Liver qi stagnation, also known as liver qi stagnation or liver qi disharmony, refers to a dysfunction of the liver’s dispersing and discharging function, leading to stagnation of qi. This syndrome is characterized by depression, chest and flank distension and pain in the lower abdomen, frequent sighing, and breast tenderness, dysmenorrhea, and menstrual disorders in women. Its occurrence is linked to a variety of factors, including emotional imbalance, improper diet, overwork, and physical weakness. Liver qi stagnation manifests in a variety of Western medical conditions, including depression, menopausal syndrome, hepatitis, chronic cholecystitis, and neurological tinnitus.
Epidemiology
Contagious
Not contagious.
Incidence
Liver qi stagnation is a common syndrome in traditional Chinese medicine.
High-risk population
It is more common in women.
Causes
Overview
According to Traditional Chinese Medicine, the liver governs qi flow and regulates the body’s qi. This function promotes blood circulation and the distribution of body fluids, coordinates the ascending and descending movement of spleen and stomach qi, promotes bile secretion and excretion, and regulates the mind and spirit. If the liver’s function of regulating qi is dysfunctional due to various factors, such as emotional imbalance, improper diet, excessive fatigue, and physical weakness, the body’s qi flow may be disrupted and unblocked, leading to stagnation.
Basic cause
1. Emotional disorders
(1) Depression: The liver is responsible for regulating emotions. If one’s emotions are depressed or depressed for a long time, it may affect the liver’s regulating function, leading to abnormal rise and fall of the body’s Qi and gradually forming liver Qi stagnation.
(2) Mental stimulation: If a person suddenly experiences a major mental stimulation, such as the death of a loved one, a change in marriage, or a setback in career, these stimulations may exceed the body’s physiological and psychological adaptability and regulation capabilities, leading to a sudden imbalance in the liver’s drainage function, disordered qi flow, and subsequently liver qi stagnation.
2. Improper diet
(1) Overeating fatty, sweet, and rich foods: Long-term preference for consuming greasy, sweet, and rich foods, such as fried foods, desserts, and fatty meats, can easily damage the spleen and stomach, leading to dysfunction of the spleen and stomach’s transportation and transformation functions. This can cause internal generation of dampness, which can obstruct the spleen and stomach, causing poor spleen and stomach qi flow and soil stagnation, further affecting the liver’s function of dispersing qi and causing liver qi stagnation.
(2) Irregular diet: If you often have irregular meals or overeat, it is easy to damage the spleen and stomach, which may lead to a lack of source for the production of Qi and blood, and the lack of nourishment for the internal organs. If the liver does not receive sufficient Qi and blood nourishment, its normal function of dispersing and discharging will be difficult to maintain, which can easily cause Qi stagnation.
3. Overwork
Long-term overwork can deplete Liver Blood. When Liver Blood is insufficient, it cannot adequately nourish the Liver Wood. In this case, the Liver’s function of dispersing Qi will be affected, leading to Qi stagnation and Liver Qi stagnation.
4. Physical weakness
Insufficient innate endowment, a weak constitution, or chronic illness can all lead to insufficient Qi and blood, preventing adequate nourishment of the Liver Wood. Without nourishment, the Liver’s function of dispersing and discharging qi is affected, leading to Qi stagnation and liver Qi stagnation.
symptom
Overview
The manifestations of liver qi stagnation are mainly reflected in qi stagnation, abnormal mental emotions, abnormal digestive function, etc. Common symptoms include chest and flank pain, lower abdominal distension and pain, depression, loss of appetite, etc.
Typical symptoms
1. Qi stagnation
When the liver’s function of dispersing and discharging qi is disordered, the qi cannot flow smoothly, and the liver meridian is blocked, the qi will be swollen, painful and uncomfortable in the chest, flanks and lower abdomen.
2. Abnormal mental and emotional state
If the liver fails to perform its function of dispersing and discharging qi and blood and is unable to regulate the spirit and emotions, the patient may feel depressed and unhappy, with a sense of chest tightness and often need to sigh deeply to relieve the symptoms.
3. Abnormal digestive function
Abnormal liver function of dispersing and discharging qi can affect the rise and fall of spleen and stomach qi, leading to dysfunction of spleen and stomach transportation and transformation, which may lead to symptoms such as loss of appetite, abdominal distension, and hiccups.
4. Others
(1) Impairment of liver function, disharmony of qi and blood, and imbalance of Chong and Ren meridians. Therefore, women may experience irregular menstruation, dysmenorrhea, amenorrhea, and breast pain.
(2) Patients with liver qi stagnation have a pale red tongue, a thin white tongue coating, and a stringy pulse.
complication
The liver regulates qi and aids the flow of water and blood. If liver qi stagnation develops further, it can lead to impaired fluid and blood circulation, eventually causing phlegm and blood stasis. Phlegm and qi stagnate in the throat, causing a foreign body sensation; stagnation in the neck can lead to goiters and scrofula. Stagnation of qi and blood, gathering under the ribs, can eventually form lumps.
examine
Scheduled inspection
If you experience persistent or recurring chest, flank, and lower abdominal pain, depression, or breast tenderness, it’s recommended to seek medical attention promptly. Doctors typically diagnose patients using the Traditional Chinese Medicine (TCM) four diagnostic methods: observation, auscultation, listening, questioning, and palpation. Depending on the specific condition, they may then select additional Western medical tests to assist in the diagnosis, such as blood and urine routine tests, biochemical tests, abdominal ultrasound, and a mental status assessment scale.
Physical examination
1. Inspection
This includes observing the patient’s complexion, expression, posture, lip and nail color, tongue quality and changes in tongue coating, etc., which helps to preliminarily determine the nature and severity of the disease.
2. Auscultation
Auscultation involves listening to sounds and smells. For patients with liver qi stagnation, the focus is on listening to sounds. Doctors diagnose the condition by identifying the patient’s tone of voice and whether they sigh deeply.
3. Medical consultation
The doctor will ask the patient in detail about the discomfort symptoms, accompanying symptoms, their duration, changes in the condition, whether the patient has received treatment, etc., in order to understand the patient’s condition.
4. Palpation
This includes pulse diagnosis and palpation. Pulse diagnosis allows doctors to understand the frequency, rhythm, and strength of a patient’s pulse, helping to determine the nature and severity of an illness. During palpation, doctors palpate and press the chest, flanks, and lower abdomen to diagnose illnesses.
Laboratory tests
Doctors may recommend that patients undergo routine blood tests, urine tests, biochemical tests, etc. to gain a preliminary understanding of their physical health.
Imaging examinations
Abdominal B-ultrasound: It can determine whether there is any damage to the abdominal organs and help diagnose the disease.
Other tests
Mental Status Rating Scale: helps doctors quantify patients’ psychological activities and assess their mental status.
diagnosis
Diagnostic principles
Doctors make a diagnosis based on the patient’s medical history (such as emotional depression or a history of trauma), typical symptoms (depression, melancholy, chest and flank pain, frequent sighing, breast tenderness, and menstrual irregularities), and the four diagnostic methods of Traditional Chinese Medicine (TCM)—inspection, auscultation, listening, questioning, and palpation—and appropriate auxiliary examinations. During the diagnostic process, it is important to differentiate between other conditions, such as liver qi rebellion.
Diagnostic basis
Differential diagnosis
Both liver qi stagnation and liver qi reversal are located in the liver, are caused by emotional imbalance, and are driven by liver dysfunction and qi dysregulation. Both present with clinical manifestations such as emotional disturbances, pain and distension along the liver meridian, and loss of appetite. The two conditions share many similarities, necessitating clinical differentiation.
Liver Qi stagnation often results from frustrated emotions, which prevent liver Qi from flowing freely, leading to stagnation of Qi within the body. The condition manifests as a suppressed state. Clinical manifestations include depression, melancholy, chest and flank fullness and pain, and frequent sighing. Impacts on the spleen and stomach can also include abdominal distension and pain, and loss of appetite. Women, often introverted by nature, are more susceptible to liver Qi stagnation.
Liver Qi reversal is caused by excessive anger that injures the liver, causing it to expand and rage. The condition manifests as a state of hyperactivity, making it highly susceptible to invading other organs. Clinical manifestations include emotional agitation, irritability, and significant abdominal pain and distension. Impacts on the spleen and stomach can result in belching, hiccups, vomiting, abdominal distension, diarrhea, and loss of appetite. Furthermore, it can attack the heart, harm the lungs, and disturb the kidneys, leading to various complications. Due to the strong temperament of men, Liver Qi reversal is more common.
treat
Treatment principles
The primary treatment principle for patients with liver qi stagnation is to soothe the liver and regulate qi. In clinical practice, doctors often prescribe appropriate Chinese herbal decoctions or patent medicines based on the patient’s specific condition. In addition to medication, other TCM therapies, such as acupuncture, auricular acupuncture, and massage, can also help alleviate liver qi stagnation.
Drug treatment
1. Chinese herbal decoction
Chaihu Shugan San, a representative prescription for treating liver qi stagnation, is formulated with dried tangerine peel, bupleurum root, chuanxiong rhizome, cyperus rotundus, fructus aurantii, peony root, and liquorice root. It is known to soothe liver qi, regulate qi, and promote blood circulation and relieve pain. In clinical practice, doctors will modify this prescription based on the patient’s specific symptoms to achieve optimal therapeutic results.
2. Chinese patent medicine
(1) Xiaoyao Pills: It is composed of Chinese medicinal materials such as Bupleurum, Angelica, White Peony Root, Atractylodes Macrocephala, Poria, and Menthol. It has the effects of soothing the liver and strengthening the spleen, nourishing blood and regulating menstruation. It is suitable for irregular menstruation, chest and flank pain, dizziness, and loss of appetite caused by liver qi disharmony.
(2) Chaihu Shugan Pills: Made of Chinese medicinal materials such as Poria cocos, Citrus aurantium, White Peony Root, Licorice, Cardamom, and Cyperus rotundus, it has the effects of soothing the liver and regulating qi, relieving bloating and relieving pain. It is suitable for treating liver qi disharmony, chest and flank fullness, indigestion, and vomiting of acid water.
(3) Others: In addition to the above-mentioned Chinese patent medicines, patients can also use Chinese patent medicines such as Shugan Jieyu Capsules, Danzhi Xiaoyao Pills, Shugan Pills, and Qizhi Weitong Granules (999) as prescribed by the doctor.
It should be noted that patients who need Chinese medicine treatment should first go to a regular Chinese medicine hospital for treatment, and then be prescribed Chinese medicine by a professional Chinese medicine doctor after diagnosis. When purchasing medicine, you should pay attention to identifying the supplier of medicinal materials. It is recommended to choose large pharmaceutical companies such as China Resources Sanjiu. Such companies can strictly follow national standards, control the quality of medicinal materials from the source, and ensure the quality and efficacy of the Chinese medicine sold.
Related drugs
Xiaoyao Pills, Chaihu Shugan Pills, Shugan Jieyu Capsules, Danzhi Xiaoyao Pills, Shugan Pills, Qizhi Weitong Granules (999)
Surgical treatment
Surgical treatment is usually not required.
Traditional Chinese Medicine treatment
1. Acupuncture
Acupoints on the Liver Meridian of Foot-Jueyin are often selected, with Qimen, Zhangmen, and Taichong as main points. Acupoints are selected based on the symptoms. For example, for irregular menstruation, add Sanyinjiao; for abdominal distension, add Zusanli.
2. Bury seeds in ear acupuncture points
The main acupoints for ear acupuncture are liver, spleen, stomach, gallbladder, Shenmen, heart, endocrine, etc. Press each acupoint for 1 to 2 minutes each time.
3. Massage
The acupoints for massage are mainly Taichong, Xingjian, Qimen, Zhangmen, Ganshu, etc. At the same time, the liver meridian and gallbladder meridian on both sides of the lower limbs can be tapped to enhance the effect of soothing the liver and relieving depression.
Treatment cycle
The treatment period for liver qi stagnation is affected by factors such as the severity of the disease, treatment plan, treatment timing, and personal constitution, and may vary from person to person.
Treatment costs
The treatment costs for liver qi stagnation may vary significantly from person to person, and the specific costs are related to the selected hospital, treatment plan, medical insurance policy, etc.
Prognosis
General prognosis
For patients with liver qi stagnation, the prognosis is generally good if they receive timely, standardized treatment and focus on regulating their emotions. However, if treatment is unavailable or inappropriate, pathological products such as phlegm and blood stasis may develop, which can lead to organ deficiency or dysfunction over time, making treatment more difficult.
Hazards
1. Liver qi stagnation can lead to emotional problems such as low mood and depression.
2. Liver qi stagnation causes poor circulation of qi, blood and body fluids, which can easily lead to phlegm, dampness and blood stasis.
3. If the condition of liver qi stagnation is not treated in time, it may affect other organs, specifically manifesting as liver qi attacking the stomach, suppressing the spleen, and invading the lungs, thereby causing a series of health problems.
4. Liver depression can easily turn into fire over time, and even lead to heat damage to Yin.
Curative
If the diagnosis is clear, the correct syndrome differentiation and medication are used, and attention is paid to emotional regulation, the disease can generally be cured.
daily
Overview
While actively cooperating with treatment, patients with liver qi stagnation should maintain a positive attitude and develop good living habits, which will help improve treatment outcomes and promote recovery.
Psychological care
1. Try to avoid negative external stimuli, maintain a good mood, be cheerful, and avoid getting angry, so as not to trigger or aggravate the condition. At the same time, patients should participate in social activities as much as possible and talk appropriately to release negative emotions.
2. Family members should listen patiently to the patient’s stories to understand the patient’s inner feelings and provide more considerate care and help.
Medication care
1. Patients should take the medicine on time and in the prescribed dosage as directed by the doctor. They should not stop taking the medicine, change the medicine, or increase or decrease the dosage on their own to avoid affecting the treatment effect.
2. Chinese herbal decoctions should be taken warm.
Life Management
1. Maintain a good work and rest habit, go to bed early and get up early, and avoid staying up late. Ensuring 6 to 8 hours of effective sleep every day will help the body recover.
2. Pay attention to the combination of work and rest, and take appropriate rest and relaxation.
3. The indoor environment should be quiet and tidy, with soft lighting, appropriate temperature and humidity, and try to eliminate noise interference.
4. Appropriate exercise can help regulate Qi and relieve liver Qi stagnation. Patients can choose appropriate exercise according to their own conditions, such as jogging, yoga, Tai Chi, etc.
diet
Dietary adjustment
Scientific and reasonable dietary management can ensure the normal functioning of the body, play a role in assisting in controlling the disease, maintaining the therapeutic effect, and promoting recovery. Patients with liver qi stagnation should eat a light diet and avoid greasy, spicy and irritating foods.
Dietary recommendations
1. Daily diet
(1) Patients can eat more foods that have the effect of soothing the liver and regulating qi, such as celery, garland chrysanthemum, tomatoes, radishes, oranges, grapefruits, tangerines, citrons, and Buddha’s hands.
(2) Pay attention to the maintenance of the spleen and stomach. Eat at regular times and in fixed amounts, and eat moderately soft and rotten food. Eat more foods that strengthen the spleen and replenish qi, such as red dates, yam, lotus seeds, and coix seeds.
2. Dietary therapy
(1) Peel the orange and squeeze out half a bowl of juice. Pour in rice wine and drink 2 to 3 spoons each time, 1 to 2 times a day.
(2) Add appropriate amount of green tangerine leaves, green tangerine peels and tangerine pith to tea leaves, and use boiling water to brew or slightly decoct and drink frequently as tea.
(3) Patients can drink rose tea daily. Place an appropriate amount of dried roses in a teacup, add boiling water, cover, and let it cool for 30 minutes before drinking. It can be consumed at any time.
Dietary taboos
1. Avoid spicy and irritating foods, such as onions, ginger, garlic, chili peppers, pepper, and Sichuan peppercorns.
2. Avoid eating greasy foods, such as fat, fried foods, etc.
prevention
Preventive measures
Liver Qi stagnation is closely related to mental factors, so prevention focuses on regulating emotions and maintaining a positive mood. At the same time, attention to dietary adjustments and a regular lifestyle can effectively reduce or alleviate the onset of the disease.
1. Keep a good mood, be open-minded, optimistic and open-minded, and avoid emotional stimulation, tension, anxiety and other triggering factors.
2. Treat various affairs correctly, be good at regulating emotions, and release negative emotions. In addition, you can cultivate hobbies, add interest to life, cultivate your sentiments, and find spiritual sustenance.
3. Maintain a reasonable eating habit, ensure that three meals a day are eaten on time and in fixed quantities, and avoid overeating and excessive intake of fatty and sweet foods.
4. Develop good living habits, have an orderly daily routine, combine work and rest, and arrange rest and sleep reasonably.
Medical Guide
Outpatient indications
1. Feeling depressed and unhappy for a long time.
2. Often feel chest tightness and long sighs.
3. Continuous or recurring distension and pain in the chest, flanks, and lower abdomen.
4. Accompanied by loss of appetite, abdominal distension, etc.
5. Women may experience breast pain, irregular menstruation, dysmenorrhea, etc.
6. Other severe, persistent or progressive symptoms and signs occur.
All of the above require timely hospital treatment.
Treatment department
Patients need to consult the Department of Traditional Chinese Medicine.
Medical preparation
1. Make an appointment in advance and bring your ID card, medical insurance card, medical card, etc.
2. Routine physical examinations may be required, and patients are advised to wear relatively loose clothing when visiting the doctor.
3. If you have had medical treatment recently, please bring relevant medical records, examination reports, laboratory test results, etc.
4. If you have taken some medicine to relieve symptoms recently, you can bring the medicine box with you.
5. Patients can prepare a list of questions they want to ask in advance.
Questions your doctor may ask
1. What symptoms do you have? When did they appear? How long have they lasted?
2. Have your symptoms gotten worse or better? When did they get worse? When did they get better?
3. Do you have any other diseases?
4. How are you usually feeling? Do you experience significant mood swings?
5. What is your usual diet? Do you smoke or drink alcohol?
6. Do you feel a lot of pressure at work?
7. How is your sleep? Are your bowel movements and urination normal?
8. Have you had any examinations recently?
9. Have you ever received treatment? How was it treated? What was the effect?
What questions can patients ask?
1. What’s wrong with me? Can it be diagnosed?
2. Is the condition serious? Do I need to be hospitalized?
3. What tests do I need to do?
4. How should I treat it? Is it curable?
5. If medication is used, what are the usage, dosage, and precautions?
6. What should I pay attention to in my daily life?
7. Do I need follow-up examinations? How often?