The best treatment for liver cirrhosis
Liver cirrhosis is incurable, but proper treatment and good conditioning can delay the disease and prolong life.
The liver is the main part of the human body? Detoxification organ? , we should be good people? Maintenance? Your own liver.
Nutritionists tell us that Gufangnuoganda has a good protective effect on the liver. The ancient prescription Nuoganda is deeply trusted by patients with liver diseases at home and abroad for its effects of protecting liver, relieving alcoholism, diuresis and preventing cancer. In addition, five nutrients, such as protein, fat, carbohydrate, vitamins and mineral elements, needed by human body are also essential nutrients for nourishing and protecting the liver. There are two main points in protecting liver by diet and ancient prescription Nuoganda: one is to optimize food and provide sufficient nutrients to meet the physiological needs of liver; Second, pay attention to food hygiene to prevent bacteria and viruses from invading the liver.
Cirrhosis is a common chronic liver disease, which can cause liver damage for one or more reasons. The liver is progressive, diffuse and fibrous. The specific manifestations are diffuse degeneration and necrosis of liver cells, followed by fibrous tissue proliferation and nodular regeneration of liver cells. These three changes are repeated alternately, which leads to the gradual reconstruction of hepatic lobule structure and blood circulation pathway, which makes the liver deform and harden, leading to cirrhosis. There were no obvious symptoms in the early stage of the disease, and a series of portal hypertension and abnormal liver function occurred in the later stage, until complications such as upper gastrointestinal bleeding and hepatic encephalopathy died.
Cirrhosis is a common chronic progressive diffuse liver disease, which is often caused by one or more pathogenic factors for a long time. Such as viral hepatitis, schistosomiasis, chronic heart failure, long-term alcoholism or drugs and chemical poisons. , can lead to cirrhosis. In addition to medication, it is also important to adhere to correct dietary guidance for the recovery of liver cirrhosis.
I. Nutritional intake
1. Dietary calorie intake. The total daily calorie of patients with liver cirrhosis is not less than 2000? 2500 calories.
Protein's intake. A high-protein diet is beneficial to cell repair, especially for patients with hypoproteinemia and ascites. Low plasma protein will aggravate the formation of ascites, so it can supply 1.5-2 grams of protein per kilogram of body weight per month, but liver cirrhosis has liver.
Use less or even protein when you are in a coma.
3. Fat intake. Due to abnormal liver function, bile synthesis and secretion are reduced, and fat digestion and absorption are affected. Patients with liver cirrhosis, especially patients with biliary cirrhosis, should not consume too much fat.
4. Vitamin intake. Does liver cirrhosis patient need to supplement carbohydrate 300 every day? 400 grams is appropriate.
5. Intake of water, inorganic salts and trace elements. Patients with ascites due to liver cirrhosis should adopt a low-salt diet, and severe cases should adopt a salt-free diet and sodium intake.
The intake should be limited to about 400 mg per day, and attention should be paid to zinc supplementation.
It is forbidden to drink alcohol, and the diet should be light, digestible and less irritating.
Second, common foods
1. Beneficial foods: foods rich in protein such as milk, fish, eggs, lean meat and bean products, and foods rich in vitamins such as yeast tablets. 1. Unhelpful food: food containing too much cellulose, such as celery, leek, radish, etc. All kinds of wine, fried and spicy food.
Third, the diet prescription
1. turtle shell jujube soup: 20 grams of turtle shell, red dates 10, 2 tablespoons of rice vinegar, and rock sugar.
Proper amount. Stir-fry Carapax Trionycis, pour in fire vinegar, stir fry quickly, then put Carapax Trionycis in a casserole, add a big bowl of red dates and water, boil, simmer 1 hour, add rock sugar, discard Carapax Trionycis when the red dates are ripe, and eat jujube soup. It has the functions of invigorating spleen, softening hard mass and resolving hard mass, and is suitable for patients with early cirrhosis. If the patient has ascites due to cirrhosis, red beans can be added to the soup. If you have obvious abdominal distension when taking this soup, you should stop taking it immediately. If there is no abdominal distension, two months is a course of treatment.
4. Pork belly porridge: pork belly 100g, rice 100g. Wash the pork belly, add water until it is 70% cooked, take it out and shred it for later use, then serve it with rice, shredded pork belly and pork belly soup (degreased). Function of regulating liver and spleen, benefiting qi and promoting blood circulation, suitable for patients with spleen deficiency, anorexia and dyspepsia in the early stage of liver cirrhosis.
3. Winter bamboo shoots and mushroom soup: 250 grams of winter bamboo shoots and 50 grams of mushrooms. Peel off the shell of winter bamboo shoots, wash and shred them, slice mushrooms, stir-fry them in a pot for about 20 minutes, and then add soup and seasoning to boil. It has the effects of invigorating spleen and soothing liver, and is suitable for patients with liver cirrhosis with symptoms such as fatigue, anorexia and abdominal distension.
4. Misgurnus anguillicaudatus stewed tofu: 500 grams of Misgurnus anguillicaudatus and 250 grams of tofu. Remove the intestines from the loach, wash it, add appropriate amount of water and salt, and stew until it is half cooked. Add tofu and stew until the loach is cooked and rotten. It has the function of promoting diuresis and diuresis, and is suitable for patients with ascites or jaundice due to liver cirrhosis.
5. Plum tea: fresh plums 100? 150g, 2g green tea, 25g honey. Cut plum into petals, add 400 ml of water, boil for 3 minutes, add green tea and honey, eat plum and drink tea, and take it three times. 10 day is a course of treatment. It has the effects of promoting blood circulation, relaxing bowels, strengthening body resistance and promoting diuresis, and is suitable for patients with cirrhosis and ascites.
Danshen drink: 30 grams of Danshen, 5 red dates, and appropriate amount of sugar. After the jujube is pitted, put it in a pot with Salvia Miltiorrhiza, fry it in water to remove residues, take juice, and add fire sugar to taste, one dose a day. It has the effects of nourishing liver, invigorating spleen, promoting blood circulation and resolving hard mass, and is suitable for patients with liver stagnation and blood stasis due to liver cirrhosis.
Life taboo of patients with liver cirrhosis
Patients with decompensated cirrhosis should pay attention to and make choices in daily nursing and tonic.
First, avoid eating a high-protein diet, and don't let the ammonia production in the human intestine suddenly increase.
Second, try to avoid the use of sedative and hypnotic drugs, and avoid the liver coma directly caused by this.
Third, you can eat bananas and other fruits, keep the stool unobstructed, 1-2 times a day, and always keep the ammonia produced in the intestines discharged in time.
Fourth, properly supplement vitamins and probiotics, such as vitamin C, vitamin B2, vitamin K, lactobacillus acidophilus, etc., to stabilize the internal environment.
Fifth, if there is loss of appetite, vomiting or diarrhea, potassium should be supplemented in time, such as drinking fresh cucumber juice and apple juice, so as to avoid hepatic encephalopathy caused by hypokalemic alkalosis.
Sixth, unless there is obvious anemia after bleeding, patients with liver cirrhosis should avoid taking nutrients or minerals containing iron preparations, because iron preparations can aggravate liver cirrhosis.
Seventh, especially don't eat a lot of animal protein. Metabolites of animal protein not only increase ammonia production, but also contain more aromatic amino acids, which can inhibit brain nerve conduction and induce hepatic coma in cirrhosis.
Eighth, the loss of liver cirrhosis.
It is advisable for patients to eat a small amount of plant protein. Because there are fewer aromatic amino acids and more branched-chain amino acids in plant proteins, branched-chain amino acids can antagonize the blocking of brain nerve function by some toxic substances.
Ninth, people with esophageal varices should usually make food fine and rotten, avoid eating too rough food, and strictly prohibit eating hard and prickly food, such as fish with thorns, chickens with bones, nuts, etc., so as not to scratch the varicose esophageal veins or gastric fundus veins, causing massive bleeding in the upper digestive tract.
Tenth, you can drink yogurt to promote digestion.
give up drinking
Long-term drinking can lead to alcoholic gastritis and even alcoholic cirrhosis. Drinking alcohol can also lead to epigastric discomfort, loss of appetite and protein and vitamin B deficiency. In addition, alcohol has a direct toxic effect on liver cells.
Health guide for patients with liver cirrhosis
1. Active prevention: Liver cirrhosis is the result of gradual degeneration of liver parenchyma caused by different reasons. We should pay attention to the prevention and treatment of various primary diseases, actively prevent and treat chronic hepatitis, schistosomiasis and gastrointestinal infections, avoid contact with and application of substances toxic to the liver, and reduce pathogenic factors.
2. Emotional stability: The liver is closely related to spirit and emotion. Bad mood, depression and anger will all affect the function of the liver and accelerate the development of the disease. Establishing a strong will, cheerful mood, uplifting spirit and eliminating ideological burden will be beneficial to the improvement of the disease.
3. Dynamic and static combination: the compensatory function of liver cirrhosis is decreased, and patients with ascites or infection must stay in bed. During the period of fully compensatory function and stable illness, you can do some relaxing work or appropriate activities and do beneficial physical exercise, such as walking, doing exercises, Tai Ji Chuan, Qigong, etc. The amount of activity is that you don't feel tired.
4. Simple medication: blind abuse of general drugs will increase the burden on the liver, which is not conducive to liver recovery. Drugs harmful to the liver, such as isoniazid and barbiturates, should be used with caution or have contraindications.
5. Quit smoking and avoid alcohol: Alcohol can help fire and replenish blood, and long-term drinking, especially hard liquor, can lead to alcoholic cirrhosis. Therefore, drinking alcohol will aggravate the condition of patients with liver cirrhosis and easily cause bleeding. Long-term smoking is not conducive to the stability and recovery of liver disease, can accelerate the process of liver cirrhosis, and has the risk of promoting liver cancer.
Nursing care of patients with liver cirrhosis
ordinary care
Ensure that patients have enough sleep and rest to reduce the burden on the liver; Reasonable distribution of diet, give it a diet with high calorie, high protein, high vitamins and low fat. Avoid sharp and irritating food, so as not to cause esophageal varices to rupture and bleed. People with edema or ascites should limit their salt intake. Strict restriction protein in patients with hepatic encephalopathy. Jaundice can cause itchy skin. Because patients have poor nutritional status, low resistance and few platelets, skin care should be done well. You can take a bath with warm water or apply an antipruritic agent to prevent bleeding and infection caused by scratching the skin. Nurses should comfort the pessimistic disappointment of patients with chronic liver disease who have not been cured for a long time and try to alleviate the pain; Do a good job in oral care, eliminate liver odor, stimulate appetite and reduce the chance of secondary infection.
Nursing care of complications
Closely observe the changes of body temperature, consciousness, bleeding, ascites, liver and kidney function in patients with liver cirrhosis. , and handle any abnormal situation in time.
1. Nursing care of patients with ascites: A large amount of ascites leads to dyspnea, and you can lie in a semi-recumbent position, which can reduce the diaphragm, increase vital capacity, reduce lung stasis and increase comfort. When umbilical hernia occurs, pay attention to local skin protection and use protective tape to prevent the rupture of umbilical hernia from causing ascites leakage and increase the chance of infection. Bedridden patients with edema should avoid long-term local compression. In order to prevent skin lesions, they can often turn over, massage bone protrusions, and alternately hold up the compressed parts with air mattresses or air cushions. When using hot water bottles, pay attention to prevent burns. Measure the abdominal circumference every day, measure the weight regularly, observe the rise and fall of ascites, and record the inflow and outflow in detail for 24 hours. Pay attention to draw blood to check electrolytes when using diuretics. Aspiration of ascites can improve the discomfort of increased abdominal pressure, but it should not be too fast and too much. At the same time, the abdominal belt should be tightened to prevent abdominal organ congestion after decompression. Observe the change of consciousness after drainage and deal with the warning of hepatic coma as soon as possible.
2. Nursing care of bleeding: Liver injury leads to inhibition of the production of prothrombin, fibrinogen and various coagulation factors, and hypersplenism is prone to bleeding. Nurses should closely observe whether patients have nosebleeds, gum bleeding and bloody stools. Pay attention to keep defecation unobstructed, and avoid defecation force, causing blood vessels around anus to rupture and bleed.
Dietary taboos in patients with liver cirrhosis
One:. Pay attention to diet care and avoid overeating. It is required to provide patients with a digestible diet with high protein, high vitamins, high calories and moderate fat. Generally,10460-11715 kilojoules of heat are given daily, and protein 100- 120g fat is not more than 30-50g, and 3-5g is given daily. Protein food should be strictly controlled when there are signs of hepatic encephalopathy, and it should not exceed 20-30g per day. People with ascites should eat less or no salt. Generally, the daily drinking water should not exceed 1000ml. If there is obvious hyponatremia, it should be limited to 500ml. When there are esophageal varices, the prepared food should be soft, hard, rough, irritating or foods with thorns and bones should be avoided to prevent esophageal varices.
2. Take a reasonable rest and avoid overwork. Regular daily life helps to restore health. Be sure to get enough sleep every day and take part in light activities, but be careful not to be too tired. Once the disease progresses, you must stay in bed and actively treat it.
3. Avoid anger and worry, and pay attention to mental conditioning and maintenance. Chinese medicine believes that "anger hurts the liver" is particularly important for maintaining the liver. Patients should be good at patience and restraint, treat their illness correctly, realize that anger after illness is unfavorable to the recovery of their illness, and be broad-minded at ordinary times, eliminate worries and calm their anger, so as to nurse their liver at ease.
Fourth, avoid patients with liver cirrhosis using drugs indiscriminately, use more drugs, and only use necessary drugs to avoid increasing the burden on the liver. Generally speaking, it is beneficial to take vitamins B and C and digestive enzymes every day. It is unwise to use all kinds of liver-protecting drugs on the market before there is reliable evidence to prove its efficacy, especially for patients with long-term liver cirrhosis.
5. Avoid excessive diuresis. When treating ascites due to liver cirrhosis, it is advisable to lose less than 2kg per week in diuretic therapy to avoid inducing hepatic coma and liver and kidney.
Syndrome and other serious side effects, and pay attention to electrolyte balance. Cirrhosis is the late manifestation of liver disease, which is closely related to liver cancer. Serum transaminase, Y- glutamyltranspeptidase, alkaline phosphatase, prothrombin time, bilirubin, alpha-fetoprotein, albumin, globulin, leukocyte classification, platelet count, urea nitrogen, blood ammonia, electrolyte, liver, gallbladder, spleen B-ultrasound and esophageal barium meal should be checked regularly.
Six: Fish is rich in protein, which is easy to digest and absorb. It is a nutritious food that patients often eat. But patients with liver cirrhosis must be careful when eating fish.
The liver is like a large chemical plant, responsible for the synthesis, decomposition, metabolism and detoxification of various substances. The plant and animal proteins that people eat are decomposed into various amino acids in the intestine, and then the protein needed by the human body is synthesized in the liver. But some amino acids are harmful to the body and should be detoxified and removed in the liver. When the liver is seriously damaged (such as cirrhosis and severe hepatitis), the synthetic protein and detoxification function are affected. Therefore, on the one hand, there is hypoproteinemia in human body, which leads to edema, ascites or malnutrition; On the other hand, toxic substances that cannot be removed by the liver enter the brain tissue, which will interfere with the normal function of the brain and cause symptoms of hepatic encephalopathy such as abnormal behavior, unconsciousness and even coma. Just like Lao Zhang, he lacks protein in his body, but after eating a lot of fish, his brain becomes confused. In addition to fish, if you eat too much other high-protein foods, it will also cause liver coma.
Dietotherapy scheme for liver cirrhosis
In addition to paying attention to daily diet and developing good eating habits, dietotherapy for patients with liver cirrhosis can also assist some dietotherapy formulas for treatment, as follows:
First, lotus leaf medicine kernel duck soup
Ingredients: 50 grams of lotus leaf, 500 grams of fresh duck meat, and drug core 100 grams.
Practice: Wash and chop fresh duck meat, put it together with Ren Yao lotus leaves, add water until the meat is rotten, without adding salt and other condiments, twice a day, about 250 ml each time, and take 10 ~ 14 days.
Efficacy: diuretic, detumescence, blood tonic and diuresis.
Second, the early eggs of Qi Zi Nan
Ingredients: Jujube 10, 30g of Lycium barbarum, 2 eggs.
Practice: Wash Lycium barbarum and jujube, add appropriate amount of water, slow fire 1 hour, then add eggs and cook for a while to make poached eggs. Eat soup and eggs twice a day.
Efficacy: nourishing liver and kidney.
Third, winter bamboo shoots and mushroom soup.
Ingredients: 250g of winter bamboo shoots and 50g of mushrooms.
Practice: peel off the shell of winter bamboo shoots, wash and shred them, slice mushrooms, stir-fry them in a pot for about 20 minutes, and then add soup and seasoning to boil.
Efficacy: It is suitable for patients with liver cirrhosis with symptoms such as fatigue, anorexia and abdominal distension. It has the effect of invigorating spleen and soothing liver.
Fourth, five-flowered porridge
Ingredients: pork tripe100g, rice100g.
Practice: Wash the pork belly, add water until it is 70% mature, pick it up and shred it for later use, and then eat it with rice, shredded pork belly and pork belly soup (degreased).
Efficacy: It is suitable for patients with spleen deficiency, anorexia and dyspepsia in the early stage of liver cirrhosis, and has the effects of regulating liver and spleen, benefiting qi and promoting blood circulation.
Five, red bean crucian carp soup
Ingredients: 3 fresh crucian carp (300g each), 30g red beans and 30g Phytolacca acinosa.
Practice: Wash the fish, put Phytolacca acinosa and kidney beans into the belly of the fish respectively, sew them with thread, and steam them into soup. Eat light food three times on an empty stomach.
Efficacy: Indications: excessive water and dampness, abdominal distension, loss of appetite, loose stool, dysuria, etc.
6. Stew 500g of bean curd with loach, remove gills and viscera, wash, add a little salt (if ascites is obvious, don't add it), add a proper amount of water, stew until it is five-cooked, add 250g of bean curd, then stew until the fish is cooked, eat fish, bean curd and soup, and eat it separately. It is mainly used for treating liver cirrhosis due to liver depression and spleen deficiency.
Seven, winter melon ginger soup
Wax gourd peel 15-30g, ginger 20g. Peel and wash wax gourd and ginger slices, and add appropriate amount of water to fry until cooked. Drink it as soup.
Relationship between liver cirrhosis and hepatic ascites
The mechanism of ascites due to cirrhosis is related to the following local and systemic factors in abdominal cavity:
1. Increased portal vein pressure: When it exceeds 300mmH2O, the hydrostatic pressure of visceral vascular bed in abdominal cavity increases, and the absorption of tissue fluid decreases and it leaks into abdominal cavity.
2. Hypoalbuminemia: Due to decompensation of liver function, protein's digestion and absorption disorder, the function of liver to process and synthesize albumin decreased, and albumin in blood decreased. When the egg white is lower than 365,438+0g/L, the colloid osmotic pressure in plasma decreases, and a large amount of water in plasma permeates into abdominal cavity.
3. Excessive lymph production: When the hepatic venous reflux is blocked, the plasma seeps into the parasinusoidal space from the hepatic sinus wall, which leads to an increase in bile lymph production (about 7- 1 1L every day, 1-3L is normal), which exceeds the drainage capacity of the thoracic duct, and lymph seeps from the hepatic capsule and hilar lymphatic vessels to the abdominal cavity.
4. Secondary aldosteronism leads to increased renal sodium reabsorption.
5. The increase of antidiuretic hormone secretion leads to the increase of water reabsorption.
6. Insufficient effective circulating blood volume: sympathetic nerve activity increases, while prostaglandin, atrial and kallikrein-kinin activity decreases, resulting in decreased renal blood flow, sodium excretion and urine volume.
undernutrition
Animal experiments show that animals fed with food lacking choline or methionine can develop cirrhosis through fatty liver.
Etiology of liver cirrhosis
There are many causes of liver cirrhosis, which can be divided into viral hepatitis cirrhosis, alcoholic cirrhosis, metabolic cirrhosis, cholestatic cirrhosis, hepatic vein reflux obstructive cirrhosis, autoimmune cirrhosis, toxic and drug-induced cirrhosis, malnutrition cirrhosis, cryptogenic cirrhosis and so on.
1. viral hepatitis
At present, viral hepatitis, especially chronic hepatitis B and C, is the main cause of portal cirrhosis in China.
Step 2 drink too much
Long-term heavy drinking is one of the factors leading to cirrhosis.
3. Malnutrition
Many mathematicians admit that malnutrition will reduce the resistance of liver cells to toxic and infectious factors and become an indirect cause of liver cirrhosis.
4. Industrial poisons or drugs
Long-term or repeated exposure to arsenic-containing pesticides, carbon tetrachloride, yellow phosphorus, chloroform, etc. Or long-term use of certain drugs such as acetaminophen, isoniazid, cincofen, tetracycline, methotrexate, methyldopa, etc., may lead to toxic or drug-induced hepatitis, and then lead to liver cirrhosis. Aflatoxin can also cause toxic damage to liver cells and cause cirrhosis.
5. circulatory disorder
Chronic congestive heart failure and chronic constrictive pericarditis can cause long-term hyperemia and hypoxia of the liver, leading to necrosis and fibrosis of hepatocytes, which is called congestion cirrhosis, also known as cardiogenic cirrhosis.
6. Metabolic disorder
Such as hemochromatosis and Wilson's disease.
7. Cholestasis
When extrahepatic bile duct obstruction or intrahepatic cholestasis occurs, high concentration of bilirubin is harmful to liver cells, and cirrhosis may occur for a long time. Primary biliary cirrhosis is caused by intrahepatic cholestasis, and secondary biliary cirrhosis is caused by extrahepatic bile duct obstruction.
8. Schistosomiasis
In schistosomiasis, eggs stimulate the proliferation of connective tissue in portal area to become schistosomiasis liver fibrosis, which can cause significant portal hypertension, also known as schistosomiasis cirrhosis.
9. The reason is unknown