(1) Herbal Therapy
1) Internal Medicine
a. Liver qi Stagnation and Spleen Deficiency
Therapeutic Methods: To soothe the liver, regulate qi circulation, activate the spleen and eliminate dampness.
Prescription: Modified Chaihu Shugan San (Bupleuri Powder for Soothing Liver Qi) and Weiling Tang (Poria Decoction for Regulating Stomach).
b. Blood Stagnation in the Liver and Spleen
Therapeutic Methods: To regulate qi circulation, activate blood, and remove blood stasis to resolve masses.
Prescription: Modified Gexia Zhuyu Tang (Decoction for Removing Blood Stasis under Diaphragm).
c. Accumulation of Damp Heat
Therapeutic Methods: To clear away heat, eliminate dampness and remove toxic substance.
Prescription: Modified Yinchenhao Tang (Artemisiae Scopariae Decoction) and Ganlu Xiaodu Dan (Sweet Dew Detoxication Pill).
d. Obstruction of Meridians by Blood Stasis
Therapeutic Methods: To remove blood stasis, dredge the collaterals, activate blood and promote diuresis.
Prescription: Modified Gexia Zhuyu Tang (Decoction for Removing Blood Stasis under Diaphragm).
e. Deficiency of Liver Yin and Kidney Yin
Therapeutic Methods: To nourish yin, reinforce the kidney, cool blood and clear away heat.
Prescription: Modified Yiguan Jian (Ever-effective Decoction for Nourishing Liver and Kidney).
f. Deficiency of Spleen Yang and Kidney Yang
Therapeutic Methods: To warm and nourish the spleen and kidney, remove dampness and promote diuresis.
Prescription: Modified Fuzi Lizhong Tang (Aconiti Lateralis Decoction for Regulating Middle Energizer) and Wuling San (Powder of Five Drugs Containing Poria).
2) External Medicine
a. Moschus (Shexiang) 0.6 g, Radix Clematidis (Weilingxian) 30 g, Baigefen (Faeces Columbae) 30 g, Ximutong (Caulis Akebiae) 9 g, Baizhi (Radix Angelicae Dahuricae ) 9 g and Xixin ( Herba Asari) 9 g. Grind the above drugs into fine powder for use. Put the powder into Zhufu (Vesica Urinaria Suillus) together with Baijiu (Vinum) 250 ml, tie the opening and place it with the opening close to the navel, then wrap a bandage around the waist. This is applicable to hepatocirrhotic ascites.
b. Radix Euphorbiae Kansui (Gansui) 3 g and Shengjiang (Rhizoma Zingiberis Recens, mashed) 9 g. Mix them thoroughly and spread the mixture over a gauze. Apply the mixture to the navel and wrap a bandage around the waist. This is applicable to hepatocirrhotic ascites.
c. Gansui ( Radix Kansui, powdered) 3 g and Shengjiang (Rhizoma Zingiberis Recens, mashed) 9 g. Mix them thoroughly and spread the mixture over a gauze. Apply the mixture to the navel and wrap a bandage around the waist once every three days. This is applicable to hepatocirrhotic ascites.
d. Right amount tender leaf of sweet potato, tender leaf of water spinach and brown sugar. Process: Pound them into a paste and apply it externally on the umbilical region, has diarrhea after 1-2 hours. This recipe is applicable to hepatocirrhotic ascites.
e. Elephantopus Scaber 50g, Rhizoma Cyperi Root 15g. Process: Wash them clean and pound into a paste, mix with fried egg and apply externally on the navel. This recipe is applicable to hepatocirrhotic ascites.
(2) Acupoints Massage
1) Press side chest and rib-sides: Raise both hands with bend elbow joints and uplift the palms, push and rub the oxters with the root of the palm from top to bottom with gradual force and uniform speed for 10 times until a local warm and comfortable sensation occurs. This method has the effect of smoothing the liver, regulating vital energy, dissipating binds and dispersing swelling.
2) Press chest: Pressing chest from top to bottom with both hands with gradual forcing for about 30 times. This method has the effect of clearing away the heart-fire, quieting the spirit, smoothing the blood vessel and accelerating the metabolism and decomposition of alcohol in the liver.
3) Adopt a supine position with fingers slightly separate, the gesture just like a comb, then comb from the midline of the chest to the both ribs with gentle force, along with the direction of the rib. This method is mainly applicable to oppression in the chest and rib-side and has the effect of dredging the channels, broadening the chest and smoothing qi. Avoid twisting and rubbing movements to the skin. This method is contraindicated for the female patients.
(3) Guasha Therapy
1) Effective channels and acupoints: Governing vessel: Zhiyang (GV9); Liver channel: Qimen (LR 14); Ren channel: Shangwan (CV 13), Shuifen (CV 9); Spleen channel: Yinlingquan (SP9), Sanyinjiao (SP6); Urinary bladder channel: Ganshu (BL 18); Gallbladder channel: Yanglingquan (GB 34), Qiuxu (GB40).
2) Paraphrase of channels and acupoints: Ganshu (BL 18) and Zhiyang (GV9) to discharge the liver channel, disperse stagnant heat and remove jaundice; Yinlingquan (SP9), Yanglingquan (GB 34), Qimen (LR 14), Qiuxu (GB40) to tonify spleen and smooth the liver, regulate vital energy and relieve pain; Shangwan (CV 13), Shuifen (CV 9), Yinlingquan (SP9) to tonify spleen, resolve dampness, disperse and eliminate swelling; Sanyinjiao (SP6) to nourish the blood and promote blood circulation.
(4) Cupping Therapy
Acupoints selected: Ganshu (BL 18), Danshu (BL19), Zhangmen (LR 13), Qimen (LR 14), Riyue (GB 24), Zhongfu (LU1), Dannang (EX- LE 6), Taichong (LR 3).
Manipulation: Apply fire cupping manipulation to each acupoint for 10-15 minutes, once a day, 10 times as a course of treatment.
