotic ascites

  Liver cirrhosis with ascites belongs to the category of “dropsy” in Chinese medicine. It has been listed as one of the four most difficult diseases of “wind consumption and dropsy” by medical practitioners for many generations. Dr. Zhong Yitang, the chief physician of the national famous veteran Chinese medicine, has clinically applied the method of nourishing Yin and invigorating Blood to treat cirrhosis ascites and has obtained good results every time. Today, we summarize his experience in the use of prescriptions and medicines as follows: 1.  Zhong believes that the formation of ascites in liver cirrhosis is mostly due to excessive alcoholism, poor diet, internal depression of the seven emotions, strain and injury, or infection with dampness, heat and insect poison. Externally it appears to be surplus, but internally it is deficient.” The liver is a rigid organ, with a yin body and a yang body, so it should be nourished rather than attacked. The liver is the general’s official, the main reservoir of blood, and it likes to be regulated. If the liver is deficient in yin, it is easy to lose its circulation and cause stagnation of qi and blood. Therefore, the treatment should be to nourish liver yin and dredge liver wood, so as to prevent microcosm and eliminate the gradual. It should be noted that patients with liver cirrhosis suffer from Qi stagnation and derangement, so the use of Qi moving and anti-inflated products should not be too fragrant and dry, so as not to produce the disadvantages of harming Yin. Drugs such as aromatic herb, Buddha’s hand, sand, large belly skin and so on, and the dose should not be too large.  2, nourish the kidney water, strong spleen yin, in order to consolidate the successive days.  The “clinical guide to medical cases” cloud: “liver is the source of disease, the stomach is the place of disease.” In the early stage of the disease, the symptoms of the gastrointestinal system include poor appetite and aversion to oil, nausea and belching, distention and fullness, loose stools, tiredness and fatigue, etc. In the later stage, there is increased pain in the dystrophy, yellowish face, wrong skin, bulging belly and abdomen, veins showing or umbilical convexity, thin limbs, fever, epistaxis, or black stool. Although the early symptoms of this disease are the first symptoms of the gastrointestinal system, Zhong Lao believes that it cannot be treated by the general method of draining the liver and stomach, after all, this is not a simple gastrointestinal system disorder, but due to liver disease and spleen, the treatment should be based on nourishing the liver with products that strengthen the spleen and stomach. This is also called. The medicine can be chosen from ginseng, poria, yam, atractylodes, rice kernel, lotus leaf, Chen Pi, dendrobium, white peony, grain malt, etc.. Especially white peony, bitter and sour, slightly cold, to the liver and spleen meridian, “Shen Nong Ben Cao Jing” contains its “main evil abdominal pain, in addition to blood paralysis, break the hard accumulation of cold and heat, hernia obstruction, pain, urination, benefit. The Compendium of Materia Medica also says that “White peony benefits the spleen and is capable of dipping wood in the earth.” This shows that it is quite compatible with this disease. In addition, the same source of the E and K, the kidney, the innate essence of the five viscera and six bowels and the collection of the kidney water loss, the liver is not nourished and blood dry, so the treatment of this disease in the strong spleen yin at the same time, do not forget to nourish the kidney water, in order to consolidate the successive heaven, drugs such as the system of shouwu, fine raw earth, wolfberry, chasteberry, turtle plate and so on. Especially wolfberry, this medicine is sweet and flat, smooth and fatty, for nourishing the liver and kidney of the wonderful product. According to the “herbal description”: this product still has the function of stopping bleeding, can treat all see blood, cough blood, etc. For chronic liver disease see gum bleeding, can be combined with ground elm, acacia flowers and other drugs, the effect is very good.  3, pass stagnation, and ligaments, to reach the evil and guide stagnation.  The Law of Medical Doctors says: “Where there is Y obstruction, accumulation of lumps, lumps, that is, the root of bloating disease, accumulation of months, the abdomen is as big as a skip, the abdomen is as big as an urn, is the list of abdominal distension.” Zhong Lao believes that the treatment of cirrhotic ascites should also be accompanied by products that activate blood circulation and eliminate Y, resolve blood stasis and open ligaments to inhibit or delay the proliferation of liver fibers and prevent the degeneration and necrosis of liver cells. However, “Y obstruction is gold, hard and firm, deep in the lower part of the body, so it is not possible to gradually grind the pills that slow down the circulation.” Therefore, it is better to choose calm medicine so as not to damage the new liver cells and cause bleeding. Medicine such as Dan Pi, Dan Shen, Xi Cao, Tao Ren, Angelica and so on. Some studies have shown that the water-ethanol extract of Radix et Rhizoma has a protective effect against liver damage caused by carbon tetrachloride and acetaminophen.  It has been reported that the formula based on nourishing yin medicine can increase t-PA activity and inhibit PAI activity, which has the effect of restoring the function of vascular endothelial cells to remove fibrin deposits from the vascular bed. Pharmacological research also shows that: Yin nourishing drugs contain a large number of various sugars, amino acids, vitamins and trace elements, which can supplement various nutrients, regulate the immune function of the body, facilitate the recovery of visceral functions, control or reduce pathological damage, such as Chinese wolfberry, shouwu, raw earth, etc. can increase the synthesis of liver glycogen, inhibit fat deposition in liver cells, and promote liver cell regeneration, while blood activating and blood stasis opening drugs such as Danshen and Cyperus can not only improve liver microcirculation, but also enhance reticuloendothelial cells and promote hepatocyte regeneration. Today, we would like to summarize his experience and share it with our colleagues in the hope that it can be beneficial to clinical practice.