It is clinically essential to differentiate excess types from deficiency ones. Excess types include liver qi stagnation and spleen deficiency, blood stagnation in the liver and spleen, accumulation of damp heat and obstruction of meridians by blood stasis. The treatment for such types is chiefly to soothe the liver and invigorate the spleen, regulate qi circulation and activate blood, and eliminate damp heat. Deficiency types include deficiency of liver yin and kidney yin, and deficiency of spleen yang and kidney yang.

Essentials for Diagnosis
(1) Mild symptoms are manifested during compensatory phase as fatigue, poor appetite, nausea, vomiting, discomfort in the epigastrium, dull pain in the right epigastrium, abdominal distension and diarrhea. The chief manifestations of decompensatory phase are poor appetite, emaciation, lassitude, diarrhea, epigastric pain, low fever, abdominal distension, hemorrhage and neuropsychic symptoms.

(2) During compensatory phase, there are no obvious physical signs but hepatomegaly may be present. Some patients may also suffer from splenomegaly accompanied by vascular spider and liver palms. But during decompensatory phase, there are manifestations as darker complexion, jaundice, fever, varicose veins of abdominal wall, ascites, hydrothorax, moderate splenomegaly, enlargement or shrinkage of the liver, gynecomastia and sparsity of pubic hair in males, scanty menstruation or amenorrhea in females, bleeding of skin and mucosa, emaciation, anemia, edema and angular stomatitis.

(3) Anemia, decrease in white blood cell and blood platelet count can be found in blood routine examination; in liver function test, increase in aminotransferase, serum bilirubin and globulin, and decrease in albumin can be found.

(4) Ultrasonography B shows that hepatic echo grows stronger, coarser and uneven. Hepatomegaly is manifested at the early stage of the disease and hepatic shrinkage at the later stage. The surface of the liver is rough, serrate and wavy. Splenic shadow becomes larger; splenic veins thicker and curved; and portal vein thickened.

(5) Hepatic biopsy shows the histological type of hepatocirrhosis, as well as the degree of hepatic cells damage and formation of connective tissue.

In TCM, a disease or a symptom might be caused by one pathogenic factor, even two or three pathogenic factors. When diagnosing a disease or a symptom, TCM doctors must follow the principle of "Syndrome Dfferentiation", and then "Suit the Remedy to the Case". In order to gain a more definite and valuable diagnosis, it's important and necessary for the doctor to learn the detailed health information of the patient, including his/her disease duration, age, sex, height, weight, family history, urine, stool, diet, sleep, sweat, energy, mood (emotion), as well as the tongue conditions and the palm conditions, etc. If you would want our expert to create a TCM diagnosis, you're welcome to contact us.