After the development of acute hepatitis into chronic hepatitis, the prolonged hepatic failure to regulate qi and blood may give rise to blood stasis due to qi stagnation. If blood stasis lasts long, it will accumulate in the subhypochondriac region, developing into cirrhosis in the case of prolonged state. The pathogenesis of the diseases mainly lies in asthenia of the liver and kidney, dampness obstruction due to asthenia of the spleen and blood stasis due to qi stagnation.
1. Syndrome differentiation and treatment
(1) Residual dampness and heat
It manifests heavy sensation of the body, insufficient food intake, anorexia, thoracic and hypochondriac distension, nausea, aversion to oil, dry mouth and bitter taste, vexation, dark and scanty urine, dry or loose stool, red lingual margin, yellowish and greasy or white and greasy fur, slippery and rapid, soft and rapid or taut and slippery pulse. It is advisable to clear away heat and remove dampness. The prescription used is the modified Three-Kernel Decoction. In the case of relatively excessive heat, add Daqingye (Folium Isatidis) and Pugongying (Herba Ta raxaci). Click here to learn Viral Hepatitis in TCM.
(2) Stagnation of the liver and asthenia of the spleen
It manifests thoracic tightness and discomfort, restlessness or depression, mental fatigue, distending or wandering pain of right hypochondrium with the right back or chest and breast or underbelly involved occasionally, bitter taste, eructation, anorexia, loose stool, pale or reddish tongue with white and thin or white and greasy fur, taut or taut and slippery pulse. It is advisable to soothe the liver and strengthen the spleen. The prescription used is the modified Xiaoyao Powder (Ease Powder). In the case of marked hypochondriac pain,?add Chuanlianzi (Fructus Meliae Toosendan) and Yanhusuo (Rhizoma Corydalis). Click here to learn Causes of Viral Hepatitis in TCM.
(3) Hepatorenal yin deficiency
It manifests tiredness, hypodynamia, light-headedness, insomnia, dream-disturbed sleep, soreness of the waist and flaccidity of legs, feverish palms and soles, vexation, dull hypochondriac pain, dry mouth, anorexia, seminal emission,? irregular menstruation,? red tongue or red tongue tip with thin fur or without fur, taut, thready and rapid or taut and thready pulse, weak pulse in the two chi regions. It is advisable to nourish the liver and kidney. The prescription used is the modified Yiguan Decoction (An Ever Effective Decoction for Nourishing the Liver and Kidney).
(4) Blood stasis due to qi stagnation
It manifests dim or blackish complexion, distending pain or stabbing pain of the hypochondriac region which has the wandering or definite site, anorexia, epigastric and abdominal distending pain, difficult defecation, enlargement of the liver and spleen, dull-colored tongue or with ecchymoses, thin fur, taut and unsmooth pulse. It is advisable to regulate qi and remove blood stasis. The prescription used is the modified Xuanfuhua Decoction (Decoction of Flos Inulae). Replace Xinjiang in the prescription with Qiancao (Radix Rubiae) and add Danggui (Radix Angelicae Sinensis), Danshen (Radix Salviae Miltiorrhizae), Taoren (Semen Persicae) and Jixueteng (Caulis Spatholobi) accordingly. In the case of subhypochondriac mass, add Renshen (Radix Ginseng), Honghua ( Flos Carthami)? and Chuanshanjia (Squama Manitis). Click here to learn Symptoms of Viral Hepatitis in TCM.
2. Rehabilitation methods
(1) Regulating emotions
The patients with hepatic disease are liable to get excited. Accordingly, it is particularly important to regulate their emotions and check their anger. The doctors may adopt the methods of straightening out the patients psychologically, checking one emotion with another, suggestion and diverting emotions in combination with the color therapy and flower therapy to help the regulation of emotions of the patients. Click here to learn TCM Diagnosis for Viral Hepatitis.
(2) Recreation therapy
Take part in the activities of appreciating music, practicing calligraphy and painting, playing a musical instrument, dancing, flying a kite, fishing and outing accordingly. In the case of depression, select classical music; in the case of hypochondriac pain, select the music from the musical prescriptions of "inhibiting restlessness and checking anger" of the musical therapy.
(3) Physical training
Select several independent movements from Taijiquan accordingly. Then, increase the amount of exercise and the content of movements gradually. It is also advisable to select the corresponding postures from eight-section brocade. In the case of thoracic tightness and discomfort, restlessness and irascibility, select "stretching both hands upwards to regulate the triple energizer, bending a bow with alternate hands to shoot a vulture"; in the case of anorexia and abdominal distension, it is advisable to practice "stretching one hand upwards to regulate the spleen and stomach". Besides, five mimic-animal games and Yijinjing may be selected in combination with the above techniques. Click here to learn Chinese medicine Treatment for Viral Hepatitis.
(4) Acumox and massage
Acurnox: The acupoints are divided into two groups. The first group includes Zhiyang (GV 9) and Zusanli (ST 36) and the second group Danshu (BL 19) and Taichong (LR 3). Use the two groups alternately once a day with the moderate stimulation. In the case of hepatalgia, add Qimen (LR 14), Yanglingquan (GB 34) and Qiuxu (GB 40); in the case of increased transaminase, add Dazhui (GV 14), Ganshu (BL 18), Yanglingquan (GB 34), Taichong (LR 3) and Zhongfeng (LR 4) ; in the case of various hepatic functional changes, add Ganyan (two cun above the tip of the medial ankle) and Taichong (LR 3) in the case of hepatosplenic enlargement, add Pigen (3.5 cun lateral to the spinous process of the first lumbar vertebra, puncture the right side in the case of hepatic enlargement and the left side in the case of splenic enlargement), Pishu (BL 20) and Ganshu (BL 18). Click here to learn TCM Treatment Evaluation for Viral Hepatitis.
Acupoint injection: Select Ganshu (BL 18), Zhongdu (LR 6), Riyue (GB 24) and Qimen (LR 14). Inject vitamin B1 or Bannangen (Radix Isatidis) into the above acupoints, 1 ml each acupoint, once a day. Ten to fifteen times constitute one course of treatment.
Ear acupuncture: As for the ear acupuncture, select Ganyandian (between Weixue and Ganzhongda), Gan (MA-SC 5), Sanjiao (MA - JC 4), Jiaogan (MA - AH 7), Ganyang, Dan (MA- SC 6), Pi and Shenmen (MA- TF 1).
Massage: Rubbing the abdomen: Go to number one first. Then, assume the supine position and flex the knees. If the patient is weak, put a pillow under the popliteal fossa to relax the abdominal muscle. Massage the abdomen with one hand or both. At first, use the pressing and stroking manipulations to massage the abdomen from the right upper side of the abdomen to the centre of the abdomen. Afterwards, adopt the kneading-pinching and vibrating methods.
In addition, it is advisable to use the kneading-pinching method with the palm or rubbing-scrubbing method with the palm. The patients may practice self massage as well. First, scrub-rub the periumbilical region with the right hand in an increasingly large circle for 20 times. Then, use the left hand to massage in the same way for 20 times. Rubbing the back: Place the left hand on the back and rub the back gently upwards and downwards for 20 times. Then, use the right hand to massage the back in the same way for 20 times. Meanwhile, digitally press Ganshu (GB 18), Danshu (BL 19) and Weishu (BL 21). Click to learn Oral Lichen Planus (OLP) in TCM.
(5) Dietary therapy
In the case of residual dampness and heat, select Celery Gruel, Gruel of Yiyiren (Semen Coicis) and Gruel of Heye (Folium Nelumbinis); in the case of hepatic stagnation and splenic asthenia, select Gruel of Meihua (Flos Mume), Gruel of Meigui (Flos Rosae) and Yiyiren and Chinese dates Gruel (Gruel of Semen Coicis and Fructus Ziziphi Jujubae); in the case of hepatorenal yin deficiency, select Stewed Pork Liver with Xuanshen (Radix Scrophulariae), Paste of Wuweizi (Fructus Schisandrae) and Thick Soup of Yiner (Tremella); in the case of blood stasis due to qi stagnation, select Gruel of Taoren (Semen Persicae and Gruel of Shanzha (Fructus Crataegi ). Click to learn Causes of Oral Lichen Planus in TCM.
The prescriptions of dietary therapy: Raise 2,000 g of live loaches in clear water for a day so that they can discharge all the intraintestinal waste. On the next day, put the loaches into an oven ( 100℃ is advisable) to make them dry. Then, grind them into powder and store the powder in a bottle. Take the powder with warm boiled water three times a day, ten grams each time. Fifteen days make up one course of treatment while the longest duration does not exceed four courses.
In the case of hepatic stagnation and splenic asthenia, it is advisable to eat the foods for strengthening the spleen and nourishing the liver such as Huaishanyao (Rhizoma Dioscoreae) and Dazao (Fructus Ziziphi Jujubae), and abstain from uncooked, cold and cool-natured foods; in the case of residual dampness and heat, accumulation of residual pathogenic factors in the liver and gallbladder, eat foods for clearing away heat and removing dampness like water melon, wax gourd, shepherd's purse, and abstain from pungent and hot-natured foods, smoking and drinking. Click to learn TCM Diagnosis for Oral Lichen Planus.
(6) External treatment with drugs
Crush a proper amount of Kuxingren (Semen Armeniacae Amarum), Shengtaoren (unprepared Semen Persicae), Shengzhizi (unprepared Fructus Gardeniae) and Sangshenzi (Fructus Mori) respectively to paste. Then, mix the paste with glutinous millet and vinegar evenly. Finally, apply the prepared drug on the navel. One dose can be applied for three times. Replace the used drug with the new one once every other day.
(7) Nursing in daily life
Abstain from sexual life in the case of chronic hepatitis at the active stage and marked injury of hepatic functions; moderate sexual life at the stationary phase as well. Married women should take care not to become pregnant. Click to learn Chinese medicine Treatment for Oral Lichen Planus.