Etiology and pathology of traditional Chinese medicine
Traditional Chinese medicine believes that the liver belongs to wood and the spleen belongs to soil, which is divided into two sides. The liver is the official of the general, responsible for draining and storing blood. Liver cancer is caused by internal injury of seven emotions, food fatigue, or invasion of pathogenic toxin, which leads to deficiency of qi and blood in viscera, spleen deficiency, qi stagnation, blood stasis, damp heat, phlegm toxin and so on. Hepatocellular carcinoma is located in the liver, and its pathogenesis is closely related to the spleen. With the progress of the course, the spleen will affect the functions of gallbladder, stomach and kidney.
There are no obvious clinical symptoms and signs in the early stage of liver cancer for about 1.5 years. In recent years, asymptomatic early liver cancer can be found through alpha-fetoprotein screening. In the middle and late stage of liver cancer, there are pain in liver area, mass in upper abdomen, abdominal distension, diarrhea, nausea, aversion to oil, vomiting, loss of appetite, weight loss, emaciation and fatigue, fever, jaundice, even cachexia and bleeding tendency. The late signs of liver cancer include hepatomegaly, splenomegaly, jaundice, ascites, limb swelling, hepatic vascular murmur and signs of cirrhosis, and some are accompanied by liver palm, spider nevus and abdominal varicose veins.
According to the etiology, pathological characteristics and clinical manifestations of liver cancer in different stages, the primary and secondary diseases of deficiency of both yin and yang and rise and fall of pathogenic factors were treated according to syndrome differentiation. In the early stage, there are many signs of spleen deficiency and liver depression, so it is advisable to replenish qi and spleen and regulate qi flow; Qi stagnation, blood stasis and phlegm-dampness are common in the middle stage, so it is advisable to regulate qi and blood, resolve phlegm and remove blood stasis.
Syndrome differentiation and treatment of TCM
1, liver depression and spleen deficiency
The symptoms are hypochondriac swelling and pain, chest tightness, no appetite, or diarrhea, or hypochondriac swelling, pale red tongue, white and slightly greasy fur, and thready pulse.
Soothing liver and relieving depression, invigorating spleen and benefiting qi.
2. Qi stagnation and blood stasis
The symptoms of this syndrome are swelling in the right hypochondrium or upper abdomen, pain refusing to press, shoulder and back pain, especially at night, abdominal distension, fatigue, loss of appetite, loose stool, dark purple tongue, ecchymosis, petechia or blood stasis, and unsmooth pulse.
Treatment: promoting blood circulation to remove blood stasis, promoting qi circulation to relieve pain, reducing swelling and resolving hard mass.
3. Damp heat accumulation
The symptoms are yellow and red eyes, or hot flashes, or high fever, dry mouth and bitter taste, upset and irritable, fullness in chest and hypochondrium, swelling and pain in right hypochondrium, yellow stool, dark purple tongue, yellow and greasy fur, and slippery or stringy pulse.
Treat damp-heat, soothe the liver and benefit the gallbladder.
4. Dampness and blood stasis
The syndrome is characterized by huge swelling under the ribs, hard texture, abdominal pain and bloating, pressing it like a water bag, yellow or dull face, short and red urine, dark tongue or ecchymosis, white and greasy fur and heavy and wet pulse.
Treat damp-heat, detoxify and remove blood stasis.
5. Yin deficiency of liver and kidney
Symptoms include hypochondriac pain, fever, palpitation, insomnia, dizziness, anorexia, abdomen as big as a drum, veins standing out, even hematemesis, dark stool, red tongue with little fur, and rapid pulse.
Treatment: nourishing yin and resolving hard mass, cooling blood and detoxifying.