Liver depression, short for liver qi stagnation or liver qi stagnation, refers to a TCM syndrome characterized by liver qi dysfunction caused by factors such as mental stimulation and pathogenic factors, leading to qi stagnation and stagnation. Clinically, it manifests as depression, sighing, and chest, flank, or lower abdominal distension and pain. Some patients may also experience dysmenorrhea and menstrual disorders. Treatment focuses on soothing the liver and relieving depression. Common methods include tea, Chinese herbal remedies, and acupuncture.
Epidemiology
Contagious
Generally not contagious.
Incidence
Liver depression is relatively common in clinical practice.
High-risk population
It is more common in introverted women.
Causes
Overview
According to Traditional Chinese Medicine, the liver has the physiological function of maintaining the smooth flow of qi throughout the body, ensuring it flows freely without stagnation and disperses without depression. This helps regulate emotions, coordinate spleen and stomach functions, promote bile secretion and excretion, and maintain blood circulation. Therefore, once mental stimulation, pathogenic factors, or other organ diseases affect the liver, this can lead to dysfunctional qi flow, preventing it from flowing freely and causing qi to stagnate, leading to corresponding clinical symptoms.
Basic cause
1. Mental stimulation
Traditional Chinese Medicine categorizes emotions into seven types: joy, anger, worry, contemplation, sadness, fear, and shock. Since anger is the liver’s organ of consciousness, excessive anger is the most damaging to the liver. Furthermore, abnormal emotions such as worry and contemplation can also damage the liver, disrupting its function to regulate qi flow and causing poor qi circulation, which can lead to liver qi stagnation.
2. Invasion of pathogenic factors
If the six external pathogens, epidemic diseases, or internal injuries persist for a long time, they can deplete the body’s vital energy, affecting the flow of Qi and leading to liver Qi stagnation. Furthermore, if blood stasis and phlegm and fluid, caused by various factors, accumulate in the liver meridian, this can hinder the smooth flow of Qi in the liver meridian, causing stagnation.
3. Other organ diseases
According to Traditional Chinese Medicine, the human body is centered around the five internal organs, which coordinate with the six bowels, the body, and the orifices through the communication of the meridian system, forming five physiological systems: the heart, liver, spleen, lungs, and kidneys. These five physiological systems are structurally interconnected and functionally unified, mutually promoting and restricting each other to maintain normal life activities. Therefore, if lesions of organs such as the kidneys and spleen are not treated promptly, they may affect the liver, weakening its function of dispersing qi and causing qi stagnation.
4. Others
For example, improper work-rest balance, improper use of medication, etc.
symptom
Overview
Liver stagnation is often linked to emotional factors. Therefore, patients often experience depression and sighing, along with distension and pain in areas along the liver meridian (such as the chest, flanks, and lower abdomen), which often move around. Women may also experience premenstrual breast tenderness, dysmenorrhea, menstrual irregularities, and, in severe cases, amenorrhea.
complication
1. Liver depression turns into fire
If the liver qi is stagnant for a long time, it will turn into fire evil, leading to symptoms such as irritability, bitter and dry mouth, red tongue with yellow coating, etc.
2. Liver depression and spleen deficiency
If liver qi stagnation is not treated in time, it may affect the spleen, affecting the spleen’s transportation and transformation function, leading to symptoms such as loss of appetite and abdominal distension.
examine
Scheduled inspection
Patients experiencing prolonged depression, sighing, chest or lower abdominal pain, and other symptoms should seek medical attention. Doctors will first perform a Traditional Chinese Medicine (TCM) examination (looking, listening, asking, and palpating). They may then recommend blood tests, blood biochemistry, thyroid function tests, hormone levels, ultrasound, CT, or MRI to further understand the condition.
Physical examination
1. Inspection
The main purpose is to observe the patient’s expression, complexion, tongue texture and tongue coating, etc.
2. Auscultation
Mainly for listening to breathing, language, etc.
3. Medical consultation
Including questions about pain, sleep, diet, bowel movements, and past medical history, etc., can help make a preliminary diagnosis.
4. Palpation
The main methods are pulse diagnosis and palpation. Pulse diagnosis involves using fingers to press the superficial arteries in specific parts of the body, feeling the pulse and feeling the sensation of the fingers, in order to understand the body’s condition and identify diseases. Palpation mainly involves pressing the chest and abdomen to detect tenderness and other problems.
Laboratory tests
1. Blood routine test
Doctors will observe changes in the levels of white blood cells, neutrophils, red blood cells, hemoglobin and other indicators to determine whether there are any problems such as infection and anemia.
2. Blood biochemistry
Doctors will determine whether there is liver cell damage by observing the levels of indicators such as alanine aminotransferase and aspartate aminotransferase.
3. Thyroid function test
Through this examination, doctors can directly understand whether the various thyroid indicators are within the normal range, and help determine whether there are diseases such as hyperthyroidism, hypothyroidism, and thyroiditis.
4. Hormone measurement
Including follicle-stimulating hormone, luteinizing hormone, estradiol, progesterone, testosterone, prolactin, etc., which helps to understand the hormone levels and cyclical changes of female patients.
Imaging examinations
Ultrasound, CT, and MRI can help clarify the condition of the patient’s thyroid, breast, liver, gallbladder, uterus, and ovaries, and rule out organic lesions.
diagnosis
Diagnostic principles
Generally, a definitive diagnosis is based on a history of mental stress, prolonged depression, frequent sighing, and chest, flank, or lower abdominal distension and pain, along with a combined Traditional Chinese Medicine (TCM) four-diagnosis examination. During diagnosis, doctors need to differentiate between symptoms such as Qi reversal and Qi stagnation.
Differential diagnosis
1. Qi reversal syndrome
Although both liver depression and qi stagnation syndrome and qi reversal syndrome are caused by poor qi movement, qi stagnation syndrome is caused by poor qi movement in a certain part of the body or organs, while qi reversal syndrome is caused by abnormal qi movement in the body, resulting in qi movement going against the flow, with cough, shortness of breath, hiccups, vomiting, etc. as the main manifestations.
2. Qi-stagnation syndrome
Although both liver depression and qi stagnation syndromes are associated with mood swings and may present with localized pain as the primary clinical symptom, liver depression and qi stagnation syndrome presents with distension and pain in the chest, flanks, and lower abdomen that wanders and moves around, with the characteristic pain being distending. Qi stagnation syndrome, on the other hand, is caused by extreme anger, shock, or excessive worry, leading to qi blockage. Clinically, symptoms such as coma and limb syncope may occur, and the pain is colic at the site of obstruction. The pulse is deep, firm, and strong, making it an acute and severe form of excess syndrome.
treat
Treatment principles
The main principle of treating liver depression is to relieve liver qi and depression. Under the guidance of a doctor, patients should choose appropriate treatment methods according to the severity of the disease and associated symptoms, such as oral Chinese medicine, acupuncture therapy, ear acupoint pressing, etc.
General treatment
1. Pay attention to adjusting your emotions, learn to relax, and avoid being in a state of tension and anxiety for a long time.
2. Improve bad living habits and avoid staying up late and overwork.
3. Engage in appropriate physical exercise to help release negative emotions.
Drug treatment
1. Traditional Chinese medicine prescriptions
For example, Chaihu Shugan San, Jiawei Xiaoyao San, etc.
2. Chinese patent medicine
For example, Chaihu Shugan Pills, Shugan Pills, Xiaoyao Pills, etc.
3. Drink as a tea substitute
Commonly used medicines include bergamot, rose, jasmine, magnolia officinalis, etc.
4. Chinese medicine fumigation
For patients with problems such as chloasma, they can also boil Chinese medicines such as Cyperus rotundus, Citrus aurantium, and Aucklandia lappa and then perform fumigation and washing.
Related drugs
Chaihu Shugan Pills, Shugan Pills, Xiaoyao Pills
Surgical treatment
This disease generally does not require surgical treatment.
Other treatments
1. Acupuncture therapy
The doctor will use filiform needles to prick or moxibustion to fumigate the liver shu, hegu, taichong, neiguan, tanzhong, qimen and other acupoints according to the patient’s specific syndrome.
2. Ear acupressure
Depending on the patient’s specific situation, the doctor will, after local disinfection, use tweezers to hold pills such as fenugreek and radish seeds and press them on certain acupoints in the ear, such as Shenmen, sympathetic, liver, gallbladder, heart, spleen, etc., to regulate the functions of the heart, liver and other internal organs, make their functions tend to be balanced, and thus improve the situation of liver qi stagnation.
3. Massage
The doctor will mainly perform massage along the course of the liver and gallbladder meridians, such as pressing the Hegu, Taichong, Xingjian and other acupoints, until there is a local feeling of soreness and swelling.
4. Others
For example, cupping and scraping can also be effective in improving this condition.
Treatment cycle
The treatment cycle is affected by factors such as the severity of the disease, treatment plan, treatment timing, age, and physical condition, and may vary from person to person.
Treatment costs
There may be significant individual differences in treatment costs, and the specific costs are related to the selected hospital, treatment plan, medical insurance policy, etc.
Prognosis
General prognosis
The prognosis of liver depression is related to factors such as the cause, severity, and daily regimen. If the condition is mild, active treatment and good nursing care can generally lead to significant improvement or even cure. However, if the condition is severe or if treatment is inappropriate or inappropriate, symptoms may recur and persist.
Hazards
1. Liver depression can cause patients to experience depression, chest or lower abdominal distension and pain, and other discomfort symptoms, seriously reducing their quality of life.
2. Liver depression can also affect other organs or develop further, leading to problems such as loss of appetite and irritability.
Curative
This disease can usually be cured through active treatment.
Recurrent
After treatment, if the patient still has long-term problems such as emotional disorders, liver depression may reappear.
daily
Overview
In daily life, patients with liver depression should first pay attention to adjusting their emotions, and secondly, they should improve bad living habits, adjust their diet, and do appropriate physical exercise, etc., in order to improve the body’s condition as soon as possible.
Medication care
Take medication at regular times and in regular amounts as prescribed by your doctor. Do not increase or decrease the dosage at will, and do not stop taking the medication on your own, so as to avoid worsening or recurring the condition.
Life Management
1. Pay attention to adjusting your emotions. You can reduce anxiety and stress by communicating with friends and family.
2. Learn relaxation techniques, such as deep breathing, progressive muscle relaxation, or meditation.
3. Maintain a regular schedule, ensure adequate sleep, and avoid staying up late.
4. Engage in appropriate physical exercise, such as walking, jogging, yoga, etc., to help release stress and tension in the body.
5. Eat a balanced diet and try to avoid eating fatty, sweet, spicy and irritating foods.
Disease monitoring
Pay attention to monitor changes in the condition, including mood changes, chest and flank pain, and menstrual conditions in women.
Follow-up Instructions
Follow the doctor’s instructions for regular checkups. Patients should bring their medical records, relevant test results, and prescriptions from their last visit when they return for follow-up visits so that the doctor can better understand their condition and adjust the prescription appropriately.
diet
Dietary adjustment
The diet of hepatitis patients should be light. They should eat more foods that have the effects of soothing the liver and regulating qi, strengthening the spleen, etc., and try to avoid eating fatty, sweet, greasy, spicy and irritating foods to promote recovery from the disease.
Dietary recommendations
1. Patients can eat more foods that have the effect of soothing the liver and regulating qi, such as radish, hawthorn, lotus root, banana, pear, spinach, celery, etc.
2. Since the patient’s spleen and stomach functions are often affected, it is appropriate to eat more foods that have spleen-tonifying effects, such as yam, red dates, etc.
Dietary taboos
1. Avoid eating fatty and sweet foods, such as fatty meat, animal offal, sweets, etc., so as not to block the Qi and aggravate the liver depression.
2. Avoid eating spicy foods, such as chili peppers, pepper, etc., so as not to affect your mood.
3. Avoid eating raw and cold foods, such as popsicles, ice cream, raw fish, cold beer, etc.
4. Avoid overeating.
5. Avoid smoking and drinking.
prevention
Preventive measures
Liver depression is a preventable disease. Preventive measures mainly include maintaining a calm and stable state of mind, maintaining a healthy lifestyle, increasing physical exercise appropriately, and eating a reasonable diet.
1. Keep a good mood and a cheerful spirit, and avoid adverse mental stimulation and excessive emotional fluctuations.
2. Maintain a regular work and rest schedule, ensure adequate sleep, and avoid excessive fatigue, staying up late, etc.
3. Appropriately increase physical exercise, such as brisk walking, Tai Chi, etc.
4. Eat more fresh vegetables and fruits, drink more water, and quit smoking and drinking.
Medical Guide
Outpatient indications
1. Long-term depression and sighing;
2. Accompanied by symptoms such as chest, flank or lower abdominal distension and pain, and dysmenorrhea;
3. Accompanied by symptoms such as decreased appetite, irritability, etc.
4. Other progressive symptoms and signs appear.
All of the above require prompt medical consultation.
Treatment department
Patients who experience symptoms such as depression, chest or lower abdominal distension and pain for a long time can go to the Department of Traditional Chinese Medicine for treatment.
Medical preparation
1. Make an appointment in advance and bring your ID card, medical insurance card, medical card, etc.
2. If you have had medical treatment recently, please bring relevant medical records, examination reports, laboratory test results, etc.
3. If you have taken some medicine to relieve symptoms recently, you can bring the medicine box with you.
4. Family members may accompany the patient to seek medical treatment.
5. Prepare a list of questions you want to ask in advance.
Questions your doctor may ask
1. What symptoms do you have?
2. How long have these symptoms been present?
3. Do you have other symptoms, such as irritability, decreased appetite, etc.?
4. How are you usually feeling?
5. Do you have any other illnesses?
6. Have you been to other hospitals for treatment? What tests have you had? What medications are you currently taking? How effective are they?
What questions can patients ask?
1. What is going on?
2. Is it serious?
3. What tests are needed?
4. What treatment is needed? Can it be cured?
5. What should we pay attention to in daily life?
6. Do I need a follow-up check? How often?