Jiang Weihang

18/0 is the National Love Liver Day, and this year's theme is "Combining Traditional Chinese and Western Medicine to Reverse Cirrhosis". The liver is the largest substantial organ in the human body, which is responsible for multiple functions such as metabolism, detoxification, and energy storage, and is essential for maintaining life activities. Can common chronic liver diseases such as fatty liver and cirrhosis be reversed? How do we take care of our liver in our daily lives...... In response to the issues of general concern to everyone, the reporter conducted an interview.

-- The editor

Fatty liver can be reversed by scientific management of the body

Reporter of this newspaper Wang

Fatty liver disease has become one of the common chronic liver diseases worldwide, which is closely related to poor dietary habits. However, many patients still have misunderstandings about fatty liver, which are not conducive to the control of the disease and may also increase the burden on the liver. In fact, fatty liver can be reversed with scientific management.

"Now, when it comes to fatty liver, many people think of obesity." Zhu Qiang, chief physician of the Department of Gastroenterology at the Provincial Hospital Affiliated to Shandong First Medical University, said, "This is a serious misunderstanding. In fact, fatty liver is not directly related to a person's weight, and thin people can also get fatty liver. ”

Last year, Zhu Qiang treated a thin fatty liver patient who was over the age of sixteen and weighed less than 60 kilograms. Patients are worried about chronic diseases such as hyperlipidemia and hypertension, and their diet is mainly vegetarian for a long time, resulting in unbalanced nutrition, decreased lipoprotein content in the human body, and disorders of fat metabolism, which accumulate in the liver to form fatty liver. After the consultation, the patient adjusted his diet according to Zhu Qiang's advice, increased protein intake, and cooperated with physical exercises such as walking, and the fatty liver gradually improved, and finally reversed.

"There are often patients who think that fatty liver is not painful or itchy, so they don't need to care." Zhu Qiang said that in fact, liver tissue is a substantial organ without pain nerves, and only the liver capsule has pain nerves.

The liver is the body's "chemical factory", responsible for the metabolism of glucose, fats, proteins and other substances. Fatty liver is not only the beginning of a variety of liver diseases, but also a danger signal for metabolic-related diseases such as diabetes and cardiovascular disease.

"Fatty liver is now diagnosed when fatty liver is detected on imaging and/or liver biopsy shows bullous steatosis in more than 5% of hepatocytes." According to Zhu Qiang, it is a disease caused by the combined effect of multiple factors such as susceptibility genes, epigenetics, diet and lifestyle. In the latest treatment guidelines in China, fatty liver has been renamed metabolism-related fatty liver disease (MAFLD), and obesity, alcohol, diabetes, drugs, pregnancy, etc. are common causes.

Clinically, fatty liver is divided into mild, moderate and severe: the proportion of hepatocyte steatosis is 66%-0%, which is mild fatty liver; The proportion of hepatocyte steatosis is 0%-0%, which is moderate fatty liver; The proportion of hepatocyte steatosis is more than 0%, which is severe fatty liver.

"In addition, for the control of fatty liver, there are also misunderstandings such as 'fatty liver can be reversed without eating meat' and 'hepatoprotective drugs can replace lifestyle'." Zhu Qiang said that eating less meat, but eating high-calorie, high-fat foods can also aggravate fatty liver. At present, there is no specific hepatoprotective drug for fatty liver, and blind consumption of health care products may also increase the metabolic burden of the liver.

Fatty liver is a metabolic alarm issued by the body, and patients with mild and moderate disease can manage their health from the 3 levels of diet, exercise, and metabolism, and can achieve the reversal of fatty liver.

"In terms of dietary regulation, patients with fatty liver disease can limit the intake of high-calorie foods such as ultra-processed foods and high-saturated fat foods, and increase the intake of high-fiber and foods rich in unsaturated fatty acids such as vegetables and whole grains, even if they do not increase exercise, they can improve a number of indicators." Zhu Qiang introduced that for adults with fatty liver and overweight, the weight loss goals are: continue to reduce ≥10% to reduce liver fat, reduce 0%-0% to improve liver inflammation, reduce ≥0% to improve fibrosis.

"In terms of exercise prescription, it is recommended that adults with fatty liver exercise according to their personal preferences and abilities, preferably more than 3 minutes of moderate-intensity physical activity or more than 0 minutes of high-intensity physical activity per week." Zhu Qiang said that a clinical study showed that an aerobic exercise regimen of 0 times a week, 0 minutes each time, for 0 months can reduce liver steatosis and reduce the risk of cardiovascular disease.

For people with severe fatty liver disease, Zhu Qiang said that these patients need to be gradually reversed by comprehensively regulating blood pressure, blood lipids and blood sugar on the basis of diet and exercise, plus drug control.

Synergistic treatment of traditional Chinese and Western medicine can improve the reversal rate of liver cirrhosis

Reporter Zhang Danhua

Cirrhosis was once regarded as an irreversible chronic disease, but with the continuous development of integrative medicine, this traditional concept is being broken.

"When Mr. Chen (pseudonym) came to our department 8 years ago, he was already in the decompensated stage of liver cirrhosis, with severe symptoms such as abdominal distention, fatigue, and jaundice." Kang Wen, director of the Department of Infectious Diseases of Tangdu Hospital of the Air Force Military Medical University, said. Mr. Chan is a 0-year-old patient with hepatitis B cirrhosis who has severely impaired his liver function due to long-term neglect of the disease, and his liver elasticity is as high as 0kPa (normal value is less than 0.0kPa). Faced with such a condition, Kang Wen formulated a personalized treatment plan for him with integrated traditional Chinese and Western medicine: Western medicine antiviral to control the replication of hepatitis B virus, supplemented by Chinese patent medicine to promote blood circulation and remove blood stasis. After several years of standardized treatment, Mr. Chen's liver function returned to normal, the ascites completely subsided, and the liver elasticity value gradually decreased to 0kPa, and his quality of life was significantly improved. "Cirrhosis can really be reversed!" Mr. Chen said with emotion. "This case shows that the combination of traditional Chinese medicine and Western medicine has a certain feasibility in the treatment of liver cirrhosis." Kangwen introduced.

Liver cirrhosis can be divided into compensated and decompensated according to the degree of liver damage. Compensated cirrhosis refers to the fact that although the liver has cirrhosis, it can still bear the body's functional needs by virtue of its remaining functions. Usually the onset of liver cirrhosis is insidious, and most patients have no obvious self-conscious symptoms in the compensatory stage, which is not taken seriously. When liver inflammation persists, cirrhosis continues to progress, and liver function gradually declines beyond its ability to compensate, it will be accompanied by a series of symptoms and signs, such as esophageal and gastric variceal bleeding, ascites, hepatic encephalopathy, hepatorenal syndrome, and spontaneous bacterial peritonitis, which is called decompensation of cirrhosis. Once patients with cirrhosis are decompensated, not only their quality of life will be significantly reduced, but their survival rate and survival time will also be significantly shortened.

Can cirrhosis decompensated revert back to compensation?

Kang Wen said that some patients with decompensated liver cirrhosis can recover to the compensated stage through etiological treatment and symptomatic treatment, which is called cirrhosis recompensation. However, due to the lack of symptoms in the early stage of liver cirrhosis, most patients are not detected in time during the compensated stage, and once they visit the clinic, they have reached the decompensated stage. At this time, the pathological changes of the liver in many patients are difficult to completely reverse. Therefore, only early detection, timely diagnosis, and standardized treatment can it be possible to return to the compensatory period.

"The synergistic effect of the integration of traditional Chinese medicine and Western medicine lies in the accurate diagnosis and control of diseases in Western medicine, and the overall conditioning of traditional Chinese medicine through methods such as blood circulation and blood stasis, spleen and dampness, liver soothing and depression relief." According to Kangwen, previous clinical studies have shown that the combination of traditional Chinese and Western medicine "bispecific antibody therapy" - antiviral plus anti-fibrotic therapy can help improve the reversal rate of liver cirrhosis. Hepatitis B patients can control the viral load at the lower limit of detection and improve liver function by taking antiviral drugs for a long time. Compound Chinese medicine can improve liver microcirculation, inhibit the activation of hepatic stellate cells, reduce collagen deposition, and inhibit the progression of fibrosis.

Kang Wen said that fatty liver is not a "benign lesion", and it can also develop into liver fibrosis, which can eventually lead to liver cirrhosis and even liver cancer. The key to reversing fatty liver and liver cirrhosis lies in early diagnosis and early treatment, and early liver fibrosis can be reversed through lifestyle modification combined with drug therapy. Patients with hepatitis B and hepatitis C should have annual ultrasound testing of liver function, viral load, liver elasticity and liver, and avoid high-fat diet and drug abuse.

Spring health care is based on the maintenance of the liver

Reporter Shi Yu

Spring is the "golden age" for liver care. Lai Jinmei, deputy chief physician of the Department of Gastroenterology of the People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, introduced that in the theory of traditional Chinese medicine, the liver is the yang in the yin, which is through the spring qi, and the function of the liver is particularly active in the spring, so the spring health preservation is also the primary task of maintaining the liver.

So, how should we take care of the liver in our daily life?

Lai Jinmei suggested that first of all, we should have a regular daily life, and the time of the child and the ugly time (3 o'clock in the evening to 0 o'clock in the morning) is the peak time for the liver to detoxify, and it is also the most important sleep time for people. "When a person moves, the blood travels to the scriptures, and when a person is quiet, the blood returns to the liver." The best way to nourish your liver is to rest. The liver stores abundant blood, which has the effect of protecting eyesight, long-term use of eyes, especially staying up late to play with mobile phones, will also lead to insufficient liver blood, and should avoid staying up late and playing mobile phones, computers, reading books and other behaviors for a long time. In addition, it is also necessary to avoid bad habits such as alcohol abuse and smoking.

It's also important to regulate your emotions. In the Seven Emotions Therapy with TCM characteristics, the five organs correspond to the five senses, and different emotional reactions will affect the five organs. The so-called "anger hurts the liver", that is, long-term mental depression or anger will lead to liver qi stagnation, and it is easy to have stomach pain, stomach distention, menstrual irregularities, breast hyperplasia, fatty liver and other diseases. When you are feeling uncomfortable, you should find a good way to vent, such as talking to friends or listening to soothing and calming music, which is also the embodiment of the "five tones of healing" in traditional Chinese medicine.

To protect liver function, you can also improve your physical state through dietary supplements, acupressure, and appropriate exercise.

In terms of daily diet, Lai Jinmei said, combined with the theory of traditional Chinese medicine, "five colors into the five organs", "color and taste when the five Tibets", "liver is the main green", we can usually eat more mung beans, spinach, celery, cucumber, broccoli, etc. to soothe the liver and nourish blood, nourish yin and dryness, eat pomegranate, sour plum, hawthorn and other sour foods to protect the liver and liver, and you can also drink chrysanthemum, rose, gynostemma and other flower teas to relieve the liver and regulate qi.

Lai Jinmei suggested that everyone can also massage the Taichong acupoint at ordinary times. Taichong is the original acupoint of the Yin and Liver meridians of the foot, located in the dorsum of the foot, between the first and second metatarsals, and in the depression in front of the metatarsal junction. This acupuncture point has the functions of soothing the liver and relieving gallbladder and calming the wind, and activating the meridians. By massaging this acupuncture point, headache, dizziness, depression, hypochondriac pain, abdominal distention, hiccups, menstrual irregularities, etc.

Moderation is also needed when it comes to supplementation. Zhu Yueyong, chief physician of the Department of Hepatology of the First Affiliated Hospital of Fujian Medical University, said that dietary supplements and other health products or other "tonics" may cause liver damage and should not be abused.

In addition, many diseases are related to excess weight. People who are overweight are often accompanied by abnormal blood glucose and lipid indicators, which can easily lead to heart and brain diseases, and can also lead to liver damage. Therefore, it is necessary to do a good job of weight management and eat less high-fat, high-sugar, and high-calorie foods. At the same time, you should exercise more, such as aerobic exercises such as swimming, running, and skipping rope, as well as resistance exercises such as lifting dumbbells. "In the theory of traditional Chinese medicine, joints, tendons, ligaments, etc. are all dominated by the liver. Long-term sitting and lying down for a long time can easily lead to stiffness of joints, tendons and ligaments, which in turn leads to liver loss and liver loss. Lai Jinmei said.

"The liver is powerful, but it lacks pain nerves inside, so it is important to have regular physical examinations and pay attention to the health of the liver." Zhu Yueyong said that people who already have chronic liver disease should be followed up regularly and not stop taking drugs at will; At the same time, we attach importance to vaccination and daily protection against viral hepatitis, and actively prevent related infectious diseases.

People's Daily (14/0/0 0 Edition)