1.Glorifying Liver Soup
Ingredients: Radix Codonopsis pilosulae, Rhizoma Atractylodis Macrocephalae, Atractylodis Macrocephalae, Radix Angelicae Sinensis, Radix Paeoniae Alba, Radix Aromaticae Sinensis, Fructus Foetida, Fructus Crataegi, Radix Zeleniae Sinensis, Oyster, Wang Bu Li Xing.
Chronic hepatitis and early cirrhosis, with evidence of liver stagnation, spleen deficiency, qi stagnation, blood stasis and damp-heat not yet cleared.
The combination of all these medicines can help to strengthen the spleen and earth, dissolve dampness, clear heat and toxicity, and dissolve blood stasis, which will help to remove the symptoms and eliminate the evil.
Hepatitis, especially cirrhosis caused by hepatitis B, is a complex disease mechanism, easy to recur and difficult to eradicate. The root cause of this is that there is both liver damage – the positive side of the deficiency, and the hepatitis B virus latent – the evil side of the actual, and carry out the entire course of the disease, and because the detoxification of evil, blood easy to hurt the positive, support the positive and easy to love the evil, so the clinical treatment is quite difficult. Therefore, it is believed that the treatment of this disease should be done with two hands: not only to eliminate the evil, but also to protect the righteousness at all times. To achieve the desired goal, we should treat the disease with both hands: to eliminate the evil and to help the positive.
2.Liver Softening Soup
Raw rhubarb, peach kernel, earth turtle, Salvia miltiorrhiza, turtle nail, gunnera, Astragalus membranaceus, Atractylodes macrocephala, Radix Codonopsis pilosulae.
Indications: obstruction, accumulation, dysmenorrhea, dropsy (early cirrhosis, mild ascites).
Explanation: This formula is based on Zhongjing’s “Jin Kui Yao”, which is based on the addition of “Lower Blood Stasis Soup”. The original formula treats postpartum abdominal pain, with dry blood in the abdomen under the umbilicus, and also menstrual flow. The modern pharmacological research proves that it can promote the improvement of liver physiological function and make the enlarged liver and spleen shrink and become soft; the salty taste of cannabis nail can soften the firmness and is good at running away, while the salty taste and cold air of turtle nail can enter the blood component of liver and spleen, which can not only nourish yin and reduce heat, but also soften the firmness and disperse the knots, both of which have better therapeutic effect on the enlarged liver and spleen in cirrhosis; the spleen mainly transports and transforms water and grain essence, which is the essence of the latter day. The combination of Astragalus, Atractylodes, and Radix Codonopsis to strengthen the spleen and enhance vital energy is in line with Zhongjing’s principle of “when we see liver disease, we know that the liver transmits the spleen, so we should first strengthen the spleen”. The dose is adjusted according to the patient’s physical deficiency, which is the meaning of supporting the righteousness and eliminating the evil. The above medicines have the functions of both attacking and tonifying, invigorating blood circulation, removing blood stasis, softening the liver and dispersing nodules. This formula is mainly designed for early stage cirrhosis of the liver. It is mainly based on activating blood stasis, softening hardness and dispersing nodules, and supplemented with products that benefit Qi, strengthen the spleen, and support the righteousness and dispel evil, which reflects Jiang’s advocated academic view of combining evidence and disease identification and his unique experience in treating liver disease by activating blood stasis. The application of Atractylodes macrocephala in the formula (the dose is as heavy as 60g) is worthy of consideration. The Materia Medica is said to be “bitter to dry dampness, sweet to nourish the spleen and gentle to the middle. In blood, it tonifies blood, and in qi, it tonifies qi”, which indicates that this product has a very good tonic effect. It is also said that it can “eliminate phlegm and water swelling and fullness, jaundice and dampness paralysis and fetishes”, which indicates that this product has a good effect of dispelling evil (water elimination), so it is most suitable for liver cirrhosis and cirrhosis of the liver ascites. Many famous scholars in China like to use this product to treat liver disease, and the original fear is here.
Add and subtract: for dampness and heat, add Yin Chen, Gardenia jasminoides, Poria, Phellodendron, gentian grass, pendula, pingdi wood, etc.; for spleen deficiency and qi stagnation, add Sha Ren, Chen Pi, Citrus aurantium, Huo Xiang, Su Stems, etc.; for liver qi stagnation, add Chai Hu, Yu Jin, Citrus aurantium, Qing Pi, Mu Xiang, Green Calyx Plum, etc.; for blood stasis in the liver complex, add Boswellia, Wu Ling Li, Red Peony, Red Flower, Nine Fragrant Worms, etc.; for liver meridian and heat stagnation, add Sang Shan Yuan, Dampi, Forsythia, Gentiana, etc. For liver and kidney yin deficiency, add Shengdi, Yangshen, Maedong, Dendrobium, Lady’s Maidenhair, Dioscorea, etc.; for yin deficiency and fire vigor, add Gentiana, Tribulus terrestris, Gardenia, etc.; for spleen and kidney yang deficiency, add Radix et Rhizoma, Cinnamomum, Ginger, Fructus edulis, Sharen, etc.; for liver disease, see impotence, do not strengthen yang, because strengthening yang will move phase fire and hurt liver yin, and the disease will become heavier. If bleeding is more frequent and the symptoms are more serious, suspend the method of activating blood circulation and resolving blood stasis, or do not use hemostatic drugs, and increase the dose with the method of strengthening the spleen to stop bleeding; if the stools are frequent and loose, reduce the amount of rhubarb or change to the decoction of rhubarb first.
3.Softening liver and reducing spleen formula
Composition: Radix Bupleurum, Scutellaria baicalensis, Cicadelle, Rhizoma Bupleurum, Turmeric, Safflower seeds, Saxifrage, Oyster, Rhubarb, Jiao Sanxian.
Indications: Early stage liver cirrhosis. It is mostly used in advanced stage of hepatitis, manifesting as dystocia, abdominal distension, obstruction of the abdomen, stasis of the tongue, white fur and stringiness of the pulse, etc. The evidence belongs to Qi stagnation and blood stasis.
Radix Scutellaria baicalensis is a bitter cold formula to clear heat and bile, and is used in combination with Radix Scutellaria baicalensis to clear heat in liver and gall bladder; Cicada, Silkworm, Ginger Yellow and Rhubarb are the famous formula of Yang Lushan in Qing Dynasty, which is good at opening up internal and external, leveling up and down, and harmonizing yin and yang qi and blood; Safflower seeds invigorate blood and can promote water circulation, remove blood stagnation and water-dampness; Jiao Sanxian eliminates stagnation and induces stagnation, opens the stomach and increases food; Turtle Nail and Oyster are salty and cold to soften hardness to disperse stagnation and eliminate obstruction. The combination of all the medicines works to promote qi, open depression, invigorate blood circulation, promote water retention, and soften the liver and reduce spleen.
Add and subtract: for abnormal liver function, yellow tongue coating with signs of dampness and heat, add Artemisia inchi and Fu Ling; for chest discomfort, good sighing, sunken and stagnant pulse, obvious qi deficiency, add Buddha’s Hand and Fragrant Herb; for cachexia, anorexia, vomiting, white and greasy coating, dampness blocking the middle jiao, add Patchouli, Perilla, Jiang Han Xia; for irritability, red and prickly tongue, fire deficiency, add Huang Lian, Gentiana and Dan Pi; for emaciation, fatigue, weak pulse, obvious qi deficiency, add Prince’s Ginseng If there is deficiency of blood, add Agaricus and Angelica; if there is deficiency of Yang in the middle and cold extremities, add Ginger and Cornu Cervi; if the tongue is red and vivid, with little coating and dryness, add Radix et Rhizoma Polygonati, Fructus Lycii and Radix et Rhizoma Polygonati.
In the early stage of cirrhosis, the clinical manifestations are quite complicated, but the evil reality of liver and spleen enlargement always prevails. Treatment should not be purely tonic because of deficiency, otherwise the phlegm and stagnation will be even worse; nor should it be too aggressive because of the real evil, which will hurt the vital energy and will not benefit the disease. It should not be decided quickly, but only slowly. The use of drugs should be more careful, not reckless. Zhao Lao’s formula with the lifting and lowering of the san is not only original, but also in line with the disease mechanism, and no harm to the positive. In addition, the stiff silkworm and rhubarb have the function of pushing out the old and bringing in the new, dispelling the turbid and raising the clear, which is beneficial for the recovery of liver cirrhosis. For example, “typhoid fever and warm epidemic article” cloud: “stiff silkworm taste hard gas thin, like dry and evil wet, get the evolution of heaven and earth, light floating and rising Yang in the Yang, so it can win the wind and remove dampness, clear heat and depression …… disperse reverse turbidity stagnant phlegm also …… can open all Fries The evil qi of depression.” Rhubarb “Ben Jing” said it “down blood stasis, blood shutdown, cold and heat, break the accumulation of obstruction, retention of drink and food, cleanse the intestines and stomach, push the old to the new, pass the water and grain, regulate the middle and transform food, peace and five organs.”
4.Soothing the liver and opening the lung soup
Radix Bupleurum, Radix Paeoniae, Radix Angelicae Sinensis, Radix Salviae Sinensis, Oyster, Radix et Rhizoma Polygonati, Rhizoma Polygonati, Rhizoma Polygonati, Aster, Radix Platycodon, Neem.
Chronic hepatitis, prolonged hepatitis and hepatic ascites due to early cirrhosis.
5.Liver Softening Decoction
Ingredients: Radix et Rhizoma prince ginseng, Radix et Rhizoma turtle shell, Atractylodes macrocephala, Poria, Citrus aurantium, Semen cuscutae, Rhizoma Dioscorea, Salviae Miltiorrhizae, Glycyrrhiza glabra, Rhizoma turtle shell.
Indications: Liver cirrhosis.
How to use: Dry and grind the turtle worms into fine powder. Three bowls of water, into the turtle shell first decoction for half an hour to 1 bowl of decoction of all the drugs, wash the ground turtle worms, dregs and then decoction. Day 1 dose.
Explanation: In this formula, Fu Ling, Atractylodes Macrocephala and Glycyrrhiza glabra strengthen the spleen and benefit the qi; Prince’s ginseng is a tonic but not a dry one, and it is very suitable for both qi and yin. The combination of all the medicines works to strengthen the spleen, nourish the liver, tonify the kidney, invigorate the blood and soften the firmness.
Add and subtract: add Gehua for alcoholic cirrhosis; add yellow bark leaves for post-hepatitis cirrhosis; add fried shamrock for portal cirrhosis; add purple pearl grass or Xianhe grass for bleeding gums; remove dioscorea and add yam and dendrobium for yin deficiency without dampness.
Liver cirrhosis belongs to the category of obstruction and dropsy in Chinese medicine, with different causes and complex pathology, but it is caused by the dysfunction of liver, spleen and kidney, resulting in the stagnation of qi, blood, phlegm and water in the abdomen. Based on decades of clinical experience, Deng believes that this disease is mostly caused by dampness and heat, evil toxins or insects and alcohol poisoning that have been invading the liver for a long time.
6.Cang Niu Fang Ji Tang
Composition: Atractylodes macrocephala, Atractylodes baileyi, Chuan, Huai Niu Knee, Fang Qi, large belly skin.
Treatment: dropsy (cirrhosis ascites).
Explanation: In this formula, Cang Zhu and Bai Zhu tonify the spleen and dry dampness to treat its root cause; Chuan and Huai Niu Knee benefit the blood and invigorate the blood, slowing down the liver and dredging the liver to facilitate spleen tonification; Fang Ji and Big Belly Bark move water and diuresis to treat its symptoms. The combination of all the drugs worked together to strengthen the spleen, invigorate the blood and promote water retention.