Hepatic hemangiomas, most of which are cavernous hemangiomas, are more common in the liver than other organs, are benign tumors, can occur at any age, but often appear in middle age, and women account for the majority.
Hemangiomas are often located under the right lobe of the liver, most of them are single, about 10% are multiple, small tumors are no more than a few millimeters in diameter, and some large ones can weigh up to 36 kg. Most scholars believe that its cause is endocrine-related.
Clinical manifestations depend on the size of the tumor, and most cases do not cause symptoms because the tumor is small, and is only detected during physical examination. If the volume is large and compresses the gastrointestinal tract, there may be symptoms such as loss of appetite, indigestion, fullness after meals, belching, nausea, vomiting and so on.
There is no record of this disease in the medical literature of the motherland, and according to the clinical manifestations, it belongs to the category of "accumulation" of Traditional Chinese medicine, "Lingshu · Hundred Diseases Begin to Be Born": "The beginning of the accumulation, the cold is the birth... If the inside is hurt in the cold, if the inside is hurt, then the qi is reversed, the qi is reversed, the six are not lost, the warm qi is not good, the coagulation is not dispersed, the jin liquid is astringent, and the accumulation is complete. ”
It shows that the cause of the disease is related to cold evil and emotion; the disease mechanism is that the qi machine is rebellious, the warm qi is not good, the blood is coagulated, the jin liquid is astringent, and it does not go away, so that it becomes a accumulation.
Western medicine for the treatment of this disease is mainly surgery, if the tumor is multiple, the lesion is widely not suitable for surgery, often give radiation therapy or take hepatic artery embolization.
Traditional Chinese medicine treatment of this disease mainly adopts the methods of liver thinning, soft and firm loose knots, and blood activation and stasis.
Prescription medication
First, liver thinning qi, blood circulation, soft and firm communication and other traditional Chinese medicine-based prescriptions
(1) Hepatobiliary damp heat type
Medicinal uses: chai hu, red peony, white fresh skin, chicken inner gold, wood fragrance each 10g, dandelion, honeysuckle vine each 30g, wild chrysanthemum flower 15g, raw rhubarb, licorice 5g each.
(2) Stasis and hemorrhoid type
Medicinal uses: peach kernel, gun mountain beetle, su mu, safflower, angelica, red peony, white peony, raw land, lulutong 10g each, seaweed 30g.
(3) Yin deficiency internal heat type
Medicinal uses: Mai Dong, Beisha ginseng, goji berries, angelica 10g each, salvia, raw land, hawthorn, turtle nail, Xu Changqing each 30g, schisandra, licorice 5g each.
Second, the treatment of traditional Chinese medicines such as soothing liver and rational qi, diarrhea, liver and spleen
Basic square composition: 60g of flat wood, 18g of corrugated seeds and stone swallows, 12g of leaky reeds, 9g each of angelica, white tribulus terrestris, madder, neem, Xuanhu and lentils, 6g each of fragrant and safflower. According to the dialectical slight addition and subtraction, decoction, 1 dose per day.
Third, fixed prescription treatment
(1) Hepatic accumulation and dissipation
This side is composed of 10g each of chai hu, tulip, red white peony, citrus shell, licorice, salvia, liu jinnu, and 6 g of turtle shell. Decoction, 1 dose daily.
Take another 12 centipedes, 15g of tridenta, 30g of ground turtles, and take 3 capsules per 3 capsules (about 1g of raw medicine), 3 times a day, 1 month for a course of treatment.
(2) Tumor elimination
The composition of the party: leech, salvia, yellow medicine, mountain mushroom, three ridges, curcuma, raw oysters, luminous sand 30g each, 10g of whole scorpion, 20g of earth turtle, yuanhu, a total of fine powder, over 100 mesh sieve, made of powder or water pills, each time 10g, 2 times a day, 20 days 1 course of treatment.
Avoid raw and cold, wine, dog meat, and mutton.
By word
Hepatic hemangioma is a common benign tumor of the liver, with the development of science and technology, the popularity of ultrasound, there is a trend of increase in the number of diagnosed hemangiomas.
Hepatic hemangiomas are more than 4 cm in diameter, often asymptomatic, and about 40% of patients with a diameter of more than 4 cm are accompanied by symptoms, abdominal pain and discomfort, hepatomegaly, abdominal lumps, compression of the gastrointestinal tract caused by loss of appetite, indigestion and other symptoms.
The occurrence of this disease is mostly related to endocrine, while Chinese medicine believes that it is often due to seven emotional knots, dietary internal injuries, etc., resulting in liver and spleen damage, organ loss, gas machine blockage, blood stasis and internal stagnation, and gradual accumulation over time.
According to the nature of the disease and the manifestation of the disease, according to the etiology dialectic and the internal organ dialectic, the disease can be divided into the following types: liver depression qi stagnation, qi depression blood obstruction, cold coagulation stagnation, depressed blood internal knot. The key to the treatment of this disease lies in the appropriate use of methods such as evacuation, elimination, attack and supplementation according to the specific situation of the patient.
It is generally believed that the occurrence of this disease is mostly caused by congenital endowments, depression, warmth, blood stasis, etc., which makes the liver drainage poor, qi stagnation and blood stasis, and long-term symptoms.
Although the disease mechanism is intricate, but it is always nothing more than stasis, depression, heat, stasis is the main cause of the disease, so the treatment always grasps a stasis, according to the different symptoms, with the selection of blood stasis of red peony, danshen, angelica, Zelan, rhubarb and so on. When facing the certificate, it is necessary to flexibly grasp the essentials of dialectics and choose the prescription according to the main certificate.
There are also people who believe that the lack of righteous qi in patients with hepatic hemangioma is fundamental, and the cold and evil invade externally, and the internal injuries and anger are so that "the blood gas is retained", "the coagulation is not dispersed", and the infusion of Jin is the key.
Therefore, astragalus, guizhi, salvia, turtle, poria, mutong, ze diarrhea, wujiapi, sea gold sand and other drugs are used to make the yang temperature transport, coagulation flow, jin liquid transfusion, and "accumulation" gradually disappear;
And because of the "liver body yin and yang", only the liver yin is full, in order to transform the qi and yang and play the yang, so the peony, licorice, raw land, northern sand ginseng and other drugs to soft liver yin and help the yang, enhance the effect of the drug, can be used for clinical reference. Note: Please follow the doctor's instructions for specific treatment and medication! This article is excerpted from "Integrated Traditional Chinese and Western Medicine Treatment of Hepatobiliary Diseases: A Collection of Prescription Drugs", edited by Wang Qingmin, published by China Medical Science and Technology Press, 1997.6.