Liver congestion

　　According to traditional Chinese medicine, liver atrophy is caused by pathogenic factors staying in the liver, leading to stagnant Qi and blood circulation. It may also be due to overwork and anger, resulting in Qi stagnation and blood stasis. 'Guide to Clinical Medicine: Epigastric Pain': 'Liver atrophy, pain in the hypochondrium, caused by overwork and anger, damaging Qi and blood.' Western medicine believes that liver atrophy manifests as symptoms of chronic hepatitis, with portal inflammation and interface hepatitis being the active and progressive lesions of chronic hepatitis B. The characteristic lesions of chronic hepatitis B include cellular degeneration and necrosis within the lobules, including coalescent necrosis and bridging necrosis, which become increasingly prominent with the progression of the disease. Inflammation and necrosis of liver cells, along with portal inflammation and interface hepatitis, can lead to excessive deposition of collagen within the liver, liver fibrosis, and the formation of fibrous septa. If further exacerbated, it can lead to disordered liver lobular structure, the formation of pseudo-lobules, and the progression to liver cirrhosis.

　　Some cases of liver atrophy can develop into liver mass, and even become liver cancer. Severe chronic hepatitis can also lead to liver failure, which can manifest as severe fatigue, severe abdominal distension, severe jaundice, and severe loss of appetite. Complications may include hypoalbuminemia, ascites and pleural effusion, abdominal infection, decreased coagulation function, upper gastrointestinal bleeding, and hepatic encephalopathy, among others.

　　Patients with liver atrophy often have a history of liver heat disease. It is generally believed that if the course of liver heat disease exceeds 6 months, with persistent symptoms and abnormal liver function, it is considered as liver atrophy. In some cases, due to a long illness, the medical history may not be clear, and it is discovered during examination. Symptoms include swelling or stabbing pain in the right hypochondrium or below the xiphoid process, often wanting to rub the area with the hand, accompanied by loss of appetite, belching, abdominal distension, loose stools, fatigue, and other symptoms.

　　In Western medicine, liver atrophy is known as chronic hepatitis. In daily life, it is necessary to maintain an optimistic attitude, correctly treat the disease, have the confidence to overcome the disease, and live a regular life.

　　1. Caution in using medication

　　Certain drugs can cause fulminant hepatitis, such as erythromycin, tetracycline, aspirin, paracetamol, antirheumatic drugs, and antitumor drugs, which have a great toxic effect on the liver. Therefore, when taking these drugs, they should be taken under the guidance of a doctor, and it is strictly forbidden to take medication privately.

　　2. Combination of treatment and nourishment

　　While actively treating liver disease in regular liver disease hospitals, it is very important to nourish the liver. Attention should be paid to maintaining a balanced diet and ensuring smooth bowel movements. It is recommended to do abdominal push self-care regularly.

　　3. Adjusting one's mindset

　　Unfavorable emotions can lead to a series of changes in nerve, endocrine, and immune function, resulting in a significant reduction in anticancer cells in the blood, which is easy to lead to the growth of tumors. Therefore, chronic hepatitis patients should maintain a positive attitude, keep a good mood, which plays a very important role in the treatment of the disease.

　　4. Regular follow-up

　　Patients need to regularly review liver function and viral indicators. Depending on whether the liver function is normal, they can be re-examined every 1 to 2 months, with continuous follow-up for 1 to 2 years. This will enable patients to understand their own condition and facilitate doctors in monitoring the effectiveness of treatment, helping patients determine the next course of medication. Medication should be taken according to the doctor's instructions, and it is not allowed to discontinue medication arbitrarily, nor should one easily believe in street quacks and folk remedies to avoid aggravating the condition and delaying treatment.

　　Liver atrophy is manifested by liver enlargement, soft or slightly hard texture, tenderness, or mild jaundice. Some patients may have spider nevi and palmar erythema, and the spleen is generally not significantly enlarged. Patients may have normal liver function tests, but common indicators such as alanine aminotransferase, alkaline phosphatase, and gamma-glutamyl transpeptidase may be slightly elevated, albumin decreased, globulin increased, and there may be an increase in r-globulin.

　　⑴ Biochemical indicators, including ALT, AST, bilirubin, albumin, and renal function.

　　⑵ Blood routine, thyroid function, blood glucose, and urine routine.

　　⑶ Viral markers, including the baseline status or level of HBsAg, HBeAg, anti-HBe, and HBV DNA.

　　⑷ For patients over 40 years old, an electrocardiogram should be performed and blood pressure should be measured.

　　⑸ Exclude autoimmune diseases.

　　⑹ Urinary human chorionic gonadotropin (HCG) test to exclude pregnancy.

　　Liver atrophy, also known as chronic hepatitis, requires dietary regulation in addition to general treatment.

　　First, what is good for the liver atrophy patient

　　1, Protein supply

　　Sufficient high-quality protein can improve the body's immune function, increase the storage of glycogen in the liver, and is beneficial for the repair of liver cells and the recovery of liver function. Since an increase in dietary protein can increase blood ammonia, it is necessary to eat protein foods with low ammonia production, such as dairy products, soy protein, and mixed animal protein, which can better exert their complementary effects and reduce the source of ammonia.

　　2, Fat

　　Experts point out that the intake of fat in the diet of chronic hepatitis patients should not be overly restricted, but it must be moderate to avoid affecting the body's energy supply and reducing appetite. However, it should be avoided to eat greasy foods, especially for those whose jaundice has not yet subsided. Excessive intake of fat in hepatitis patients may lead to fatty diarrhea, while too little intake may affect appetite and the absorption of fat-soluble vitamins. It is advisable to use vegetable oil.

　　3, Carbohydrates

　　When the intake of carbohydrates exceeds the body's needs, it will be converted into fat and stored in the body, causing complications such as obesity, hyperlipidemia, and fatty liver. The supply of carbohydrates should account for 60% to 65% of total energy, that is, the amount of staple food per day is about 350 grams, and it should be accompanied by fresh vegetables and fruits.

　　4, Vitamin

　　When liver disease is severe, vitamin deficiencies such as vitamin C, B1, and B2 may occur due to impaired vitamin absorption. Increasing the supply of vitamins is beneficial for the repair of liver cells, enhancing detoxification function, and improving the body's immune function. The combined use of vitamin C, E, and K in the treatment of hepatitis can improve symptoms and promote the improvement of liver function. Therefore, hepatitis patients can choose foods rich in vitamins, such as green vegetables, tomatoes, fruits, and so on.

　　5, Drink green tea

　　Hepatitis patients are suitable for drinking green tea. In daily life, green tea can be skillfully matched with spices to have the effect of treating various diseases. Green tea has anticoagulant, prevents platelet adhesion and aggregation, reduces the decrease of white blood cells, and has the effect of activating blood circulation and removing blood stasis. For patients with blood stasis and blood heat type, such as chronic hepatitis patients with five heart flurries, dry mouth and bitter taste, and red and swollen gums with bleeding, it has an auxiliary therapeutic effect.

　　When drinking tea, pay attention to the right time and amount. Liver disease patients feel thirsty and want to drink. In the morning, you can brew one cup of green tea, continue to add water for drinking, and the tea should not be too strong. The total amount of tea water throughout the day should not exceed 1000 to 1500 milliliters. Generally, drinking tea one hour before meals should be stopped to avoid diluting gastric acid and reducing the absorption of food.

　　Secondly, what foods should liver attachment patients avoid eating

　　(1) Hepatitis patients are strictly prohibited from drinking alcohol, as alcohol can cause acute injury to liver cells, increase transaminases, worsen hepatitis, and lead to fatty liver, alcoholic hepatitis, and liver cirrhosis.

　　(2) It is better to eat less of some刺激性 foods, such as ginger, scallion, chili, etc., as these are all spicy foods that can help damp-heat, making the liver damp-heat worse, thus aggravating clinical symptoms.

　　(3) Try to avoid greasy and fried foods, as they are difficult to digest and are also prone to produce dampness and heat, which is not conducive to the recovery of the disease.

　　(4) Diet should be based on natural foods and try to avoid synthetic convenience foods, as they contain some artificial colors and preservatives to varying degrees. At the same time, when eating natural foods, try to clean them thoroughly to avoid the pesticides on them from further damaging the liver.

　　(5) Acute jaundice hepatitis is due to excessive internal damp-heat, so it is taboo to eat spicy and hot foods such as chives, mutton, chicken, star anise, clove, and pepper.

　　(6) Liver cirrhosis patients may have varying degrees of varices due to portal hypertension, mainly including esophageal varices, gastric varices, and lower esophageal varices. If diet is not paid attention to, these varices can easily rupture, leading to gastrointestinal bleeding, triggering hepatic coma, and in severe cases, resulting in death. Therefore, liver cirrhosis patients should avoid eating tough, spiky, or bony meats, as well as vegetables with too much plant fiber, as these foods are easy to injure the varices.

　　Liver attachment is characterized by pain in the right rib, mass in the lower right rib, slight relief upon pressing and striking with the hand, and abnormal liver function as the main clinical manifestation of visceral disease. Traditional Chinese medicine divides liver attachment into several types:

　　1. Liver and gallbladder damp-heat syndrome

　　(1) Syndrome: Distension and pain in the right rib, pain upon pressure, slight jaundice in both eyes, fever and thirst, annoyance in the heart, dry and bitter mouth, nausea and vomiting, abdominal distension, constipation or pale stools, dark yellow urine, red tongue with thick and greasy coating, wiry and rapid pulse, clearing the damp-heat in the liver and gallbladder.

　　(2) Treatment principle: Drain dampness and clear heat, clear the liver and benefit the gallbladder.

　　(3) Main formula: Yin Chen Five-Flavor Powder; Long Dan Xie Gan Decoction.

　　(4) Herbal medicine: Scutellaria baicalensis, rhubarb, Tangerine peel, Cynanchum stauntonii, Lysimachia christinae, Gentiana scabra, Coptis chinensis, etc.

　　2. Liver Qi stasis syndrome

　　(1) Syndrome: Slight pain in the two sides of the ribs, mass in the lower ribs, abdominal distension and discomfort, epigastric fullness and loose stools, frequent belching, thin white or thin yellow tongue coating, wiry and thin pulse.

　　(2) Treatment principle: Use methods of soothing the liver and regulating Qi to relieve depression and dissolve blood stasis to unblock the pulse.

　　(3) Herbal medicine: Bupleurum, Cyperus rotundus, Tangerine peel, raw Rehmannia, Angelica sinensis, Red Peony, cow horn, Chuanxiong, peach kernel, safflower, Salvia miltiorrhiza, sandalwood, licorice, etc. Bupleurum, Tangerine peel, and Cyperus rotundus are used to soothe the liver and relieve depression. Peach kernel, safflower, Chuanxiong, Red Peony, and Salvia miltiorrhiza are used to activate blood circulation and remove blood stasis, which helps to unblock the meridians of the heart. Angelica sinensis, raw Rehmannia, and cow horn nourish the blood and promote blood circulation. When all the herbs are combined, they help to smooth the flow of liver Qi and heart pulse, and when the heart pulse is unblocked, chest tightness and chest pain can be alleviated.

　　3. Liver Qi Depression and Spleen Deficiency

　　(1) Syndrome: Distension and pain in the hypochondrium, chest tightness and abdominal distension, mass below the hypochondrium, fatigue, decreased appetite, loose stools or diarrhea, thin white tongue fur, wiry and thin pulse.

　　(2) Treatment Principle: Soothe the liver, regulate Qi, and invigorate the spleen.

　　(3) Main Prescription: Tangxiaoyao Decoction with modification.

　　(4) Prescription: Bai Zhu, Bai Shao, Chen Pi, Fang Feng, Mu Xiang, Sha Ren, Yun Ling, Shan Yao, Gan Cao. This is due to liver and gallbladder Qi depression, affecting the spleen and stomach, and the spleen losing its healthy function. Clinically, it is characterized by distension and pain in the hypochondrium, varying in severity, and intestinal rumbling and diarrhea. It is often related to emotional factors. Therefore, Bai Zhu and Yun Ling invigorate the spleen and stop diarrhea, Chen Pi and Fang Feng invigorate the spleen and clear the Qi, Bai Shao softens the liver and relieves pain, Mu Xiang and Sha Ren regulate Qi and the spleen, Shan Yao nourishes the spleen and stomach, and Gan Cao harmonizes all herbs.

　　4. Cold and Dampness Restricting the Spleen

　　(1) Syndrome: Pain in the right hypochondrium, mass below the hypochondrium, epigastric and abdominal distension, slight edema of the lower limbs, fatigue, aversion to cold, laziness, poor appetite, loose stools, white slippery or greasy tongue fur, slow pulse.

　　(2) Treatment Principle: Warm the middle, invigorate the spleen, and transform dampness.

　　(3) Main Prescription: Puyin Decoction, Pingwei Powder, Shiyi Decoction, Lizhong Pill, Linggui Zhigan Decoction, and other formulas can be selected according to the syndrome.

　　5. Stagnation in the Liver Collaterals

　　(1) Syndrome: Stabbing pain in the hypochondrium, mass below the hypochondrium, severe pain when pressed, abdominal distension, dilated collaterals, blood spots on the cheeks, chest, and arms, filamentous red threads, red palm, purple-brown lips, thirst without desire for drinking, black stools, purple-red tongue with spots, wiry and涩 pulse.

　　(2) Treatment Principle: Promote Qi, remove blood stasis, and unblock the meridians. Main prescription: Inula flower decoction with modification.

　　(3) Prescription: Inula flower (wrapped in cloth), three scallion stalks, Xin Jiong, Salvia miltiorrhiza, Angelica sinensis, Uncaria sinensis, luffa sinensis. Boil in water, take 250-300 milliliters of juice, take warm, 1-2 doses per day, divided into 2-3 times. At the same time, it is also possible to take Biejia Wan.

　　6. Liver and Kidney Yin Deficiency Syndrome

　　(1) Syndrome: Hidden pain in the liver area, abdominal distension, poor appetite, fatigue, dizziness, dry mouth and bitter taste, irritability, insomnia, red tip of the tongue, thin yellow fur, wiry and thin pulse or wiry and rapid pulse.

　　(2) Treatment Principle: Tonify the Liver and Kidney.

　　(3) Main Prescription:杞菊地黄丸, 一贯煎, 大补阴丸, 滋水清肝饮, 滋水生肝饮, and other formulas.