CN107375748B

CN107375748B - Liver softening ointment

Info

Publication number: CN107375748B
Application number: CN201710655519.7A
Authority: CN
Inventors: 李朝宏; 张江海; 刘科; 宋婷; 马瑶; 黄杰梅; 洪波; 刘成竹
Original assignee: Individual
Current assignee: Individual
Priority date: 2017-08-03
Filing date: 2017-08-03
Publication date: 2020-11-06
Anticipated expiration: 2037-08-03
Also published as: CN107375748A

Abstract

The invention discloses a liver softening ointment which comprises the following components in parts by weight: 20-30 parts of turtle shell, 10-20 parts of tortoise plastron, 10-30 parts of Chinese yam, 10-20 parts of bighead atractylodes rhizome, 20-40 parts of astragalus membranaceus, 10-20 parts of radix bupleuri, 10-20 parts of scutellaria baicalensis, 10-30 parts of red peony root, 10-20 parts of prepared rehmannia root, 10-20 parts of cortex moutan, 10-20 parts of elecampane, 20-40 parts of rhizoma alismatis, 10-20 parts of dogwood, 20-40 parts of fructus trichosanthis, 10-20 parts of angelica sinensis, 10-30 parts of poria cocos, 10-20 parts of peach kernel, 10-15 parts of ligusticum wallichii, 20-30 parts of lalang grass rhizome, 10-20 parts of pericarpium arecae and 5-10 parts of pig bile, and the invention has the advantages that: the Chinese medicinal composition has the advantages of remarkably improving clinical symptoms of patients, enhancing immunity, increasing the compliance of the patients after long-term administration, improving the life quality of the patients and having no obvious toxic or side effect.

Description

Liver softening ointment

Technical Field

The invention relates to the technical field of liver disease drugs, in particular to the technical field of liver disease drugs and a processing and manufacturing method thereof.

Background

The liver is the most important metabolic organ of the human body, has metabolic functions such as protein metabolism, sugar metabolism, fat metabolism, vitamin metabolism and hormone metabolism, and can secrete bile to help digestion and absorption of fat. Meanwhile, the liver is also the largest detoxifying organ of the human body and can oxidize, reduce and decompose toxins in the body. In addition, the liver is an important immune organ of the human body, which can sequester and eliminate various invading and endogenous antigens by phagocytosis. Therefore, the health of the liver is very important. The liver disease refers to the pathological changes occurring in the liver, and is a common extremely harmful disease, the common liver diseases include various viral hepatitis, liver cirrhosis, alcoholic liver, liver abscess, primary liver cancer and the like, and the treatment of the liver diseases, particularly the viral hepatitis, has been a great problem in the medical field all the time. At present, common liver disease treatment drugs in the market comprise antiviral drugs such as entecavir, adefovir dipivoxil and lamivudine which are mainly prepared from western medicines, and liver protection drugs such as reduced glutathione and ornithine aspartate, however, the drugs have many defects in the aspects of resisting hepatic fibrosis, enhancing immunity and improving general clinical symptoms of patients, have large toxic and side effects on human bodies and more adverse reactions, and can reduce the compliance of the patients after long-term administration, thereby influencing the treatment of liver diseases.

Disclosure of Invention

The invention aims to solve the defects and provide the good-medicine liver softening ointment which has good treatment effect, can effectively prevent and treat hepatic fibrosis and enhance immunity, can improve the compliance of patients by taking the traditional Chinese medicine of the natural therapy for a long time, is very beneficial to the recovery of patients with the hepatic diseases and has small toxic and side effects on human bodies.

The technical solution adopted by the present invention to solve the above technical problems is as follows:

the liver softening ointment comprises the following components in parts by weight: 20-30 parts of turtle shell, 10-20 parts of tortoise plastron, 10-30 parts of Chinese yam, 10-20 parts of bighead atractylodes rhizome, 20-40 parts of astragalus membranaceus, 10-20 parts of radix bupleuri, 10-20 parts of scutellaria baicalensis, 10-30 parts of red peony root, 10-20 parts of prepared rehmannia root, 10-20 parts of cortex moutan, 10-20 parts of elecampane, 20-40 parts of rhizoma alismatis, 10-20 parts of dogwood, 20-40 parts of fructus trichosanthis, 10-20 parts of angelica sinensis, 10-20 parts of schisandra chinensis, 20-30 parts of lily, 5-10 parts of red ginseng, 20-40 parts of calcined oyster, 10-30 parts of salvia miltiorrhiza, 10-30 parts of radix puerariae, 10-20 parts of pseudo-ginseng, 10-30 parts of poria cocos, 10-20 parts of peach kernel, 10-15 parts of ligusticum wallichii, 20-30 parts of lalang grass rhizome, 10-20 parts of.

The preferable components and the weight portion ratio are as follows: 25 parts of turtle shell, 15 parts of tortoise plastron, 20 parts of Chinese yam, 15 parts of bighead atractylodes rhizome, 30 parts of astragalus, 15 parts of radix bupleuri, 15 parts of scutellaria baicalensis, 20 parts of red paeony root, 15 parts of prepared rehmannia root, 15 parts of cortex moutan, 15 parts of costustoot, 30 parts of rhizoma alismatis, 15 parts of dogwood, 30 parts of fructus trichosanthis, 15 parts of angelica, 15 parts of schisandra chinensis, 25 parts of lily, 8 parts of red ginseng, 30 parts of calcined oyster, 20 parts of salvia miltiorrhiza, 20 parts of radix puerariae, 15 parts of pseudo-ginseng, 20 parts of poria cocos, 15 parts of peach kernel, 12 parts of ligusticum wallichii, 25 parts of lalang grass rhizome, 15 parts of pericarpium.

The processing and manufacturing method of the liver softening ointment comprises the following steps:

a. grinding all the components except the pig bile into powder, then fully and uniformly mixing the ground powder with 400-750 parts of honey, decocting the mixture for 3.5-4.5 hours by using slow fire, and continuously stirring the mixture in the decocting process;

b. and (b) adding 250-500 parts of brown sugar and the pig bile by weight into the material decocted in the step (a), fully and uniformly mixing, then continuously decocting with slow fire for 3.5-4.5 hours, and continuously stirring in the decocting process to prepare the liver softening ointment.

The temperature of the slow fire is 120-170 ℃.

The invention adopts the technical proposal to achieve the following beneficial effects: liver cirrhosis belongs to the category of traditional Chinese medicine accumulation or tympanites (liver cirrhosis Bing ascites), pathological organs are mainly in liver and spleen, and the key pathogenesis is qi disorder, vital qi deficiency and blood stasis. The liver softening ointment is a self-made prescription which is elaborately formulated according to the pathogenesis of deficiency of vital qi, qi stagnation and blood stasis and by combining with modern medical research, mainly comprises astragalus, peach kernel, turtle shell, ligusticum wallichii, salvia miltiorrhiza and the like, and has the main effects of tonifying qi and spleen, cooling blood and activating blood, softening liver and dissipating stagnation. The turtle shell is used for nourishing liver yin, softening and resolving hard mass, the ligusticum wallichii, the salvia miltiorrhiza, the peach kernel and the lalang grass rhizome are used for activating blood and cooling blood, dissolving stasis and promoting tissue regeneration, the astragalus mongholicus, the red ginseng and the white atractylodes rhizome are used for tonifying qi and strengthening spleen, and strengthening body resistance to consolidate constitution, the areca peel is used for promoting qi circulation and removing stagnancy, inducing diuresis and reducing edema to prevent ascites from being generated, and the modern pharmacological research shows that the peach kernel water decoction extract has the effects of promoting hepatic fibrosis reversal and adjusting abnormal immune state. Salvia miltiorrhiza has the effects of inhibiting or relieving hepatocyte degeneration, necrosis and inflammatory reaction; and has anti-hepatic fibrosis effect. The previous experiments also prove that the traditional Chinese medicine for promoting blood circulation and removing blood stasis has the function of expanding blood vessels; reducing blood viscosity, reducing blood flow resistance, increasing liver blood flow perfusion, improving hepatocyte hypoxia state, and promoting collagen hepatic fiber degradation and absorption, thereby gradually reducing liver to retract, and playing a good role in preventing and treating hepatic fibrosis. Experiments show that the liver softening ointment obviously improves the clinical symptoms of patients, enhances the immunity, increases the compliance of the patients after long-term administration, improves the life quality of the patients, and has no obvious toxic or side effect.

Detailed Description

Example 1: the liver softening ointment comprises the following components in parts by weight: 20 g of turtle shell, 10 g of tortoise plastron, 10 g of Chinese yam, 10 g of largehead atractylodes rhizome, 20 g of astragalus root, 10 g of Chinese thorowax root, 10 g of baical skullcap root, 10 g of red paeony root, 10 g of prepared rehmannia root, 10 g of tree peony bark, 10 g of costustoot, 20 g of oriental waterplantain rhizome, 10 g of common macrocarpium fruit, 20 g of snakegourd fruit, 10 g of Chinese angelica, 10 g of Chinese magnoliavine fruit, 20 g of lily, 5 g of red ginseng, 20 g of calcined oyster shell, 10 g of danshen root, 10 g of kudzuvine root, 10 g of pseudo-ginseng, 10 g of Indian buead, 10 g of peach seed.

a. grinding all the components except the pig bile into powder, then fully and uniformly mixing the ground powder with 400 g of honey, decocting the mixture for 3.5 hours by slow fire, and continuously stirring the mixture in the decocting process;

b. and (b) adding 250 g of brown sugar and pig bile into the materials decocted in the step (a), fully and uniformly mixing, then continuously decocting with slow fire for 3.5 hours, and continuously stirring in the decocting process to prepare the liver softening ointment.

The temperature of the slow fire is 120 ℃.

Example 2: the liver softening ointment comprises the following components in parts by weight: 25 g of turtle shell, 15 g of tortoise plastron, 20 g of Chinese yam, 15 g of bighead atractylodes rhizome, 30 g of astragalus root, 15 g of bupleurum root, 15 g of scutellaria baicalensis, 20 g of red paeony root, 15 g of prepared rehmannia root, 15 g of cortex moutan, 15 g of costustoot, 30 g of rhizoma alismatis, 15 g of dogwood, 30 g of fructus trichosanthis, 15 g of angelica, 15 g of schisandra chinensis, 25 g of lily, 8g of red ginseng, 30 g of calcined oyster, 20 g of salvia miltiorrhiza, 20 g of radix puerariae, 15 g of pseudo-ginseng, 20 g of poria cocos, 15 g of peach kernel, 12 g of ligusticum wallichii, 25 g of lalang grass rhizome, 15.

a. grinding all the components except the pig bile into powder, then fully and uniformly mixing the ground powder with 500 g of honey, decocting the mixture for 4 hours by slow fire, and continuously stirring the mixture in the decocting process;

b. and c, adding 300 g of brown sugar and pig bile into the materials decocted in the step a, fully and uniformly mixing, then continuously decocting with slow fire for 4 hours, and continuously stirring in the decocting process to prepare the liver softening ointment.

The temperature of the slow fire is 150 ℃.

Example 3: the liver softening ointment comprises the following components in parts by weight: 30 g of turtle shell, 20 g of tortoise plastron, 30 g of Chinese yam, 20 g of largehead atractylodes rhizome, 40g of astragalus root, 20 g of Chinese thorowax root, 20 g of baical skullcap root, 30 g of red paeony root, 20 g of prepared rehmannia root, 20 g of tree peony bark, 20 g of costustoot, 40g of oriental waterplantain rhizome, 20 g of common macrocarpium fruit, 40g of snakegourd fruit, 20 g of Chinese angelica, 20 g of Chinese magnoliavine fruit, 30 g of lily, 10 g of red ginseng, 40g of calcined oyster shell, 30 g of danshen root, 30 g of kudzuvine root, 20 g of pseudo-ginseng, 30 g of Indian buead, 20 g of peach seed.

a. grinding all the components except the pig bile into powder, then fully and uniformly mixing the ground powder with 750 g of honey, decocting the mixture for 4.5 hours by slow fire, and continuously stirring the mixture in the decocting process;

b. and c, adding 500 g of brown sugar and pig bile into the materials decocted in the step a, fully and uniformly mixing, then continuously decocting the materials with slow fire for 4.5 hours, and continuously stirring the materials in the decocting process to prepare the liver softening ointment.

The temperature of the slow fire is 170 ℃.

The storage method of the liver softening paste comprises the following steps: and storing the prepared liver softening paste in a wide-mouth glass bottle, and cooling and then placing the bottle in a cool and ventilated place.

The taking method comprises the following steps: taking 10-15 g of the medicine each time, and taking the medicine with warm water; the medicine is taken 2-3 times a day after meals and is continuously taken; contraindications in taking: raw, cold, spicy and pungent food are prohibited during administration.

The course of treatment is as follows: 2-3 doses of the traditional Chinese medicine are taken as a treatment course, and 2-4 treatment courses are taken every year.

Indications are as follows: liver cirrhosis and ascites due to various viral hepatitis, schistosomiasis liver disease, alcoholic hepatitis, etc.

Contraindications: 1. those with diabetes; 2. liver cirrhosis with hemorrhage of upper and lower digestive tracts; 3. those with liver cirrhosis and hepatic encephalopathy.

The following cases are treated by the liver softening ointment:

case one

Name: high for a certain sex: age of the male: 54-year-old hospitalization number: 00139720

Admission diagnosis: traditional Chinese medicine diagnosis: blood pattern hematemesis blood deficiency cold syndrome of spleen and stomach

And (3) Western diagnosis: 1. Upper gastrointestinal hemorrhage to be examined:

1) bleeding due to esophageal varices rupture;

2) peptic ulcer bleeding;

3) gastrointestinal tumors and hemorrhage

2. Post-hepatitis cirrhosis decompensation phase

3. Chronic severe hepatitis B

Admission condition and diagnosis and treatment process: the patient is admitted to the hospital for 'more than 6 hours of hematemesis', has the history of hepatitis B for more than 15 years, has the history of cirrhosis for more than 1 month, and has the history of lobster and mutton allergy. Admission to the examinee: mild anemia, lack of ruddy eyelid and cheilosis, no obvious congestion in pharynx, central tongue extending, no tonsil, equal-sized pupils on both sides, sensitive light reflex, and no obvious abnormality in ear and nose. Soft neck, no anger in jugular vein, auscultation of both lungs with no smell and obvious dry and wet rale, small heart boundary, arrhythmia, auscultation of each valve with no smell and obvious pathological noise, and flat and soft abdomen,the lower parts of the ribs of the liver and the spleen are not touched, the abdomen is soft, the lower middle abdomen is tendered, no rebound pain exists, the mobility is voiced (-), the bowel sound is normal, the double kidneys do not have percussion pain, and the double lower limbs do not have obvious edema. The muscle strength and the muscle tension of the limbs are normal, physiological reflex exists, and pathological reflex is not led out. Pale tongue with thin coating and thready pulse. Auxiliary detection: admission and blood review routine: WBC 3.0 × 10⁹/L，NEUT%66%，RBC 2.99×10¹²/L，HGB:97g/L，HCT%29.4%，PLT 49×10⁹And L. Urinary sediment indication: ketone body 1 +; feces sediment: OB +: liver function indication: TBIL 31.5umol/L, DBIL 11.6umol/L, ALB36.8g/L, AST 54U/L; renal function indication: BUN 12.66 mmol/L; blood coagulation function shows: PT 14.7s, INR 1.22; AFP 6.14IU/ml, CEA 1.97 ng/ml: two pairs of hepatitis B indicate positive HBsAg and Anti-HBc; thyroid function shows: TSH 2.177uIU/ml, FT410.848pmol/L, FT32.754pmol/L: the blood sugar, the blood fat, the electrolyte, the blood amylase, the cardiac enzyme, the troponin, the hepatitis C, the Anti-HIV, the TP-Ab and the RPR are not abnormal. Electrocardiogram representation: sinus rhythm, ST-T abnormality (I, avL, V3-V6). Abdomen color ultrasonography: 1. cirrhosis of the liver, ascites; 2. cystic wall edema, considering liver disease changes; 3. splenomegaly. Chest radiography: no obvious X-ray abnormality was seen in the heart-lung diaphragm. Electronic gastroscopy: 1. esophageal varices (severe); 2. chronic superficial gastritis. HBV-DNA of 8.88X 10⁵IU/ml. The urinary sediment and the electrolyte are checked again and are not abnormal. Abdomen color ultrasonography: cirrhosis, portal hypertension, splenomegaly. The Chinese medicament is admitted to be used for hemostasis, acid inhibition, infection resistance, fluid infusion, diuresis, virus resistance, liver protection and symptomatic treatment support, and the Chinese medicament is used for blood nourishing and hemostasis as a main formula.

Discharge diagnosis: traditional Chinese medicine diagnosis: blood pattern hematemesis blood deficiency cold syndrome of spleen and stomach

And (3) Western diagnosis: 1. esophageal varices and bleeding due to rupture

2. Severe ascites and esophageal varices in the decompensated stage of cirrhosis after hepatitis

3. Chronic severe hepatitis B

4. Mild hemorrhagic anemia

5. Chronic superficial gastritis

Discharge conditions: the patients have clear mind, good diet and sleep, no complaints and good defecation. Physical examination: the face appearance of chronic liver disease, eyelids, labial nails are not ruddy, pupils on both sides are equicircular, the light reflex is sensitive, and no obvious abnormality is seen in ears and noses. The heart and lung are not obviously abnormal, the abdomen is flat and soft, the lower part of the rib of the liver and spleen is not touched, no tenderness and rebound pain exist, the mobility is voiced (-), the bowel sound is normal, the double kidneys do not knock and do not have pain, and the double lower limbs do not have obvious edema. The muscle strength and the muscle tension of the limbs are normal, physiological reflex exists, and pathological reflex is not led out. Pale with thin coating and thready and wiry pulse.

Ordering for discharge: order to order the patients to take a low-salt and low-fat diet outside the hospital, pay attention to rest, continue to take liver protection, stomach protection, diuresis, antivirus and other treatments, and check the hematuria routine, the liver and kidney function, the blood sugar, the blood fat, the electrolyte, the thyroid function, the hepatitis B two-half and two-half, the hepatitis B DNA, the CEA, the AFP, the abdominal color excess and the like after three weeks, if the patients are uncomfortable, the patients need to come to the hospital to see a doctor in time.

After half a month of discharge, the ointment is prepared according to example 1 and taken 10-15 g/time, 3 times/day. During which the examination is repeated every 3-6 months.

In 2016, splenic artery angiography and partial splenic artery embolization were selected by percutaneous puncture of right femoral artery.

At present, physical examination: the face appearance of chronic liver diseases is facial appearance, no obvious yellow stain exists on the skin and sclera of the whole body, and no obvious spider nevus of the liver palm is seen. The abdomen is flat and soft, no obvious tenderness and rebound pain exist, the lower part of the liver rib is not reached, the lower part of the spleen rib is 1.0cm reached, the ascites sign is negative, and no obvious edema exists in the two lower limbs. A pale-red tongue with thin and white coating and a wiry pulse. Auxiliary detection: blood analysis: white blood cell 3.54X 10⁹L: neutrophil% 61.3%: erythrocyte 3.86X 10¹²L: 99 g/L of hemoglobin: platelet 111X 10⁹L: the routine of urine: no abnormal myocardial enzyme is found: creatine kinase 156U/L: creatine kinase isoenzyme 26U/L: liver function: albumin 44.1 g/L: globulin 29.8 g/l: total bilirubin 16.3 umol/L: direct bilirubin 7.1 umol/L: indirect bilirubin 9.2 umol/L: glutamic-pyruvic transaminase 18U/L: glutamic-oxaloacetic transaminase 32U/L: gamma-glutamyl transpeptidase 43U/L: renal function: urea 7.84 mmol/L: creatinine 77 umol/L: uric acid 366 umol/L: blood fat: total cholesterol 3.15 mmol/L: triglyceride 0.45 mmol/L: potassium 4.13 mmol/L: sodium 142.3 mmol/L: glucose 4.81mmol/L: prothrombin time 14.0S: thrombin time 18.5S: tumor markers: alpha-fetoprotein 26.80 ng/mL: carcinoembryonic antigen 1.73 ng/mL: carbohydrate antigen 12572.45U/ml: carbohydrate antigen 19-914.48U/ml: hepatitis B DNA negative. Electrocardiogram: 1. sinus rhythm 2. left atrial burden 3.ST segment depression. Abdominal color ultrasonography: 1. cirrhosis, liver internal lesion 2, gallbladder wall thickening 3, splenomegaly, and is suitable for spleen embolism postoperative change.

The traditional Chinese medicine continues to treat the liver softening ointment.

Case two

Name: a sex of Liu: age of the male: hospitalization number 49 years: 00174093

Admission diagnosis: traditional Chinese medicine diagnosis: syndrome of accumulated qi stagnation and blood stasis

And (3) Western diagnosis: 1. chronic severe hepatitis B

2. Post-hepatitis cirrhosis decompensation phase

3. Spleen enlargement

Admission condition and diagnosis and treatment process: the patient, male, was 49 years old and admitted to the hospital for "one week of dull pain in the right hypochondrium". The existing hepatitis B history is more than 10 years, and lamivudine and adefovir dipivoxil are used for treating hepatitis B virus for more than one year. There was a history of left knee degenerative disease. Deny other medical history. Deny the history of surgery and blood transfusion. Physical examination: yellow stain on skin and sclera, no liver palm, no spider nevus, flat and soft abdomen, no obvious tenderness, no rebound pain, untouched below the ribs of liver and spleen, negative moving voiced sound, normal bowel sound and no edema of both lower limbs. The tongue is pale red with ecchymosis on the edge, thin and white coating, and thready and wiry pulse. Auxiliary inspection: color ultrasonic display: cirrhosis, splenomegaly, and a small amount of ascites (1.7 cm); electrocardiogram representation: 1. sinus rhythm (73 beats/minute) 2. normal range electrocardiogram; chest radiography: no obvious real change shadow is seen in the lung field; blood routine: RBC 3.78X 10¹²/L、PLT 82×10⁹L, the rest is normal; the liver function is TP 59.2g/L, ALB 37.2.2 g/L, PA 55mg/L, TBIL 44.1.1 umol/L, DBIL 24.9.9 umol/L, IBIL 19.2.2 umol/L, ALT84U/L, AST86U/L, GGT 135U/L, TBA 38.2.2 umol/L, and the rest is normal; AFP 229.73IU/mL, CEA4.10ng/mL, no obvious abnormality is found in blood sugar, renal function, myocardial zymogram, troponin, blood fat, electrolyte and urinary sediment; blood sedimentation of 5mm/h。HBV-DNA＜5.00×10²IU/mL. The traditional Chinese medicine is admitted to protect liver and supports treatment for symptoms, and the traditional Chinese medicine is characterized in that: medium frequency pulse Chinese medicine introduction, biological red light, etc. The traditional Chinese medicine is matched with the main method of soothing liver and relieving depression, regulating qi and relieving pain, and the traditional Chinese medicine special treatment is matched, so that the condition of the patient is improved and discharged.

Discharge diagnosis: traditional Chinese medicine diagnosis: syndrome of accumulated qi stagnation and blood stasis

And (3) Western diagnosis: 1. chronic severe hepatitis B

2. Post-hepatitis cirrhosis decompensation phase

3. Spleen enlargement

Discharge conditions: the patient feels the distending pain under the right hypochondrium which is obviously improved than before, and has no other special discomfort. Physical examination: the patient has stable vital signs, and yellow stain, no liver palm and no spider nevus are seen on the skin and sclera. The cervical part is soft, the jugular vein is not irritable, no obvious abnormality is caused by cardiopulmonary examination, the abdomen is flat and soft, no obvious tenderness and rebound pain exist, the lower part of the liver and spleen rib is not touched, the mobility is negative in voiced sound, the bowel sound is normal, and no obvious edema exists in the lower limbs. A pale-red tongue with thin and white coating and a wiry pulse.

Ordering for discharge: the traditional Chinese medicine composition is used for protecting liver, resisting virus and treating diseases outside hospital, taking low-salt and low-fat diet, paying attention to rest, rechecking blood routine, AFP, blood biochemistry, blood sedimentation, blood coagulation, tumor markers, HBV-DNA, abdominal hypercoloration and the like in one month, and immediately visiting a hospital for symptoms such as abdominal distention and discomfort, fever, abdominal pain, nausea, vomiting and the like.

After discharge, the ointment is prepared according to the example 1, and the administration is started, 10 to 15 g/time and 3 times/day. During which the examination is repeated every 3-6 months.

At present, physical examination: the face appearance of chronic liver diseases is marked, the skin and sclera of the whole body are not obviously yellow-stained, and liver palms and spider nevus are not seen. Superficial lymph nodes were palpable and had marked swelling. The abdomen is flat and soft, and no obvious tenderness and rebound pain exist. The lower limbs of the liver and spleen are not in the reach, no obvious edema exists in the lower limbs, physiological reflex exists, and pathological reflex is not led out. An old surgical scar about 20cm long is seen in the right abdomen. Tongue pulse: a pale-red tongue with thin and white coating and a wiry pulse. Auxiliary detection: electrocardiogram: sinus rhythm (79 beats/minute). Blood routine: RBC 3.87X 10¹²/L，HGB 135g/L，PLT61×10⁹And L. Liver function: TBIL 27.4umol/L, DBIL 9.6umoL/L, IBIL 17.8 umol/L, ALB46.8g/L. Blood sugar, kidney function, myocardial zymogram, blood fat, blood amylase and electrolyte have no obvious abnormality. Blood coagulation function: PT14.1s, INR1.19, FIB 1.31 g/L. No obvious abnormality was seen in AFP, CEA, CA 125. CA 19-956.26U/ml. Hepatitis B is divided into two halves: HBsAg positive, HBeAg positive, HBcAb positive. Epigastric CT + enhancement: changes after liver tumor resection, cirrhosis of the liver, splenomegaly, and small cysts in the liver. Quantification of hepatitis B DNA<5.0×10²IU/ml。

Third case

Name: sex of the populus: age of the male: hospitalization number 55 years: 0083313

Admission diagnosis: traditional Chinese medicine diagnosis: accumulation of qi deficiency and blood stasis

And (3) Western diagnosis: 1. chronic severe hepatitis B

2. Coronary heart disease ischemic cardiomyopathy II grade

Admission condition and diagnosis and treatment process: the patient is admitted to the hospital for "dull pain and discomfort in the right hypochondrium for more than one week". Taking Adefovir dipivoxil tablets for more than one year after the history of hepatitis B; coronary heart disease is treated discontinuously for two years. Physical examination: shenqing, poor spirit, dark and gloomy complexion, and slight yellow staining of skin and sclera. Auscultation of the heart and lung did not smell and obviously produce noise. The abdomen is flat and soft, and there is no tenderness and rebound pain, and there is no edema in both lower limbs. Auxiliary detection: abdominal color ultrasonography: cirrhosis of the liver; electrocardiogram: sinus rhythm, normal electrocardiogram; chest radiography: no obvious abnormality is seen; blood routine: WBC 1.5X 10⁹/L、HGB 132g/L、PLT 47×10⁹L; PT 16.6 sec; hepatitis B is divided into two halves: HBsAg (+), anti-HBc (+); HBV-DNA: negative; 30.9g/L, TBIL 43.8.8 umol/L, ALT 45U/L, AST 56U/L albumin and 63.0umol/L TBA63. After the patient is admitted, the liver protection and microcirculation improvement support treatment are carried out.

Discharge diagnosis: traditional Chinese medicine diagnosis: accumulation of qi deficiency and blood stasis

And (3) Western diagnosis: 1. post-hepatitis cirrhosis decompensation phase

2. Chronic severe hepatitis B

3. Coronary heart disease ischemic cardiomyopathy II grade

Discharge conditions: the patients have clear mind, good diet and sleep, and no special discomfort. Physical examination: the vital signs are stable, the complexion is dark and the skin and sclera are slightly yellow. Auscultation of the heart and lung did not smell and was apparently abnormal. The abdomen is flat and soft, and there is no tenderness and rebound pain, and there is no edema in both lower limbs.

Ordering for discharge: continuously protecting liver for treatment outside the hospital; taking a rest, and examining blood routine, liver function, electrolyte and the like after a week; discomfort and follow-up diagnosis.

After discharge, the ointment is prepared according to example 2, and the administration is started, 10-15 g/time and 3 times/day. During which the examination is repeated every 3-6 months.

At present, physical examination: the chronic liver disease is facial appearance, no obvious yellow stain exists on the skin and sclera of the whole body, no liver palm is seen, and the thoracopathy can be seen in spiders and nevus. Superficial lymph nodes were palpable and had marked swelling, soft neck, and no deformity in size of the skull. The respiratory sound of the two lungs is clear, and dry and wet rales are not smelled. The heart boundary is small, HR102 times/minute, regular, and the auscultation area of each valve does not smell and has obvious pathological noise. The abdomen is flat and soft, and no obvious tenderness and rebound pain exist. There was no edema in the lower limbs. Auxiliary inspection: liver function: albumin 38.9g/L, TBIL23.8umol/L, ALT 45U/L, AST 56U/L, TBA 63.0.0 umol/L blood conventional: white blood cell 2.5(10^9/L) ↓, lymphocyte absolute number 0.3(10^9/L) ↓, neutrophil absolute number 1.0(10^9/L) ↓, red blood cell 3.59(10^12/L) ↓, hemoglobin 117(g/L) ↓, red blood cell pressure volume 35.2(%) - ↓, platelet 57(10^9/L) ↓, platelet pressure volume 0 ↓, platelet distribution width 18.2(fL) ×; blood coagulation: PT16.3 seconds. Abdominal color ultrasonography: 1. cirrhosis of the liver; 2. splenomegaly; head color ultrasound: bilateral vertebral artery and basilar artery are deficient in blood supply. Electrocardiogram: 1. sinus bradycardia; raising the ST segment, and considering an early cathode; no abnormality is found in the skull CT.

Four cases

Name: aging for a certain sex: age of the woman: hospitalization number 52 years: 89045

Admission diagnosis: traditional Chinese medicine diagnosis: syndrome of tympanites, qi stagnation and dampness obstruction

And (3) Western diagnosis: 1. post-hepatitis cirrhosis decompensation phase

2. Chronic severe hepatitis B

3. Schistosomiasis cirrhosis

4. After splenectomy

5. Cervical spondylosis of cervical vertebra

Admission condition and diagnosis and treatment process: the patient is admitted to the hospital for "abdominal distension, scanty urine and yellow color for more than one week". Physical examination: the skin and sclera are not yellow-stained, and the liver and palm and spider nevus are not seen. The abdomen is raised, no obvious tenderness and rebound pain exist, the lower part of the liver rib is not reached, the mobility voiced sound is positive, the bowel sound is normal, and the lower limbs are slightly edematous. Tongue pulse: pale tongue with thin, white and greasy coating and wiry pulse. Auxiliary detection: blood routine: WBC 3.5X 10⁹/L、Hb 55g/L、PLT 299×10⁹L; liver function: ALB 32g/L, DBIL 4.8.8 umol/L, TBIL 15.5.5 umol/L, ALT20u/L, AST 32u/L, BUN 3.04.04 mol/L; hepatitis B three lines: HBsAg (+), anti-HBc (+), anti-HBe (+); PT 13.7S. Electrocardiogram: normal electrocardiogram; abdominal color ultrasonography: 1. ascites due to cirrhosis, and calcification focus in the liver 2. edema of gallbladder wall, considered as a change of liver disease; chest radiography: the heart shadow is large; cervical vertebra lateral oblique position tablet: the curvature of the cervical vertebra is flat and straight, and the vertebra hyperosteogeny is caused. After the hospital is admitted, the liver protection, acid inhibition, anti-infection and symptomatic support treatment are carried out, and the traditional Chinese medicine characteristic treatment comprises the following steps: the ear acupuncture points of the seed of the cowherb seed are pressed and stuck, acupuncture and moxibustion are performed, and ultrasonic treatment is performed. The traditional Chinese medicine is used for treating liver soothing, qi regulating, dampness removing and fullness dispersing and the like, and the patient is discharged after the condition of the patient is improved.

Discharge diagnosis: traditional Chinese medicine diagnosis: syndrome of tympanites, qi stagnation and dampness obstruction

And (3) Western diagnosis: 1. post-hepatitis cirrhosis decompensation phase

2. Chronic severe hepatitis B

3. Schistosomiasis cirrhosis

4. After splenectomy

5. Cervical spondylosis of cervical vertebra

6. Superficial gastritis

7. Anemia of moderate degree

Discharge conditions: patients have poor spirit, complaints of dizziness, fatigue, reduced feelings of strength, no abdominal fullness and discomfort, poor appetite, yellow urine, normal stool and insomnia. Physical examination: the skin and sclera are not yellow-stained, and the liver and palm and spider nevus are not seen. A swollen abdomen without tenderness and rebound pain, a sunken hypochondrium, positive mobility voiced sound, normal bowel sound and mild edema of both lower limbs. Tongue pulse: pale tongue with thin, white and greasy coating and wiry pulse.

Ordering for discharge: continuously protecting liver for treatment outside the hospital; taking a rest, and periodically rechecking the functions of the liver and the kidney; if the symptoms of nausea, vomiting, dizziness, anorexia and other discomforts appear, the patient can come to the hospital to see a doctor in time.

At present, physical examination: the face appearance of chronic liver diseases is characterized by no obvious yellow stain on the skin and sclera of the whole body and no obvious liver palm and spider nevus. The abdomen is flat and soft, and there is no tenderness and rebound pain. The lower limbs of the liver and spleen are not in the reach, the mobility is negative with voiced sounds, and edema does not exist in the lower limbs. Auxiliary detection: blood routine: RBC 3.76X 10¹²/L，Hb 105g/L、PLT 299×10⁹L; (ii) a Liver function: ALB 39.2g/L, DBIL 7.7umol/L, TBIL27.0umol/L, ALT 50u/L, TBA 80.7.7 umol/L; myocardial zymogram: LDH 271U/L, CK-MB 70U/L; electrolyte: K3.39mmol/L; ESR 38 mm/h; blood coagulation: PT 14.9s, INR 1.22; tumor markers: CEA 4.2 ng/ml; hepatitis B three lines: HBsAg (+), anti-HBc (+), anti-HBe (+). Electrocardiogram: sinus tachycardia is a long Q-T interval. No obvious abnormality is seen in the chest film; abdominal color ultrasonography: cirrhosis of the liver. It can protect liver, inhibit acid, resist virus, emit biological red light and support the treatment of symptom. The traditional Chinese medicine soft liver paste continues to treat.

Case five

Name: a certain sex of bear: age of the woman: hospitalization number 45 years old: 70905

Admission diagnosis: traditional Chinese medicine diagnosis: tympanites, qi stagnation and dampness obstruction

And (3) Western diagnosis: 1. post-hepatitis cirrhosis decompensation phase

2. Chronic severe hepatitis B

Admission condition and diagnosis and treatment process: the patients have more than 6 years of viral hepatitis due to abdominal distension and anorexia for more than one month. Deny other medical history. Deny the history of surgery and blood transfusion. Admission to the examinee: the patients have poor spirit and diet, and the heart-lung auscultation has no smell and obvious abnormality. A distending abdomen, untouched lower costal areas of the liver and spleen, moving voiced (+), intestineThe sound is not swollen in both lower limbs, the tongue is pale, the coating is white and greasy, and the pulse is wiry. And further perfecting related auxiliary detection after admission: electrocardiogram representation: 1. sinus rhythm (84 beats/minute) 2. normal electrocardiogram; abdominal color ultrasonography: cirrhosis, ascites (about 9.8cm liquid dark space): cystic wall edema is considered to be a change in liver disease. Albumin 30.1g/L, AFP 149.2IU/ML, CA125131.0U/ML, HBV-DNA 5.24X 10³And the blood sedimentation is 52 mm/h. After the patient is admitted, the liver protection, dehydration and diuresis are performed, and the symptomatic support treatment is performed, the traditional Chinese medicine is mainly used for soothing the liver, regulating qi, removing dampness and dispelling fullness, and the traditional Chinese medicine acupuncture and moxibustion and ultrasonic treatment are assisted. The patient is required to be discharged when the condition of the patient is improved.

Discharge diagnosis: traditional Chinese medicine diagnosis: tympanites, qi stagnation and dampness obstruction

And (3) Western diagnosis: 1. post-hepatitis cirrhosis decompensation phase

2. Chronic severe hepatitis B

Discharge conditions: patients did not complain of special discomfort, physical examination: the patient has stable vital signs, the face of the chronic liver disease is beautiful, the heart-lung auscultation has no obvious abnormality, the lower part of the hepatic rib is not in the reach, the lower part of the splenic rib is 3.0cm, the patient has moving voiced sounds (-), the bowel sound is clear, and the lower limbs of the patient are not swollen.

Ordering for discharge: carrying out continuous dehydration diuretic symptomatic treatment outside the hospital, and periodically rechecking related auxiliary detections such as abdominal color Doppler ultrasound, electrolytes and the like; low-salt and low-fat diet, and avoids overwork; the patients with the symptoms of distending and uncomfortable feeling in the stomach and hypochondrium, fever, abdominal pain, nausea, vomiting and the like can be seen immediately in the hospital.

After discharge, the ointment is prepared according to example 1, and the administration is started, 10-15 g/time and 3 times/day. During which the examination is repeated every 3-6 months.

At present, physical examination: the face appearance of chronic liver diseases is characterized by no obvious yellow stain on the skin and sclera of the whole body and no obvious liver palm and spider nevus. The abdomen is flat and soft, the pain is pressed under the xiphoid process, the lower part of the liver rib is not reached, the lower part of the spleen rib is about 1.0cm accessible, the mobility is voiced (-), and no obvious edema exists in the two lower limbs. Physiological reflex exists, and pathological reflex is not led out. The tongue is pale red, the coating is thin and white, and the pulse is thready and unsmooth. Auxiliary detection: liver function: ALB 40g/L, DBIL 4.8.8 umol/L, TBIL 15.5.5 umol/L, ALT20u/L, AST 32u/L, BUN 3.04.04 mol/L, HBV-DNA, negative. Abdominal color ultrasonography: cirrhosis, edema of the gallbladder wall, changes in liver disease considered, gallstone; spleen is large and there are nodules in the spleen.

Six cases

Name: sex of land: age of the woman: hospitalization number 57 year old: 92675

Admission diagnosis: traditional Chinese medicine diagnosis: syndrome of liver depression and spleen deficiency

And (3) Western diagnosis: 1. post-hepatitis cirrhosis decompensation phase

2. Chronic severe hepatitis B

Admission condition and diagnosis and treatment process: the patient is admitted to the hospital for "distending and stuffy discomfort in the stomach and hypochondrium, and half a month of abdominal mass". Physical examination: the face appearance of chronic liver diseases is facial, the skin and sclera of the whole body are not yellow-stained, and obvious liver palms and spider nevus are not seen. The abdomen is flat and soft, no obvious tenderness and rebound pain exist, the lower part of the liver rib is not in the reach, the lower part of the spleen rib is 1.0cm, the mobility is positive in voiced sound, and no obvious edema exists in the lower limbs. Auxiliary detection: blood routine: WBC 2.2X 10⁹/L、HGB 134 g/L、RBC 4.59×10¹²/L、PLT 104×10⁹L; blood biochemistry: ALB 35.2g/L, TBIL22.2umol/L, DBIL 9.0.0 umol/L, ALT 100U/L, AST 96U/L, TBA 11.02.02 umol/L, BS 4.94.94 mmol/L, LDH 244U/L, ESR 5 mm/L; blood coagulation: PT 14.2S; HBV-DNA 8.84X 10⁴IU/ml. Etiology: HBsAg (+), anti-HBc (+), and E-C all negative. Electrocardiogram: sinus bradycardia; chest radiography: no obvious abnormality is seen; abdominal color ultrasonography: cirrhosis of the liver, ascites; slightly hyperechoic masses (hemangiomas) in the liver; electronic gastroscopy: 1. esophageal varices are mild 2. erosive gastritis. The traditional Chinese medicine is used for protecting liver, lowering transaminase, inhibiting acid, protecting stomach, resisting virus and supporting treatment for symptoms, and the traditional Chinese medicine is used for soothing liver, strengthening spleen, promoting qi circulation and activating blood circulation, and the condition of the patient is improved to be discharged by matching with the special treatment of the traditional Chinese medicine.

Discharge diagnosis: traditional Chinese medicine diagnosis: syndrome of liver depression and spleen deficiency

And (3) Western diagnosis: 1. post-hepatitis cirrhosis decompensation phase

2. Chronic severe hepatitis B

3. Erosive gastritis

Discharge conditions: clear mind, good spirit and diet, peace and quiet night sleep, no complaints of distending and stuffy feeling in the stomach and hypochondrium, no gastric upset, slight sense of debilitationWithout fever, nausea, vomiting, thick stool and yellow urine. Physical examination: the face appearance of chronic liver diseases is facial appearance, no obvious yellow stain exists in the skin and sclera of the whole body, and no obvious spider nevus of the liver palm is seen. The abdomen is flat and soft, and no obvious tenderness and rebound pain exist. Not in the hypochondrium, 1.0cm below the splenic costal region, negative in mobility voiced sounds, and no obvious edema in both lower limbs. Tongue pulse: a pale-red tongue with thin and white coating and a wiry pulse. Auxiliary detection: blood analysis: WBC 2.7X 10⁹/L、PLT 100×10⁹L; the blood is biochemical, ALB 36.2g/L, ALT 71U/L, AST 69U/L, TBA 11.01.01 umol/L, BS5.45mmol/L, LDH 223U/L and blood coagulation is normal.

Ordering for discharge: continuously protecting liver, inhibiting acid, protecting stomach, resisting virus and supporting treatment for diseases outside hospital, taking decoction of Chinese medicinal materials before administration, keeping light diet, and taking rest; the blood routine and blood biochemistry are rechecked for half a month; the patient can see the symptoms of distending, oppression and discomfort in the stomach and hypochondrium, nausea, vomiting and the like immediately.

After discharge, the ointment is prepared according to example 3, and the administration is started, 10-15 g/time and 3 times/day. During which the examination is repeated every 3-6 months.

At present, physical examination: the face appearance of chronic liver diseases is marked, the skin and sclera of the whole body are not obviously yellow-stained, and liver palms and spider nevus are not seen. Superficial lymph nodes with obvious swelling, soft neck and no deformity of skull size. The respiratory sound of the two lungs is clear, and dry and wet rales are not smelled. The heart is not large, HR60 times/min and regular, and the auscultation areas of the valves do not hear pathological noise. The abdomen is flat and soft, and no obvious tenderness and rebound pain exist. The lower limbs of the liver and spleen are not in the reach, edema does not exist in the lower limbs, physiological reflex exists, and pathological reflex is not led out. Auxiliary detection: electrocardiogram: sinus bradycardia; chest radiography: no obvious real change shadow is seen in the lung lobes, and the clinical application is combined; abdominal color ultrasonography: 1. cirrhosis 2. splenomegaly 3. splenomegaly nearby consider the accessory spleen; blood routine: WBC 3.3X 10⁹/L、RBC 4.36×10¹²/L、HGB 141g/L、PLT 91×10⁹L; urinary sediment: -white blood cells +; the feces sediment, liver and kidney functions, blood sugar, blood fat, electrolyte, cardiac enzyme, troponin and hepatitis B are half-and-half, and no obvious abnormality is found in tumor markers; hepatitis B DNA negative; five items of hepatitis B are quantified: HBsAg1.08IU/ml (+), Anti-HBs 0.00 mIU/ml (-), HBeAg 0.243S/CO (-), Anti-HBe 1.49S/CO (-), Anti-HBc 5.54S/CO (+).

Description of the drawings: the difference of the ointment used by each patient is mainly determined according to the principle of treatment based on syndrome differentiation of traditional Chinese medicine and the indexes of symptoms, physical signs, biochemistry and the like of the patients.

Claims

1. A liver softening ointment for preventing ascites due to cirrhosis is characterized in that: the components and the weight portion ratio are as follows: 20-30 parts of turtle shell, 10-20 parts of tortoise plastron, 10-30 parts of Chinese yam, 10-20 parts of bighead atractylodes rhizome, 20-40 parts of astragalus membranaceus, 10-20 parts of radix bupleuri, 10-20 parts of scutellaria baicalensis, 10-30 parts of red peony root, 10-20 parts of prepared rehmannia root, 10-20 parts of cortex moutan, 10-20 parts of elecampane, 20-40 parts of rhizoma alismatis, 10-20 parts of dogwood, 20-40 parts of fructus trichosanthis, 10-20 parts of angelica sinensis, 10-20 parts of schisandra chinensis, 20-30 parts of lily, 5-10 parts of red ginseng, 20-40 parts of calcined oyster, 10-30 parts of salvia miltiorrhiza, 10-30 parts of radix puerariae, 10-20 parts of pseudo-ginseng, 10-30 parts of poria cocos, 10-20 parts of peach kernel, 10-15 parts of ligusticum wallichii, 20-30 parts of lalang grass rhizome, 10-20 parts of.

2. The liver softening paste for preventing ascites due to cirrhosis according to claim 1, wherein: the components and the weight portion ratio are as follows: 25 parts of turtle shell, 15 parts of tortoise plastron, 20 parts of Chinese yam, 15 parts of bighead atractylodes rhizome, 30 parts of astragalus, 15 parts of radix bupleuri, 15 parts of scutellaria baicalensis, 20 parts of red paeony root, 15 parts of prepared rehmannia root, 15 parts of cortex moutan, 15 parts of costustoot, 30 parts of rhizoma alismatis, 15 parts of dogwood, 30 parts of fructus trichosanthis, 15 parts of angelica, 15 parts of schisandra chinensis, 25 parts of lily, 8 parts of red ginseng, 30 parts of calcined oyster, 20 parts of salvia miltiorrhiza, 20 parts of radix puerariae, 15 parts of pseudo-ginseng, 20 parts of poria cocos, 15 parts of peach kernel, 12 parts of ligusticum wallichii, 25 parts of lalang grass rhizome, 15 parts of pericarpium.

3. The processing and preparation method of the liver softening paste for preventing ascites due to cirrhosis according to claim 1, wherein the processing and preparation method comprises the following steps: the processing and manufacturing method comprises the following steps:

b. and (b) adding 250-500 parts of brown sugar and pig bile into the materials decocted in the step (a), fully and uniformly mixing, then continuously decocting with slow fire for 3.5-4.5 hours, and continuously stirring in the decocting process to prepare the liver softening ointment.

4. The processing and preparation method of the liver softening paste for preventing ascites due to cirrhosis according to claim 3, wherein the processing and preparation method comprises the following steps: the temperature of the slow fire is 120-170 ℃.