A 95-Year-Old Patient with Cirrhotic Ascites Achieved Symptom Relief after More Than One Month of Treatment with Chinese Herbal Medicine
The patient, surnamed Yan, is the grandmother of a friend of the author. She is 95 years old and resides in Pingxiang, Jiangxi Province. On June 30, 2026, she was admitted to a local hospital in Pingxiang for edema of both lower limbs and was diagnosed with: (1) ascites (large volume); (2) decompensated cirrhosis; (3) chronic hepatitis B; (4) hypoproteinemia; (5) hyperuricemia; and (6) renal insufficiency.
After six days of hospitalization, the ascites did not resolve. Unwilling to remain in the hospital, the elderly patient requested discharge. Because she still had a large amount of fluid in the abdominal cavity and marked pitting edema of both lower limbs, the local hospital prescribed the diuretics furosemide and spironolactone, along with many other Western medicines. Being advanced in age and having come to terms with life and death, the patient was unwilling to take these oral medications after discharge and did not comply with treatment.
The family, however, refused to give up and kept urging the elderly patient to accept treatment. In the end, she reluctantly agreed to take Chinese herbal medicine together with entecavir, an antiviral agent against hepatitis B. The patient's granddaughter then asked the author for suggestions on Chinese herbal medicine.
According to the family's report, in addition to ascites, the patient also currently had hematuria. In light of the elderly patient's condition, the author considered focusing on reinforcing the vital qi and consolidating the root (fuzheng guben), invigorating the spleen and replenishing qi, with moderate use of herbs that promote diuresis and reduce edema, while also addressing the hematuria. The author therefore made the following prescription for consideration by her local physician:
- Dangshen (Codonopsis root) 15 g
- Huangjing (Polygonatum rhizome) 15 g
- Baizhu (Atractylodes macrocephala) 10 g
- Fuling (Poria) 10 g
- Zhuling (Polyporus) 10 g
- Mohanlian (Eclipta herb) 10 g
- Nüzhenzi (Ligustrum fruit) 10 g
- Shayuanzi (Astragalus complanatus seed) 10 g
- Tusizi (Cuscuta seed) 10 g
- Fried malt 15 g
- Charred hawthorn fruit 10 g
- Fried chicken gizzard lining 15 g
- Yiyiren (Coix seed) 30 g
- Yimucao (Motherwort) 20 g
- Xiaoji (Cirsium herb) 30 g
- Shiwei (Pyrrosia leaf) 30 g
One dose daily, decocted twice, and taken in three divided doses.
In this formula, Dangshen, Huangjing, and Baizhu are all herbs that invigorate the spleen and replenish qi; Fuling, Zhuling, and Yiyiren have diuretic and edema-reducing effects; Mohanlian, Nüzhenzi, Shayuanzi, and Tusizi constitute the "four kidney herbs" (shen si wei) — in TCM terms, these are kidney-tonifying herbs that help improve the elderly patient's physical strength and enhance her immunity; fried malt, charred hawthorn fruit, and fried chicken gizzard lining aid digestion; Yimucao activates blood circulation, resolves stasis, promotes diuresis, and protects the kidneys — modern pharmacological studies have shown it to be a good herb for treating kidney diseases; and both Xiaoji and Shiwei not only promote diuresis but also treat hematuria.
The above formula can not only promote diuresis but also improve the patient's hematuria, hypoproteinemia, hyperuricemia, and renal insufficiency.
The patient began taking the herbal medicine on July 13 and continued until August 26. The edema of the abdomen and lower limbs was completely resolved, and her physical condition was good. When the family asked again for further medication advice, the author suggested switching to prepared medicines that soften the liver, such as those containing Biejia (turtle shell), for the follow-up period, and closely monitoring changes in the elderly patient's abdomen and lower limbs; if edema recurred, she should continue taking the above formula.
For a 95-year-old patient, one should not rashly use large doses of herbs with strong properties during treatment. Only mild herbs with targeted symptomatic effects can be used to relieve the patient's symptoms, improve her quality of life, and prolong her survival. This is why the author made such medication suggestions, and the therapeutic effect proved to be reasonably good.
Judging from the treatment of this patient, when treating similar patients, as long as we do not seek quick results and instead use gentle, steady formulas, the therapeutic effect may actually be better.