Clinical Syndrome Differentiation of Hepatic Disease

1. To disperse the depressed liver-qi and strengthen earth at first step, and the liver and spleen can be regulated effectively; the formula is modification of Si Ni San.

2. Liver yin can be hurt by over dispersing the depressed liver-qi, and it should be treated by clearing away liver heat and nourishing yin; the formula is modification of Suan Zao Ren Tang.

3. Jaundice is caused by stagnation of damp and heat, and the pathogenic turbidness is eliminated by clearing away heat and toxin.  The formula is Yin Chen Tang combining with Huo Pu Er Chen Tang.

4. The treatment shouldn't be limited by clearing away heat and toxin, and Wu Zhu Yu and Gui Zhi with the function of warming liver are right on it. The modification of Wu Zhu Yu Tang is used, besides, in Treatise on Cold-induced Febrile Diseases， Gui Fu Fu Zi Tang for Taiyang diseases has the functions of warming the liver and harmonizing nutrient-blood also.

5. Downward flow of damp and heat causes Diarrhea, and it can be treated by calming the liver and inhibiting wood. The formula is Bai Tou Wong Tang added with Jiao Zhi Ren and Ban Lan Gen.

6. Deficiency of  liver yin causes stagnation of dampness in spleen, and the preferred method is enriching the insufficiency of yin and relieving qi stagnation in the liver. Gan Mai Da Zao Tang added with Tai Zi Shen, Shan Yao, Shao Yao, Shi Hu, Wu Gui, Bie Jia, etc. are applied to enrich the insufficiency of yin; Lu Gen, Che Qian Zi and Yun Ling are applied to eliminate dampness; Yu Jin and Chai Hu are applied to relieve qi stagnation in the liver. If the hepatitis B patients are deficiency of earth and excess of wood, and treated with Shao Yao Gan Cao Tang; If the hepatitis B patients are spleen deficiency and dampness excess caused by transverse liver qi, Xiao Jian Zhong Tang is applied.

   Treating hepatic disease should strengthen spleen firstly, in case of the transmission of disease, hence, the Zi Cao Ban Lan Jiang Zao Tang for tonifyiing spleen and cleaning away heat and toxin are effective on negative conversion of HBSAg. The formula is Tai Zi Shen, Shan Yao, Yi Yi Ren, Shan Zha, prepared Gan Cao, Hu Zhang, Zi Cao, Jiang and Da Zao.
  
Key words: Hepatic disease, clinical syndrome differentiation, Chinese herbs

Writer: Xiyan Yang
TCM department of Jining railway hospital, Hohhot Railways Bureau, Inner Mongolia autonomous region (012000)