Patient's question:
Alanine aminotransferase: 216.00Triglycerides: 9.31
Fatty liver
Liver and spleen enlargement (Right liver 80×87, Left liver 149×110, Spleen 54×127)
Doctor's answer:
Disease Analysis: Causes of Liver Enlargement:(1) Fatty liver
(2) Hemochromatosis
(3) Glycogen storage disease
(4) Wilson's disease
(5) Schistosomiasis
(6) Clonorchiasis
(7) Toxoplasmosis
(8) Cytomegalovirus infection
(9) Rubella virus infection
(10) Hepatitis B virus infection
(11) Congenital biliary atresia
(12) Hepatocellular carcinoma
(13) Kaschin-Beck disease
(14) Paragonimiasis
(15) Hepatic echinococcosis
(16) Toxic hepatitis
(17) Galactosemia
(18) Amyloidosis of the liver
(19) Portal hypertension
2. Causes of Spleen Enlargement:
(1) Cytomegalovirus infection
(2) Rubella infection
(3) Hepatitis B virus infection
(4) Infectious mononucleosis
(5) Toxoplasmosis
(6) Schistosomiasis
(7) Echinococcosis
(8) Amyloidosis
(9) Gaucher's disease
(10) Galactosemia
(11) Hyperlipoproteinemia
(12) Fanconi syndrome
(13) Splenomegaly
(14) Tumefactive encephalopathy
(15) Mucopolysaccharidosis type I
(16) Histoplasmosis
(17) Kala-azar
Guidance: According to Traditional Chinese Medicine theory, "Nourishing the healthy to eliminate the stagnant," the deficiency of qi and blood in the spleen and stomach is a significant factor in the pathogenesis of liver and spleen enlargement. For patients with persistent liver or spleen enlargement that does not respond to treatment, focus on tonifying the spleen and stomach while using some blood-stasis-dispersing and hardening-reducing herbs, such as Fulang He for harmonizing the liver and spleen, and Fulang Ni for transforming fibrosis, which are highly effective. Avoid excessive aggressive treatment. Do not use herbs like Sanleng, E Zhu, Hirudo, and Musca for long periods, as they may damage the liver.
In treating liver cirrhosis, the primary goals are to soften the liver, shrink the spleen, and alleviate or resolve esophageal varices. If during treatment, the liver shrinks while the spleen enlarges and esophageal varices remain unchanged, it is not a positive outcome, and medication should be adjusted. Conversely, if the spleen recedes while the liver only softens without shrinking or even enlarges, and no signs of cancer are detected, it is often a sign of liver regeneration and compensation, which is a positive outcome. In such cases, symptoms and liver function often improve, and the prognosis is generally favorable.