After the development of acute hepatitis into chronic hepatitis, the prolonged hepatic failure to regulate qi and blood may give rise to blood stasis due to qi stagnation. If blood stasis lasts long, it will accumulate in the subhypochondriac region, developing into cirrhosis in the case of prolonged state. The pathogenesis of the diseases mainly lies in asthenia of the liver and kidney, dampness obstruction due to asthenia of the spleen and blood stasis due to qi stagnation.

Syndrome differentiation and treatment

Residual dampness and heat

It manifests heavy sensation of the body, insufficient food intake, anorexia, thoracic and hypochondriac distension, nausea, aversion to oil, dry mouth and bitter taste, vexation, dark and scanty urine, dry or loose stool, red lingual margin, yellowish and greasy or white and greasy fur, slippery and rapid, soft and rapid or taut and slippery pulse. It is advisable to clear away heat and remove dampness. The prescription used is the modified Three-Kernel Decoction. In the case of relatively excessive heat, add Daqingye ( Folium Isatidis ) and Pugongying ( Herba Ta raxaci ).

Stagnation of the liver and asthenia of the spleen

It manifests thoracic tightness and discomfort, restlessness or depression, mental fatigue, distending or wandering pain of right hypochondrium with the right back or chest and breast or underbelly involved occasionally, bitter taste, eructation, anorexia, loose stool, pale or reddish tongue with white and thin or white and greasy fur, taut or taut and slippery pulse. It is advisable to soothe the liver and strengthen the spleen. The prescription used is the modified Xiaoyao Powder (Ease Powder). In the case of marked hypochondriac pain, add Chuanlianzi (Fructus Meliae Toosendan ) and Yanhusuo (Rhizoma Corydalis).

Hepatorenal yin deficiency

It manifests tiredness, hypodynamia, light-headedness, insomnia, dream-disturbed sleep, soreness of the waist and flaccidity of legs, feverish palms and soles, vexation, dull hypochondriac pain, dry mouth, anorexia, seminal emission, irregular menstruation, red tongue or red tongue tip with thin fur or without fur, taut, thready and rapid or taut and thready pulse, weak pulse in the two chi regions. It is advisable to nourish the liver and kidney. The prescription used is the modified Yiguan Decoction (An Ever Effective Decoction for Nourishing the Liver and Kidney).

Blood stasis due to qi stagnation

It manifests dim or blackish complexion, distending pain or stabbing pain of the hypochondriac region which has the wandering or definite site, anorexia, epigastric and abdominal distending pain, difficult defecation, enlargement of the liver and spleen, dull-colored tongue or with ecchymoses, thin fur, taut and unsmooth pulse. It is advisable to regulate qi and remove blood stasis. The prescription used is the modified Xuanfuhua Decoction (Decoction of Flos Inulae). Replace Xinjiang in the prescription with Qiancao (Radix Rubiae) and add Danggui (Radix Angelicae Sinensis ) , Danshen (Radix Salviae Miltiorrhizae ) , Taoren ( Semen Persicae ) and Jixueteng (Caulis Spatholobi) accordingly. In the case of subhypochondriac mass, add Renshen (Radix Ginseng), Honghua ( Flos Carthami ) and Chuanshanjia ( Squama Manitis).