Treatment of moderate fatty liver, TCM syndrome differentiation treatment

Generally, mild fatty liver has no symptoms, while moderate fatty liver will cause malignancy, fatigue, loss of appetite, and weight loss. This is also the so-called "rich disease". Moderate fatty liver can be treated with Chinese medicine differentiation and treatment.

1. Sweet tongue

A total of 29 cases were treated, all of which were diagnosed by blood lipids and B-ultrasound. Clinically, there are often abdominal distension and pain, loss of appetite, vomiting and nausea, pale complexion, or loose stools, drowsiness, white and greasy or thick tongue, and slow or wet pulse. However, there are also patients with less obvious symptoms, such as only a sweet taste on the tongue. A sweet taste in the tongue is usually caused by dampness and turbidity rising up, which is closely related to the spleen. The spleen likes dryness and hates dampness. Dampness can easily trap the spleen, blocking the Qi flow, causing blood lipids to fail to transport and transform normally and accumulate in the blood as phlegm and stasis. It blocks the liver and causes fatty liver.

To treat, the aroma should be used to eliminate turbidity, and the prescription can be modified from Sanren Decoction and Yinchenhao Decoction: apricot kernel, coix seed, white cardamom seed, Magnolia officinalis, Pinellia, Poria, Cymbidium orchioides, Artemisia capillaris, talc, rhubarb, Angelica sinensis, Cassia seed, Curcuma aromatica, red peony root, Smilax glabra, Doujuan, and Patchouli. The treatment course lasted 2 to 3 months, and all patients recovered.

2. Tongue acid

The patients felt a sour taste on their tongue and in their mouth, but no acid water came out. A total of 18 cases were diagnosed and treated, and all were confirmed by blood lipids and B-ultrasound. It is mostly caused by abnormal spleen function, indigestion of food, or overeating that damages the spleen, food accumulation in the stomach and intestines, disharmony between the liver and spleen, and the rising of turbid air. Yu Tuan's "Medical Biography" said: "There are also people with weak spleen and stomach qi, wood taking over the earth position, and sour mouth". The liver and stomach are not in harmony, qi is stagnant and dampness is blocked, phlegm is stagnant and blood is stasis, and there is obstruction of the liver meridians. Therefore, there are occasional pain in the abdomen, flank distension and nausea, noisy belching, irregular bowel movements or abdominal pain and diarrhea with foul smells, thick and greasy or yellow tongue, and stringy and slippery or deep and solid pulse.

The treatment is to attack the accumulation and eliminate the stagnation, promote qi and eliminate the abdominal distension. The prescription of Zhishi Daozhi Pills and Muxiang Binglang Pills is modified with: rhubarb, Zhishi, Shenqu, malt, hawthorn, Poria, costus root, areca catechu, tangerine peel, scutellaria, Alisma, Coptis chinensis, Curcuma, Trillium, Amomum, Angelica, Cassia, lotus leaf, Cyperus rotundus, and Curcuma. All cases were cured after 1 to 3 months of treatment.

3. Spicy tongue

The patient feels a spicy, numb or fishy taste on his tongue. This is rare in clinical practice. Four cases were diagnosed and all were confirmed by blood lipids and B-ultrasound. The main symptoms are restlessness of the heart and gallbladder, invisible qi and fire with phlegm and turbidity, which are consistent with the pathogenesis of fatty liver. "Popular Treatise on Febrile Diseases" says: "If the mouth is spicy, it means that the heat from the lungs has entered the stomach." Zhu Danxi said: "If the mouth is spicy due to lung heat, Gan Jue Decoction and Xie Bai San are suitable. Clinically, symptoms include abdominal distension, chest tightness and shortness of breath, or excessive phlegm and inability to lie flat, or even edema of the face, loose stools, dark tongue with thin and greasy coating, and a wiry and slippery pulse.

The treatment should be to clear the lungs and heat, soothe the liver and harmonize the stomach. The prescription should be Xiebai San and Chaihu Shugan San with modifications: Scutellaria baicalensis, Pinellia ternata, Morus alba bark, Rehmannia root bark, Tangerine peel, Radish seed, Sinapis alba, Cyperus rotundus, Curcuma aromatica, Toosendan fruit, Cassia seed, Alisma orientalis, and Crataegus pinnatifida. The above 4 cases were all cured within 1 to 3 months.

4. Bitter tongue

A total of 36 cases were diagnosed, all of which had high blood lipids and were confirmed to have fatty liver by B-ultrasound. Clinically, there are abdominal distension, flank pain, dizziness, tinnitus, or constipation, dry throat and mouth, white or yellow greasy tongue, and a stringy and slippery pulse, but most of them only have bitter taste in the mouth and constipation, without other symptoms. Bitterness is the taste of bile, which is related to the liver's secretion; bitterness belongs to fire, and when fire is strong, the mouth will be bitter. "Suwen Wei Lun" states: "If the liver qi is hot, the gallbladder will leak and the mouth will be bitter..." "Lingshu Zhang Lun" states: "If the gallbladder is swollen, there will be pain and swelling under the ribs and bitterness in the mouth."

The treatment should be to clear the liver and gallbladder, soothe the liver and relieve depression. Longdan Xiegan Decoction can be used with modifications: Bupleurum, Angelica, Alisma, Scutellaria, Gardenia, Cassia, Rhubarb, White Peony, Curcuma, Toosendan, Taraxacum, Patrinia, Crataegus, Radish Seed. The above cases showed slight improvement after medication, and all were cured after 2 to 4 months of treatment.