Traditional Chinese medicine diagnosis and treatment of primary liver cancerPrimary hepatocellular carcinoma (HCC) is a cancer of the liver
Traditional Chinese medicine diagnosis and treatment of primary liver cancer
Primary hepatocellular carcinoma (HCC) is a cancer of the liver or intrahepatic bile duct epithelial cells. It is one of the common malignant tumors in china. Hepatocellular carcinoma (HCC) is characterized by insidious onset, high malignancy, rapid progress, strong invasiveness, poor prognosis and high mortality.
This disease is equivalent to the national standard of TCM also belongs to the category of liver cancer, liver volume, mass, accumulation, swelling, jaundice, ruffian, yellow and other diseases.
Clinical diagnosis and staging
1 clinical diagnostic reference "clinical guidelines, oncology diagnosis of this disease" (edited by Chinese Medical Association. Clinical guidelines and oncology. Beijing: People's Medical Publishing House, 2005) diagnostic criteria for primary hepatocellular carcinoma.
2 clinical stage with reference to the 2001 China Association for the prevention of liver cancer, cancer of the Specialized Committee, "the Guangzhou meeting in September 2001," the standards set by.
Two, Chinese medicine treatment program
Principles of treatment: three principles should be followed: "early treatment", "staged treatment" and "comprehensive treatment".
Early (stage Ia ~ IIa): for surgical resection, postoperative treatment with Chinese medicine. Is unable resection, transcatheter arterial chemoembolization and radiotherapy (including gamma knife, nuclear particle implantation) and comprehensive treatment of percutaneous ethanol injection and radiofrequency ablation, microwave, ultrasonic knife shaped, cryotherapy therapy combined with traditional Chinese medicine therapy. Because of the high recurrence rate of liver cancer, it is suggested that Chinese medicine should be used to prevent recurrence and metastasis.
The middle stage (IIb ~ IIIa): surgical resection or non surgical local treatment combined with traditional Chinese medicine treatment. Two stage resection.
Advanced stage (stage IIIb): Chinese medicine treatment and biological targeted therapy, with the best support treatment.
Syndrome differentiation and treatment based on syndrome differentiation
On the basis of disease differentiation, the treatment of syndrome differentiation should be carried out.
1 liver stasis and spleen deficiency syndrome is the most common form of primary liver cancer.
The main symptoms: liver area pain or tingling, abdominal distension Na reduction, pale tongue or purple or ecchymosis.
Secondary symptoms: dark complexion, less gas lazy words, belching, nausea, progressive weight loss, limb weakness or Chu foot swelling, loose stools, wiry or astringent.
Treatment: Spleen Qi, stasis and softening, detoxification.
Recipe: liver modified Huangqi dangshen: Baizhufuling Chaihu Taoren (zedoary Rhizoma Cyperi Pericarpium Citri Reticulatae Biejia decocted) oyster (Xian Jian) Paris Banzhilian Hedyotis diffusa licorice decoction.
Add: anorexia, Ganekin, hawthorn, malt, fried rice sprout; constipation, increase the yellow, Magnolia, Zhishi; will dilute, plus Wu Zhuyu, Coptis, fried lentils; abdominal fullness, oliguria and Pericarpium Arecae, Fructus aurantii, cortex mori; pain worse, Fructus toosendan, radix curcumae, Rhizoma Corydalis, and hematoxylin; nausea, addition of pinellia, bamboo shavings, Amomum; kidney, and Chinese wolfberry, Ligustrum lucidum, dodder.
2 types of spleen deficiency and Dampness Retention
The main symptoms: abdominal distension, lassitude, anorexia and body weight, leg foot swelling Chu, oliguria.
Secondary symptoms: sticky and do not want to drink, when you feel nausea; loose stool; pale tongue with scalloped tongue, thick and greasy fur; thready pulse or slippery or moisten.
Treatment: Spleen Qi, stasis and softening, dampness detoxification.
Recipe: four gentleman Decoction and five PI Decoction: Baizhu Huangqi Dangshen
Poria Rhizoma Cyperi Pericarpium Citri Reticulatae Pericarpium Arecae Fructus aurantii waxgourd peel of Solanum nigrum peach zedoary
The turtle (first decoct) Banzhilian Hedyotis diffusa Radix Glycyrrhiza decoction.
Add: nausea, addition of pinellia, bamboo shavings, Amomum; diarrhea heavier, add ginger, fried Atractylodes, lentils; yellowing of the body and eyes, with wormwood, gardenia seed, Radix Paeoniae Rubra; severe ascites, and Eupatorium, Polyporus, Plantago (cloth).
3 damp heat toxin syndrome
The main symptoms: liver pain and burning, anorexia, abdominal nausea, constipation or viscous uncomfortable, yellow greasy.
Secondary symptoms: fever, jaundice, mouth pain, dry mouth, irritability, yellow urine, red tongue, pulse or slippery.
Treatment: heat dampness, stasis.
Recipe: Yinchenhao Decoction: wormwood Gardenia rhubarb and red peony root pangolin scales (first fried) agaric Poria cocos Coix Pericarpium Arecae Pericarpium Citri Reticulatae Banzhilian Hedyotis diffusa officinalis nigrum licorice decoction.
Add: dry stool, Houpu, or even take Zhishi; abdominal distension,
Modified Fuling peel, Fructus aurantii, Adenophora; heat plus bupleurum, Scutellaria, gypsum (fried).
4 liver and kidney yin deficiency
The main symptoms: hepatic region pain, Yaoxisuanruan, persistent fever or hot feeling, red tongue without fur or exfoliative fur or light moss.
Secondary symptoms: irritability, dizziness and insomnia, fever sweating, thirst or thirst without desire to drink, thin or rapid pulse.
Treatment: nourishing liver and kidney, jieduhuayu.
Recipe: consistently Decoction: students Radix Angelica medlar children Sadako dodder Baizhufuling toosendan Huangqi dangshen (Radix Paeoniae Rubra Biejia decocted) Banzhilian Hedyotis diffusa licorice decoction.
Add: fever, dry mouth and throat, with sweet wormwood, bupleurum root, asparagus and silver gum; nasal bleeding, plus agrimony of Rhizoma imperatae; hematemesis and melena, combined with Yunnan Baiyao (blunt), rhubarb (blunt).
(two) disease modifying drugs
1 commonly used Chinese medicine (including hospital preparation)
(1) Ganfule tablet: efficacy for detoxification, spleen qi, stasis and softening; for patients with hepatic stasis spleen deficiency syndrome; usage: 6 to 8 tablets each time, 3 times / day orally.
(2) liver like tablets (hospital preparations): effect of invigorating spleen and regulating qi, detoxification, stasis and softening; for patients with hepatic stasis spleen deficiency syndrome; usage: 8 to 10 tablets each time, 3 times / day orally.
(3) liver like mixture (hospital preparations): effect of invigorating spleen and regulating qi, clearing heat and removing dampness, stasis and softening liver stasis and spleen deficiency; suitable water dampness stasis syndrome patients; 30 ~ 50 ml / time, 3 times / day orally.
(4): compound capsules cantharidin supplementing qi and nourishing Yin, promoting blood circulation to remove blood stasis; usage: oral, 2 tablets each time, 3 times a day.
(5) the Brucea javanica oil soft capsule: Ruanjiansanjie, anticancer; usage: oral, 4 tablets each time, 3 times a day.
(6): Brucea javanica oil oral emulsion Ruanjiansanjie, anticancer; usage: oral, 20ml each time, 3 times a day.
(7) Xihuang Capsules: jiedusanjietang, Xiaozhongzhitong; usage: oral, 4-8 each time, 2 times a day.
(8) babaodan capsules: clearing heat, detoxification, pain to yellow; usage: oral, 2 tablets each time, 3 times a day.
(9) the disease huishengkoufuye: Huayu Xiaozheng; usage: oral, 10ml each time, 2 times a day.
(10) the United States and the United States Department of resistance: anti cancer; usage: every time 1 or 1 tablets, oral, a day 3 times.
2 commonly used Chinese medicine injections
(1): the effect of cinobufacini injection for detoxification, Ruanjiansanjie, suitable for patients with liver stasis and spleen deficiency syndrome; usage: 10 ~ 15ml/ times, adding 5% glucose 500ml intravenous injection, 1 times / day, for 3 weeks, 1 weeks for 1 courses of treatment, continuous observation of 2 courses.
(2) compound Sophora flavescens injection: the efficacy of heat clearing and detoxifying, suitable for damp heat toxin syndrome patients; usage: 200ml ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 20ml into the saline intravenous drip, 1 times / day. The total amount of 200ml as a course of treatment, can be used continuously for 2 to 4 courses.
(3): the efficacy of Kang'ai injection for supplementing qi and nourishing Yin, suitable for liver kidney yin deficiency syndrome; usage: 40 ~ 50ml/, diluted with 5% Glucose Injection 250ml ~ 500ml or saline, intravenous drip, 1 ~ 2 times / day, 30 days for a course.
(4): Addie injection efficacy for detoxification, Xiaoyu Sanjie; suitable for yin deficiency, blood stasis poison inside the card; usage: a 50 ~ 100ml, 5% ~ 500ml or Glucose Injection 250ml saline diluted intravenous infusion, once a day, 14 to 21 days for a course.
(5) Brucea javanica oil injection time 20 ~ 30ml, 5% ~ 500ml or Glucose Injection 250ml saline diluted intravenous infusion of 1, 1 times a day, 14 to 21 days for a course.
(6): xiaoaiping injection efficacy for detoxification, phlegm Ruanjian phlegm heat stasis; suitable for use; 5% or 10% Glucose Injection diluted infusion, a 20 ~ 100ml, once a day, 14 days for a course.
Elemene Injection (7): efficacy as anticancer; usage: a 400-600mg (4-6), 5% Glucose Injection 400-500ml dilution, intravenous infusion, once a day, 14 to 21 days for a course.
(three) interventional therapy of traditional Chinese medicine is mainly suitable for patients with stage II and stage III.
1 indications: no resection of liver cancer, portal vein without cancer embolus, no serious liver cirrhosis and liver dysfunction, jaundice, ascites.
2 commonly used drug perfusion and embolization agent: Brucea javanica oil emulsion and Elemene Injection, cinobufacini injection, lipiodol and gelfoam.
(four) after surgery, interventional therapy and radiotherapy
1 after surgery (one month after surgery)
Treatment: nourishing both qi and blood, and invigorating spleen and stomach, promoting blood circulation to remove blood stasis.
Prescription: Bazhen Decoction: Codonopsis Atractylodes
Fuling Tian 37 Angelica Radix Rehmanniae Radix Paeoniae Alba
Magnolia Pinellia Amomum barbata
Hedyotis Spatholobi licorice.
Add: virtual trouble insomnia, and wild jujube, Polygala; hypochondriac pain, abdominal distension, and Corydalis Kawa Ko;, add fried Guya, fried malt
Fried Fructus aurantii.
2 after interventional therapy (after interventional surgery for 15 days)
Treatment: tonifying liver and kidney, Qi and stomach, stasis.
Recipe: six Chaishao Liujunzi Decoction of Bupleurum Radix changii Atractylodes
Peony Forsythia perilla stem peel. Water decoction.
Add: nausea and vomiting, and Jiang Zhuru; lassitude to dangshen, plus ginseng (Zheng Dui); red urine, with wormwood, gardenia; liver pain, and Corydalis, Tian 37.
3 after radiotherapy and thermotherapy
Treatment: Nourishing Yin and stomach, liver qi, detoxification.
Recipe: Shashen Maidong Decoction: Shashen, ophiopogon root, Chinese yam, bamboo shavings, pinellia, Amomum 10g, Fructus aurantii 10g, orange peel 10g, 15g heterophylla, Astragalus 30g, Poria 10g, 30g Hedyotic diffusa, Scutellaria barbata 30g, licorice. Water decoction.
Add: liver pain, and Corydalis Kawa Ko; hematemesis or melena, plus Burnet carbon, Coptis chinensis, Herba agrimoniae, tin powder (blunt); 37 were with dwarf, mouth parched and tongue scorched, Dendrobium; jaundice was significantly and urine red, with wormwood, gardenia, desmodium.
(five) the characteristics of Chinese medicine treatment of advanced liver cancer complicated with jaundice, bulging
Advanced liver cancer complicated with refractory ascites, Huang Danzheng, liver failure, TCM belongs to "bulge" and "jaundice" and other disease areas, the treatment is quite difficult, there is no effective methods and drugs can delay the pathological process. Our department for many years to carry out this stage of the rule of syndrome and treatment research, the results show that the disease in the liver, spleen, kidney, liver and spleen, the basic pathogenesis is long, damage of spleen and stomach, qi stagnation, blood stasis and Dampness Retention; most discernible as the "spleen deficiency and dampness stagnation syndrome or blood stasis syndrome of damp heat", with dampness, invigorating spleen and regulating qi is the basic treatment, or with blood stasis, clearing heat and removing dampness, nourishing liver and kidney etc..
1 Characteristics of Chinese herbal medicine decoction
In four five PI Decoction of Sijunzi Decoction (Radix Astragali Radix Codonopsis Poria Atractylodes Rhizoma Cyperi Pericarpium aurantii peel Exocarpium Benincasae nigrum peach
Zedoary turtle (Xian Jian) Banzhilian Hedyotis Paeoniae Glycyrrhizae
Water decoction. Add: nausea, addition of pinellia, bamboo shavings, Amomum; diarrhea heavier, add ginger, fried Atractylodes, lentils; yellowing of the body and eyes, with wormwood, gardenia seed, Radix Paeoniae Rubra; severe ascites, and Eupatorium, Polyporus, Plantago (cloth).
2 characteristics of proprietary Chinese medicine treatment
Liver like mixture (hospital preparations): effect of invigorating spleen and regulating qi, clearing heat and removing dampness, stasis and softening liver stasis and spleen deficiency; suitable water dampness stasis syndrome patients; 30 ~ 50 ml / time, 3 times / day orally.
3 external therapy of Chinese Medicine
Umbilicus: 1.5g Euphorbia kansui, musk 0.5g, at the end of the research, adjustable sticking umbilical fossa, 1 times a day; with water by drinking, detumescence, suitable for liver cancer complicated with ascites.
4 characteristics of traditional Chinese medicine perfusion therapy
After B-ultrasound localization, the abdominal cavity was inserted into the central venous catheter for drainage, and the patients were continuously, slowly and intermittently drained within 3 to 5 days. Transcatheter infusion of 45 C saline, every 1500 ~ 2000mL, kept for 20 minutes, again as peritoneal lavage fluid, so repeated 3 times for abdominal cavity heat perfusion, 1 times in the last row of the net lavage fluid, injected 45 C saline 100ml+ 15mg dexamethasone + Brucea javanica oil emulsion 60ml catheter (or Elemene Injection 0.4 ~ 0.6g) after extubation. After the injection the symptoms in the 2H transform to posture, drugs and even contact with the peritoneum. 1 times a week, two times for a course of treatment, a total of 1 courses. Adverse reaction for routine antiemetic, symptomatic and supportive treatment.
(six) external treatment
1 Kings (analgesic ointment made of rhubarb, nux vomica, scorpion, toad, Paris, shancigu, Jiang Huang, musk 20 finish medicine, composed of plaster), sticking in the liver area pain or place or point, 24 ~ 28 hours for 1 times, 7 days as a course. Liver cancer pain.
2 acupuncture acupoints: Zusanli acupoints, liver Yu, with Yanglingquan, Qimen, Zhang door, Sanyinjiao, daily acupuncture 1 ~ 2 times, 10 days for 1 courses. Adjuvant therapy for liver cancer.
The 3 point: the acupoint application main points: Chapter door, door, Ganshu, Neiguan, gongsun. The pain with acupoints: Zusanli and Yanglingquan, Waiguan; ascites with air sea, waterways, yinlingquan, Sanyinjiao; with chize, Neiguan, Geshu, Quze, Hegu and upper gastrointestinal bleeding. Every time points 4 ~ 6, soft paste strychnos. Once a day, the use of alternating points, 2 ~ 3 weeks as a course of treatment. Suitable for liver cancer.
(seven) the emotional counseling and therapy
For liver cancer patients with emotional disorders, with a variety of Chinese emotional counseling therapy, including patients with a single "talk therapy", "enlighten Seishi Anshen", "happy happy", "doubts", "transferring method",
"Guidance for gas law" and "emotion" and other similar individual psychotherapy, collective mutual emotional counseling therapy and five for music counseling and therapy.
(eight) specialty Chinese medicine treatment equipment
1 liver disease therapy instrument in the treatment by ultra low frequency electric pulse stimulation technology of effective acupuncture points of the human body, achieve the treatment of liver cancer, liver cirrhosis, viral hepatitis and other liver diseases, can effectively improve the clinical symptoms, liver function, become one of the effective methods of non drug treatment of liver disease. Suitable for patients with liver cancer, take the corresponding points, each treatment for 30 minutes, daily 1 times, a course of treatment for two weeks.
2 external high frequency thermotherapy machine: treatment by high frequency electromagnetic field generated "heat" principle in the human body, effectively killing cancer cells without damaging normal tissues, combined with traditional Chinese medicine, can increase the curative effect. For patients with solid tumors, with cancer patients, take corresponding parts, 60 minutes each treatment, 1 times a week, four weeks, but after 2 courses.