Each human body has a heart, lungs, liver, kidneys and other organs to ensure the continuation of life activities and metabolism, I think you probably know that the heart is the cardiovascular system organs, playing a pumping role, maintaining the circulation system required for life; lungs dominate human respiration, the oxygen in the air is inhaled into the lungs, into the blood, is circulated to various tissues and organs; liver plays an important role in detoxification, metabolism; kidneys play a role in excretion, many metabolic products are secreted through the kidneys and excreted in the form of urine, otherwise people will be poisoned! The liver plays an important role in detoxification and metabolism; the kidneys play a role in excretion, many metabolites are secreted through the kidneys and excreted in the form of urine, otherwise people will be poisoned! In addition to the above organs, the human body also has a spleen, which makes up the so-called: heart, liver, spleen, lungs and kidneys; location and function in the human body, the spleen in Western medicine and Chinese medicine, little known, here, tell you about the spleen of those things. The spleen is located in the upper left abdominal cavity of the human body, behind the rib cage, and is generally untouchable under the rib cage, and is often overlooked because its function is not as important as the above organs. The spleen has immune functions (the largest and most efficient immune organ in the body, the center of cellular and humoral immunity, playing a role in immune surveillance and regulation), filtration functions (removal of foreign bodies, germs and cells, such as filtering out senescent and abnormal cells), storage functions (selective retention and storage of platelets, lymphocytes, reticulocytes, etc.), blood volume regulation functions (regulation of plasma volume and (regulation of plasma volume and albumin synthesis), hematopoietic function (fetal period has a certain role in hematopoiesis, after that, gradually transferred to bone marrow hematopoiesis), and so on. Some blood disorders are often accompanied by splenomegaly, and immune dysfunction of the spleen can lead to blood cell abnormalities; (a) Splenomegaly is common in the following diseases: 1) chronic myeloproliferative diseases (such as true erythropoiesis, primary thrombocythemia, chronic myeloid leukemia, etc.) and myelodysplastic syndromes, which are related to the blood filtration, storage and potential hematopoietic functions of the spleen Chronic lymphoproliferative diseases, such as chronic lymphocytic leukemia and various lymphomas, are associated with the lymphatic organs of the spleen; 3. Acute leukemia of various types often results in varying degrees of enlargement due to infiltration of leukemic cells; 4. 5, other diseases such as infectious diseases, common viral infections, especially presenting chronic, developing cirrhotic stage, etc.; connective tissue diseases can also cause splenomegaly and, of course, certain rare diseases of the spleen itself accompanied by different degrees of enlargement. (b) Abnormal spleen function associated with autoimmune hematologic diseases: such as immune thrombocytopenia/purpura, which is common clinically, the spleen is usually not enlarged, but the immune function is abnormal, producing antibodies against its own platelets and causing destruction, and thrombocytopenia occurs; autoimmune hemolytic anemia is the production of antibodies against red blood cells for destruction causing anemia; leukopenia is common clinically, mainly refers to chronic ones of unknown cause, often related to autoimmunity, the spleen plays a not insignificant role; of course, the above-mentioned types of diseases, autoimmune function abnormalities, mainly related to the function of the spleen as an immune organ; not only that, the previous so-called viral hepatitis, if poorly controlled and developed to the stage of cirrhosis, often cause splenomegaly, easily accompanied by hyperfunction, called hypersplenism (referred to as hypersplenism) This causes a decrease in blood cells, commonly white blood cells and platelets. We often talk about the spleen in Chinese medicine, which has two meanings: one is the spleen, which belongs to the anatomical category of Western medicine, which is what we talked about in the first part: the body parts and functions, etc.; the other is the spleen in Chinese medicine, which is mainly the efficacy, including the function of the spleen. “For example, we often say: “The spleen is the master of transportation (digesting food), the master of blood (regulating blood and preventing bleeding), and the master of biochemistry (transforming gas and blood)”, etc. Problems with the spleen in Western medicine are related to the series of diseases mentioned in Part II. In Western medicine, problems with the spleen are related to the series of diseases mentioned in Part II. In Chinese medicine, problems with the spleen mainly manifest a series of clinical symptoms, such as deficiency of qi and blood, such as lack of color, lassitude, shortness of breath, palpitations and shortness of breath, etc.; derangement of the spleen’s control causes bleeding manifestations: purpura of the skin, blood oozing from the teeth and nose, heavy menstruation in women, etc.; unfavorable digestion and bloating in the upper abdomen, poor appetite, loose stools, etc. Some diseases in Western medicine, such as enlargement of the spleen or reduction of blood cells due to immune dysfunction of the spleen, have some correlation with the “spleen” in TCM, although not all of them are related; for example, thrombocytopenia and bleeding due to immune dysfunction of the spleen, through identification, some patients can be For example, some of the patients may have “spleen deficiency”: deficiency of qi and blood and loss of blood control, so they are given treatment to strengthen the spleen and nourish the blood, and to benefit the qi and blood intake, which is effective. 4. The experience of spleen adjustment and treatment and the “evidence-based spleen treatment” is one of the common treatments for blood diseases in Western medicine, regardless of the type of disease causing spleen enlargement or the cause of immune dysfunction of the spleen causing blood cell reduction. The enlarged spleen often causes fullness in the upper abdomen, poor appetite, swelling of the lower limbs, etc. Immune abnormalities cause hemocytopenia, and hemorrhagic symptoms such as purpura due to thrombocytopenia are common, and a considerable number of patients are accompanied by deficiency of spleen qi: less color or atrophy, tiredness and weakness, recurrent bleeding, etc. Treatment should regulate the spleen: strengthen the spleen to benefit qi (ginseng, codonopsis, astragalus), or benefit the spleen to nourish yin (princely ginseng, codonopsis, maitake or tonifying the spleen and warming the yang (Cuscuta sinensis, Radix et Rhizoma rehmanniae, Red ginseng), or strengthening the spleen and benefiting the qi and regulating the blood (Xianhecao is used, especially in large doses! Secondly, the five organs are related to each other, and the “five elements (liver wood, heart fire, spleen earth, lung gold, kidney water)” in Chinese medicine are treated from the perspective of the law of birth and death, and the clinic has figured out how to regulate the liver to support the spleen, nourish the kidney to warm the spleen, and promote the lung to cultivate the earth (spleen is also the earth!). For example, spleen deficiency with dampness, qi deficiency with stasis and siltation, spleen deficiency with liver deficiency and depression, etc. The clinical evidence requires a balance of deficiency and reality, and on the basis of strengthening the spleen and benefiting qi, we should add treatments and prescriptions to resolve dampness, eliminate stasis and dredge the liver. The treatment of hematological spleen and immune disorders caused by hematopenia with internal Chinese medicine alone is often clinically ineffective! I remember ten years ago, I met a patient with chronic primary myelofibrosis and was prescribed Qing Dai powder to shrink the spleen, however, after taking Qing Dai, the patient’s gastrointestinal pain was unbearable, so he refused to continue taking it. After that, we created the “Qing Dai Si Huang San Spleen Compressing Therapy” for the treatment of myelofibrosis and its chronic bone marrow, chronic lymphoproliferative diseases, etc. The spleen was obviously enlarged, and the effect was obtained to varying degrees, and we have organized doctors and nurses to conduct Recently, we have been trying to apply Chinese herbal medicine to the spleen for the treatment of thrombocytopenic purpura due to abnormal function of the spleen without enlargement, and some patients have obtained unexpected results. Through continuous clinical exploration and discussion, we have gradually formed the prototype of “evidence-based spleen compressing therapy”. ), applying spleen to produce blood, applying spleen to soften hardness, etc., together with internal Chinese medicine, internal and external application to obtain further clinical efficacy. For example, in chronic granulocytic leukemia, which is often accompanied by an obvious enlargement of the spleen, when there was a lack of good drugs to control the leukocytes and the spleen, spleen removal helped to relieve the symptoms of enlargement and compression and to reduce the tumor load in the body, which was a stopgap measure. However, in myelofibrosis, another myeloproliferative disease, where the compression of a large spleen cannot be relieved by drugs, or where a large spleen brings about significant and persistent hematocrit, surgical splenectomy can help relieve the compression and hematocrit. Although it was not considered in the past, nowadays it tends to be more aggressive; according to my experience, it may be tried if necessary, and it is expected to promote the patient’s quality of life after “spleen removal” and survival with the disease. In the case of thalassemia, which is characteristic of the Guangxi region in Guangdong, due to long-term chronic hemolysis, the spleen, as a blood filtering and storage organ, will gradually swell up, and after swelling, it will cause splenic-derived blood cells to be removed, resulting in further reduction of blood cells, at this time, surgical means of spleen removal can be adopted; if it is a single lymphoma, surgery is a good choice. So, can splenectomy be considered for the treatment of thrombocytopenic purpura due to abnormal immune function when the spleen is not large? The answer is yes, for patients who are treated conservatively with internal medicine and the effect is not good or even very poor, more than six months to one year and above, if there is no contraindication and physically and psychologically acceptable, it can be considered to implement; because the immune biochemical system of the spleen is malfunctioning, producing antibodies that destroy platelets, and withholding and removing platelets, “de-spleen ” treatment is effective. In addition to traditional surgical resection, nowadays, the development of minimally invasive surgery reduces trauma and enhances safety; and interventional techniques can implement “splenic artery embolization”, which means inserting a catheter through the artery and placing some embolic agent to eliminate the function of the spleen, commonly known as “home depletion of the spleen “Radiologists are not left behind, and irradiation of the splenic region has been clinically effective for patients who are not suitable for surgery, even if minimally invasive, although it is rarely used in clinical practice. Nevertheless, for the above-mentioned patients, especially those with primary immune thrombocytopenic purpura, splenectomy still carries certain risks: surgical and anesthetic risks, immune deficiency of “de-splenicized” patients and their susceptibility to infection, significant elevation of acquired platelets after splenectomy, clean removal of the secondary spleen, ineffective or repeated splenectomy, significant reduction of platelets These issues require a comprehensive and systematic review and evaluation by the hematology department, and the surgical department must weigh the pros and cons before spleen removal can be performed. It is indisputable that the spleen functions properly in the body and protects the health of the organism! As a practitioner of traditional Chinese medicine and Chinese and Western medicine, I have gradually come up with non-invasive spleen dressing therapy for those with obvious enlargement of the spleen, which is effective. The treatment is still being further explored and the rules of the Chinese medicine discriminative spleen dressing therapy are being improved.