Liver Fibrosis
Hepatic fibrosis (hepatic fibrosis) is listed as a disease in the International Classification of Diseases (ICD-10; K74.001), but is primarily a histopathological concept. It is a pathological change caused by chronic liver injury resulting from various disease-causing factors. It is characterized by excessive proliferation and abnormal deposition of extracellular matrix (ECM) components in the liver, leading to structural and/or functional abnormalities. Structurally, this includes sinusoidal capillarization and fibrosis within the hepatic lobules and portal areas; functionally, it may manifest as impaired liver function and portal hypertension. Its development is mainly associated with long-term, chronic liver injury from factors such as hepatitis viruses, alcohol, drugs and toxins, schistosomiasis, metabolic and genetic factors, cholestasis, and autoimmune liver disease. This injury activates hepatic stellate cells (HSCs) and disrupts the metabolism of collagen and other extracellular matrix components, such that production exceeds degradation, promoting ECM deposition and tissue remodeling in the liver. Hepatic fibrosis occurs in most chronic liver diseases of various causes and may progress to cirrhosis, seriously affecting patients’ health and lives.
TCM Pattern Identification and Medication Information
|Common Symptoms
Traditional description:
Dull pain in the flanks and rib area, soreness and weakness in the lower back and knees, and dry mouth and throat. The tongue is red with a thin white coating and little moisture; the pulse is wiry and thready.
In plain language:
- A dull ache on both sides of the ribs, usually in a relatively fixed location, with greater discomfort during movement or when pressed.
- Soreness and weakness in the lower back and knees, with reduced support and easy fatigue when walking or sitting for a long time.
- A dry mouth and throat, with noticeable dryness when speaking or swallowing.
- The tongue appears red in color.
- The tongue coating is thin and white, with little moisture; the tongue surface may look somewhat dry.
- The pulse feels taut and thin under pressure.
|Treatment Approach
Traditional description:
Nourish the Liver and Kidneys
In plain language:
- Nourish the Liver and replenish its essence and blood, with the aim of easing discomforts such as dizziness, blurred vision, irritability, or weakness in the muscles and bones.
- Nourish the Kidneys and replenish essence and qi, with the aim of easing manifestations such as soreness and weakness in the lower back and knees, tinnitus, forgetfulness, or fatigue.
- Promote coordinated functioning of the Liver and Kidneys and greater balance between yin and yang, with the aim of gradually improving overall energy and complexion.
|Related Products
The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Traditional description:
Dry or bitter mouth, or bad breath; distending pain or discomfort in the flanks. The tongue is red with a yellow, greasy coating; the pulse is wiry and rapid, or wiry, slippery, and rapid.
In plain language:
- A dry mouth with a bitter taste, or noticeably unpleasant breath, leaving the mouth feeling unclean.
- Distension or pain on both sides of the chest beneath the ribs, more noticeable with movement or pressure.
- The tongue appears red in color.
- The tongue coating is yellow and greasy, appearing as though a layer of oily yellow coating covers the tongue.
- The pulse feels taut and relatively fast, or both taut and slippery and relatively fast.
|Treatment Approach
Traditional description:
Clear Heat and Transform Dampness
In plain language:
- Help clear internal Heat, with the aim of easing manifestations such as feeling feverish and restless, thirst, a dry throat, or facial flushing.
- Help transform and eliminate internal Dampness, with the aim of easing discomforts such as heaviness in the body, chest oppression, abdominal distension, or difficulty urinating.
|Related Products
The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Traditional description:
Stabbing pain in the flanks; a dark or dull complexion; a palpable mass below the ribs (enlargement of the liver or spleen). The tongue is purplish and dark, sometimes with purple spots or patches; the veins beneath the tongue are distended; the pulse is thready and choppy.
In plain language:
- Stabbing pain on one side beneath the ribs, sharp and intense enough to be difficult to tolerate.
- The face looks dark or dull, with a poor-looking complexion.
- A firm lump may be felt below the ribs, often presenting as enlargement in the area of the liver or spleen.
- The tongue looks dark purple, or purple spots or patches may be visible on its surface.
- The veins beneath the tongue are enlarged and prominent, and may appear dark purple.
- The pulse is thin and uneven, with a rough, impeded sensation under pressure.
|Treatment Approach
Traditional description:
Invigorate Blood and Resolve Stasis
In plain language:
- Help promote blood flow and resolve stasis, with the aim of easing discomforts such as painful bruising, localized swelling or firmness, or menstrual flow difficulties.
- Help improve blood circulation and nourishment, with the aim of easing manifestations such as a dull complexion, numbness in the limbs, or joint pain.
|Related Products
The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Traditional description:
Distension and pain in the flanks and rib area, epigastric and abdominal fullness and oppression, and loose or watery stools. The tongue is pale with teeth marks and a white coating; the pulse is deep and wiry.
In plain language:
- Distension and pain in both sides beneath the ribs, with greater discomfort during movement or when pressed.
- A feeling of fullness and oppression in the upper abdomen and belly, as though things are not moving freely.
- Stools may be poorly formed or soft and loose, with a lingering sense of discomfort after a bowel movement.
- The tongue looks pale, and tooth marks may be visible along its edges.
- The tongue is covered with a white coating.
- The pulse feels deep under pressure and taut, like a stretched string.
|Treatment Approach
Traditional description:
Soothe the Liver and Strengthen the Spleen
In plain language:
- Regulate Liver qi and promote its smooth flow, with the aim of easing distension and fullness in the chest and flanks, low mood, or irritability and unease.
- Support Spleen and Stomach function and digestion and absorption, with the aim of easing poor appetite, abdominal distension, loose stools, or fatigue and weakness.
- Promote coordinated functioning of the Liver and Spleen and support the generation of qi and blood, with the aim of gradually restoring energy and stamina.
|Related Products
The products below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a doctor or pharmacist.
References
- Liver Disease Professional Committee of the Chinese Association of Integrative Medicine. Guidelines for the Diagnosis and Treatment of Hepatic Fibrosis with Integrated Chinese and Western Medicine[J]. Chinese Journal of Hepatology, 2006, 14(11): 866-870.
- Liu Ping. Issues in the development of integrated Chinese and Western medicine diagnosis and treatment for hepatic fibrosis and cirrhosis[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2015, 35(3): 268-271.
- Liu Ping, Mu Yongping, Liu Chenghai. Strengthening research on the diagnosis and treatment of hepatic fibrosis[J]. Chinese Journal of Hepatology, 2012, 20(8): 561-562.
- Liu Ping, Mu Yongping, Liu Chenghai. Advances in clinical and basic research on the treatment of chronic liver disease with traditional Chinese medicine[J]. Journal of Clinical Hepatology, 2011, 27(5): 451-457.
- Mu Yongping, Liu Chenghai, Zhang Hua. The theory of “deficiency and depletion give rise to accumulation” in cirrhosis: An analysis of Professor Liu Ping’s academic thought[J]. Journal of Shanghai University of Traditional Chinese Medicine, 2013, 27(2): 1-4.
- Teng Xiaoying, Zhou Xingang, Sun Lei, et al. Application of refined staging criteria for hepatic fibrosis in chronic hepatitis in the evaluation of drug efficacy[J]. Chinese Journal of Hepatology, 2013, 21(4): 271-274.