Liver cirrhosis is a common chronic liver disease, which can cause liver damage by one or more reasons. The liver is progressive, diffuse and fibrous. Diffuse degenerative necrosis of hepatocytes, fibrous tissue proliferation and nodular regeneration of hepatocytes occur. These three changes alternate repeatedly. As a result, the structure of hepatic lobules and blood circulation pathways are gradually reconstructed, leading to liver cirrhosis due to liver deformation and hardening. There were no obvious symptoms in the early stage, and a series of portal hypertension and liver dysfunction in the later stage, until the death of complications such as upper gastrointestinal bleeding and hepatic encephalopathy.

Liver cirrhosis is a chronic systemic disease with liver damage as its main manifestation. It is caused by a series of pathological changes such as hepatocyte degeneration, necrosis, regeneration and fibrous tissue proliferation. As a result, the normal structure of the liver is disturbed, the liver is deformed and the texture is hardened. Liver cirrhosis. Its main clinical manifestations are a series of symptoms and signs caused by hypohepatic function and portal hypertension.

Although there is no name of "liver cirrhosis" in TCM literature, from the clinical manifestations of this disease, we can see the records of this disease in the symptoms of "bloating", "single abdominal distention", "accumulation". For example, the symptoms of abdominal distention recorded in "Lingshu Shuizhang" are "abdominal distention, body is large... The colour is pale and the abdomen tendons are raised. This is also the time. Feijingyue Quanshu Swelling in describing the cause of swelling disease, said: "Alcohol without restraint, more into water." It is believed that the formation of ascites is caused by abdominal mass, such as "symptoms, bumps, that is the root of distension, accumulated over time, abdomen as big as a skip, abdomen as big as an urn is the list of abdominal distension." It can be seen that TCM has a certain understanding of this disease very early.


I. Differentiation and Treatment Based on Syndrome Differentiation

In the early stage of the disease, most of them belong to liver depression and spleen deficiency and qi stagnation and blood stasis; once ascites is formed, it belongs to internal obstruction of water and dampness; in the later stage, it mostly involves the kidney, and is divided into spleen and kidney yang deficiency and liver and kidney yin deficiency. The treatment principle is to treat both the root causes and the root causes, and to treat the root causes by promoting qi, removing blood stasis and eliminating water, so as to regulate the liver, spleen and kidney.

(1) Compensation period of cirrhosis

1. Liver Depression and Spleen Deficiency

Main symptoms: loss of appetite, chest and abdomen swelling, belching, bilateral flank pain, or occasional nausea and vomiting, fatigue, loose stool. The moss is white and slippery.

Treatment: soothing the liver and strengthening the spleen.

Prescription: Xiaoyao San or Chaihu Shugan San plus Sijunzi Decoction.

Chaihu 15g, Zhihu 10g, Paeonia lactiflora log, Poria Cocos 30g, Fried Atractylodes macrocephala 15g, Chuanxiong log, Xiangfu 15g.

Clinical additions and subtractions: If the tongue coating is thick and greasy, chest tightness and fullness are serious, Atractylodes rhizoma, Magnolia officinalis, hawthorn, chicken gold and so on can be added; those with spleen deficiency and stagnation, Astragalus membranaceus, Amomum seed; those with liver Qi stagnation, tulip, bergamot and Chenxiang tablets can be added.

2. Liver and spleen blood stasis

Main Syndrome: Obvious rubies, red lines on both cheeks, palms of liver, spider nevus, or pain, tingling, swelling or acid under the left hypochondrium can be touched. The tongue is dark red or purple, or there are bruises and ecchymosis on the edge of the tongue, with gentle or astringent pulse strings.

Therapy: Regulating Qi and Promoting Blood Circulation, Eliminating Symptoms and Resolving Knots.

Prescription: Gexia Zhuyu Decoction added or subtracted.

Angelica sinensis 15g, Paeonia lactiflora 30g, Peach kernel 15g, Safflower 15g, Salvia miltiorrhiza 30g, Rhizoma Cyperi log, Fructus Aurantii log, Wulingzhi 12g.

Clinical additions and subtractions: notoginseng, Xuanhu, tulip, etc. in patients with obvious pain; Astragalus membranaceus, Cinnamon Twig and poria cocos in those with spleen deficiency and dampness; for those with Yin deficiency, adding birthplace and Paeonia lactiflora; for those with lower limb acidity, adding Achyranthes bidentata.