It is well known that China is a large country with hepatitis B. This, coupled with the current influence of various bad habits such as drinking alcohol and staying up late, has kept the incidence of liver disease high. If liver disease is repeatedly attacked and not controlled for a long time, it will easily form diffuse liver damage and cause liver cirrhosis. And cirrhosis is also an important risk factor for the occurrence of liver cancer, so it is important to actively control cirrhosis to delay or prevent the occurrence of liver cancer. So how do we treat cirrhosis if we have it?
For the treatment of cirrhosis, we need to know that it requires a comprehensive treatment method. The first thing to do is to get rid of the various causes of cirrhosis. For cirrhosis that has already occurred, we should give: general supportive therapy, treatment of cirrhotic ascites, and stem cell therapy according to the condition.
I. Removal of causative factors.
For cirrhosis that has a clear etiology, the etiology should be eliminated.
1. Patients with alcoholic cirrhosis must absolutely abstain from alcohol. Other causes of cirrhosis should also abstain from alcohol. Those with a history of schistosomiasis infection should be treated with anti-bilharzia therapy. For patients with congenital liver disease, such as hepatomegaly, the main thing is to raise awareness and give identification, otherwise it is easy to misdiagnose, so that patients do not get the appropriate treatment and delay the disease.
2. Hepatitis B infection is the main cause of liver cirrhosis in China. For those who are positive for hepatitis B markers and hepatitis B virus quantification in blood, anti-hepatitis B virus treatment will be given as appropriate.
Second, general supportive therapy.
Patients with cirrhosis often have poor general nutritional status. The purpose of supportive therapy is to restore the general condition and supply the liver with sufficient nutrition to facilitate the repair and regeneration of liver cells.
1, rest: compensated cirrhosis can be appropriate work or labor, but should pay attention to the combination of work and rest. The decompensated stage of cirrhosis should stop working and rest or even basic bed rest to reduce the body’s demand for liver function. Work can be resumed appropriately in the recovery period.
2.Diet: In principle, the diet of cirrhosis patients should be high in calories, adequate protein, restricted sodium intake and sufficient vitamins.
Cirrhosis is a chronic wasting disease, so calories should be supplied adequately. The source of calories is mainly sugar. Sugar is decomposed into glucose in the intestine and absorbed, and turned into hepatic glycogen in the liver, which is beneficial to the regeneration of liver cells and prevents damage to liver parenchyma by toxic substances. For those who are seriously ill, enteral nutrition preparations can be applied. These preparations are based on the principle of comprehensive and balanced nutritional formulas, and the amount of intake can be adjusted according to the condition to avoid excessive protein and ammonia intake. For those who cannot eat, intravenous glucose solution with appropriate amount of insulin and potassium chloride can be administered. Or give intravenous nutrition.
A high-protein diet with 1-1.5g of protein per kg of body weight per day is appropriate. Lean meat, fish, chicken, soy products and dairy can be consumed, and food should contain less animal fat. It is advisable to eat vitamin-rich vegetables and fruits, and take oral multivitamin preparations if necessary. Alcohol consumption is strictly prohibited. For those who have the first symptoms of hepatic encephalopathy, protein intake should be limited. Those who have esophageal varices should avoid hard and rough food to avoid damage to the esophageal mucosa causing bleeding, and those who are thin should increase their weight appropriately, but should not be too obese or gain weight too fast to avoid promoting fatty liver.
Restrict sodium intake: Patients with cirrhosis should have less salt diet, especially those with ascites should limit the intake of sodium.
Third, the treatment of cirrhosis ascites.
When cirrhosis ascites occurs, patients often feel abdominal discomfort, easy to complicate the spontaneous bacterial peritonitis, easy to lead to water-electrolyte disorders, a large amount of ascites accumulation is complicated by liver and kidney syndrome. Therefore, it is very necessary to treat and reduce water use.
1, general treatment: bed rest should be given and low-salt diet. Limit the amount of water intake.
2, the application of diuretics: diuretics are spironolactone, aminopterin, thiazide diuretics, furosemide, etc. The use of diuretics should be noted: (1) should not be a large number of, rapid, eager to achieve. Because the absorption rate of ascites is at most 700-930ml per day, a large amount of diuresis beyond this limit will inevitably lead to a drop in circulating blood volume, which is not good for patients, so it is appropriate to start diuresis in small and medium doses. (2) The amount of diuretic should be individualized, because the diuretic response varies from patient to patient. (3) In order to prevent electrolyte disorders, especially the occurrence of hypokalemia, the combination of potassium-removing diuretics and potassium-preserving diuretics is recommended. For thiazide and tab diuretics, intermittent application is recommended, with 4-5 days and 2-3 days stop.
IV. Stem cell therapy for cirrhosis.
Mesenchymal stem cells of umbilical cord origin have the functions of multi-directional differentiation, massive proliferation and immune regulation. Studies have shown that MSCs can promote liver regeneration, nutritionally repair the diseased liver cells and restore their functions. To a certain extent, they relieve patients’ discomfort and improve liver function and patients’ prognosis. It opens up a new way for the treatment of decompensated cirrhosis. Stem cell therapy transplantation has become an important method for the treatment of cirrhosis and liver failure.
1. Mesenchymal stem cells nourish and repair diseased liver cells to restore their functions.
MSCs secrete various bioactive molecules such as anti-apoptotic factors and anti-inflammatory factors to promote liver regeneration, inhibit hepatocyte apoptosis, resist fibrosis, and delay gallbladder ligation and carbon tetrachloride induced cirrhosis.
2. Stem cells differentiate into hepatocyte-like cells.
MSCs transplanted into the body enter the liver with blood flow, cross the vascular endothelial gap and then enter the liver tissue. Stem cells differentiate into hepatocyte-like cells under the stimulation of local liver injury microenvironment.
3. MSCs have the function of two-way regulation of immunity.
Mesenchymal stem cells have low immunogenicity and almost no rejection reaction, and also have the function of bi-directional regulation of immunity to achieve balance, which has a very good therapeutic effect on autoimmune diseases.
As with other diseases, early treatment is crucial to the recovery of cirrhosis. Once cirrhosis is diagnosed, go to the hospital as early as possible to develop a reasonable and suitable treatment plan for you. To avoid causing more damage to the body.