Portal vein thrombosis is a common complication of hepatocellular carcinoma, and it is the most important treatment for hepatocellular carcinoma. At present, the treatment of portal vein cancer embolism in hepatocellular carcinoma is at the initial stage, and the following methods have been reported in the literature: hepatic artery embolization chemotherapy, continuous chemotherapy via portal vein, anhydrous alcohol injection in cancer embolism, hepatic artery embolization chemotherapy plus radiation therapy and surgical removal of cancer embolism. Once ascites appears, the above methods are difficult to implement. Through clinical diagnosis and the characteristic of liver “using yang while using yin”, I have achieved good results in treating portal vein cancer embolism by adopting the method of nourishing yin and invigorating blood, warming yang and promoting water.
The first patient with portal vein cancer embolism was seen to have distended abdomen, edema of both lower extremities, jaundice, distended stomach, low appetite, fatigue, dry mouth, hypochondriac pain, emaciation, dark red tongue, yellow moss, fine pulse, yellow staining of skin and sclera, spider nevus all over the face, liver larger than 5 cm below the midclavicular line, medium hardness, no nodules, tenderness, frog-shaped abdomen, abdominal circumference 106 cm, mobile turbid sound ( ++).
Abdominal CT showed.
1, large foci of mild heterogeneous enhancement in the right and left lobes of the liver with fading in the portal phase.
2, portal vein cancer thrombosis, size about 3.0×2.0 cm.
3, splenomegaly and ascites.
Ultrasound of abdomen.
AFP257ng/ml. This is an advanced stage of hepatocellular carcinoma, with evidence of liver-yin deficiency, blood stasis and water stagnation. After 40 days, the patient’s symptoms disappeared, her weight increased, and the repeat abdominal CT and hepatobiliary ultrasound both indicated that the portal vein cancer thrombus disappeared.
The patient’s symptoms disappeared and his weight increased. After 20 days, the abdominal ultrasound indicated that the portal vein cancer thrombus disappeared. Less than a month later, he went to a hospital in Beijing to consult a Dalian patient with hepatocellular carcinoma complicated by portal vein cancer thrombosis, and was treated with “nourishing Yin, invigorating Blood, warming Yang and promoting water” herbal soup as the main treatment. Since then, 15 cases of portal vein cancer embolism were treated with “nourishing Yin, invigorating blood, warming Yang and promoting water” method, and 12 cases were cured, of which the fastest disappearance of portal vein cancer embolism was 12 days and the longest was 56 days.
The basic formula for the treatment of portal vein cancer thrombosis is: 20-30g of raw Astragalus membranaceus, 15-20g of Dashengdi, 15-20g of Cornu Cervi Pantotrichum, 15g of Turtle Board, 10g of Curcuma longa, 15g of Radix et Rhizoma lingzhi, 15g of Chuanjiaomu, 10g of Cinnamomum cassia, 15g of Dashengbei, 10g of Yin Chen, 15g of each of Poria poria, 15-20g of Lungwort, 1 dose daily with water.
Addition and reduction.
1, in case of pain in the liver area Add 15g of Yujin, 30g of Bupleurum, 40g of Rhamnus, 15g of Yuanhu.
2, jaundice Add Yin Chen to 15g, with 1g of mannitol and 1g of kufu alum to be taken with powder.
3. In case of low fever, add 15g of Artemisia annua, 15g of Radix Bark of the Earth and 15g of Yin Chai Hu.
4, ascites, give 10g of sesame, 15g of Sichuan pepper, 15g of Longji, 10g of cinnamon, 10g of each of the two ugly, 30g of raw astragalus, the drugs are decocted twice to remove the dregs and concentrated into a thick paste, add 20g of gum to melt, after cooling, add 1g of ice chips, take 3g of the paste placed in the umbilical point, external ginger moxibustion, once a day for 2 hours.
5, diarrhea, remove the raw earth, lingxiaohua, Yin Chen, plus roasted licorice 30g, 15g of red stone resin or five times the seeds of research and vinegar to dress the umbilicus.
6, constipation, add 10g of raw rhubarb, 20g of fried lycopodium.
7, blood in the stool or vomiting blood Add 20g of earthen rhubarb, 15g of Pu huang charcoal, 15g of blood surplus charcoal, 10g of burnt dried toad, and in case of rapid bleeding, give the treatment of sedative drip, thrombin and epinephrine with ice saline frequently. At the same time, apply Golden Dragon capsule and Huachansu tablets.
It must be noted that.
1. the treatment of ascites is an important part in the process of treating portal vein cancer embolism, and the abatement of ascites helps the disappearance of portal vein cancer embolism. Ascites in hepatocellular carcinoma has the characteristics of stubborn, large volume and recurrence. Treatment with traditional methods such as diuretic, supplemental albumin, fluid extraction and intraperitoneal injection often has little effect and will cause many adverse reactions. We use the method of moxibustion of umbilical points to treat ascites caused by liver cancer, stomach cancer and ovarian cancer, which is more effective than other uses of Chinese medicine.
The specific method is: decoct the Chinese medicine twice to remove the slag, combined with thick decoction into a thick paste, then add gum to melt, after cooling, put ice chips, each time take 3g, put on the umbilical point, placed on the small empty ginger slices, and then put the appropriate amount of moxa on the ginger slices, ignite the moxa moxibustion, the first time moxibustion for 2 hours, the second time after each moxibustion for 1 hour, moxibustion will be left in the umbilical point, external plastic film, once a day, fifteen days for 1 Fifteen days is one course of treatment. Patients cannot operate on their own, must have an assistant or medical assistance to prevent burns, local heat to the extent that the patient can tolerate, too hot, then change the ginger, and so repeatedly operate.
2, treatment of portal vein cancer embolism is not a single attack, but according to the clinical diagnosis and liver body yin and Yang characteristics of the choice of drugs, if Meng Lang use things to promote patient failure and death.