Hepatic system 1

Question 1

What is the Hepatic system?

Answer 1

• Refers to pathologies of the Liver which is essential for digesting food and ridding the body of toxic substances

Question 2

What are some common hepatic disorders?

Answer 2

• Common hepatic disorders include viral infection hepatitis, autoimmune hepatitis and non-alcoholic fatty liver disease.

Question 3

What are the signs and symptoms of Liver Disease?

Answer 3

• Common signs and symptoms of Liver disease may include chronic indigestion, jaundice, hypochondriac pain, abdominal pain and/or distension, abdomen swelling, chronic fatigue, tendency to bruise easily

Question 4

What are some red flags of the hepatic system?

Answer 4

• Acute and severe epigastric abdomen/hypochondriac/back pain, jaundice, significant weight loss, unexplained fever, persistent vomiting, bleeding signs, or changes in bowel movements etc.
• Hypochondriac pain should be differentiated with chest pain and cardiac pain which may result in heart attack.

Question 5

How does the GI tract play a role in the hepatic system?

Answer 5

• Research shows that gastrointestinal microbiome plays an important role in various physiological and pathological processes including digestion, nutrient absorption, immune system development and regulation of metabolic functions.

Question 6

What pain assessment tools can be used for the hepatic system?

Answer 6

• Pain assessment tools: OPQRST, TCM symptom checklist, PROMS, NRS, SF-36 questionnaire for quality of life, GSRS, following the results of blood test, Liver and GB imaging.

Question 7

What are symptoms of the Liver channel?

Answer 7

• Lower back pain
• Unable to bend back forwards or backwards
• Swelling of scrotum in men
• Swelling of lower abdomen in women
• Dry throat
• Grey or pale complexion
• Cold, numbness or pain along the channel pathway

Question 8

What are the patterns of the Liver channel?

Answer 8

• Liver Qi depression
• Liver Blood xu
• Liver Yin xu
• Liver yang xu
• Liver depression and blood stasis
• Internal stirring of Liver wind
• Liver Yang transforming into Wind
• Cold stagnating in the Liver meridian
• Dampness-heat in the liver meridian

Question 9

What are the treatment principles for Liver patterns?

Answer 9

• Soothe the Liver and regulate Qi
• Nourish the blood and emolliate the Liver
• Emolliate Liver and enrich Yin
• Tonify Liver yang
• Soothe the Liver, activate blood and resolve stasis
• Calm the Liver to extinguish wind
• Cool the liver to extinguish wind
• Warm the Liver meridian to dissipate cold and relieve pain
• Purge the Liver and eliminate Damp

Question 10

What are GB channel symptoms?

Answer 10

• Bitter taste in mouth
• Deep sighing
• Chest and hypochondriac pain
• Cannot turn side to side
• Grey and dull complexion
• Hot feet
• Headache
• Pain and swelling in the supraclavicular fossa
• Swelling in the armpits
• Swollen necks
• Malaria
• Pain and numbness along the channel pathway

Question 11

What are GB Channel patterns?

Answer 11

• Ascendant hyperactivity of liver yang
• Life fire flaming upward
• Liver-GB dampness-heat
• Depressed GB with harassing phlegm
• GB heat
• GB Qi Xu

Question 12

What are the treatment principles of the GB channel?

Answer 12

• Pacify the Liver to subdue yang
• Clear liver fire
• Purge the Liver-GB and eliminate dampness
• Soothe the Liver-GB, dispel phlegm
• Clear GB heat
• Tonify gallbladder qi

Question 13

What is hypochondriac pain?

Answer 13

• Also called Xie Tong in TCM
• Is pain, aching or discomfort over and beneath the costal margin where the area is influenced by the Liver and GB
• Pain most commonly occurs on the RHS but also can be felt on the LHS / bilaterally
• For chronic onset, Spleen and Kidney may be involved

Question 14

What is the biomedicine perspective of hypochondriac pain?

Answer 14

• Hypochondriac pain is a symptom seen in many digestive, hepatic and GB system disorders such as hepatitis, cirrhosis, liver parasite disease, liver cancer, cholecystitis, chronic pancreatitis, rib trauma and intercostal neuralgia.
• May co-exist with symptoms such as indigestion, jaundice, epigastric pain, abdomen pain or distension.

Question 15

What do the classics say about hypochondriac pain?

Answer 15

• All illnesses arise from the Qi
• Shaoyang syndrome caused by external cold attack and/or combined internal aetiological factors of improper diet, emotional injuries and weak constitution
• Liver affecting the Spleen

Question 16

What is GB disorder?

Answer 16

• Also called Dan Zhang refers to a group of conditions associated with pathology of the GB, specifically characterised by right hypochondriac and epigastric distension and pain, bitter taste in the mouth and frequent sighing.
• Hypochondriac pain can be one of the symptoms in GB disorder

Question 17

What is the biomedicine view of GB disorder?

Answer 17

• May involve inflammation, infection, stones or blockage of the GB.
• Common diseases include cholecystitis (inflammation of the GB), Gallstones, chronic acalculous GB disease (in which the natural movements needed to empty the GB do not work well), cysts or tumours or cancers in the GB and bile ducts, etc.

Question 18

What do the classics say about GB disorder?

Answer 18

• Can be traced back to the discussion of distension. Distension refers to pain below the ribs, bitter taste in the mouth, and frequent sighing.