Fufang Biejia Ruangan Pian: A Modern Chinese Patent Medicine for Hepatic Fibrosis and Early Cirrhosis

Fufang Biejia Ruangan Pian is a modern Chinese patent medicine. Its composition includes: Biejia (Soft-shelled Turtle Shell, Carapax Trionycis), Sanqi (Pseudoginseng, Radix Notoginseng), Chishao (Red Peony, Radix Paeoniae Rubra), Huangqi (Astragalus, Radix Astragali), Danggui (Angelica), Ezhu (Zedoary, Rhizoma Curcumae), Dangshen (Codonopsis), Dongchongxiacao (Cordyceps), Banlangen (Isatis Root), Lianqiao (Forsythia Fruit), and others. Each tablet weighs 0.5 g; the dose is oral, 4 tablets three times daily.

This formula softens hardness and disperses nodulation, resolves stasis and detoxifies, and boosts qi and nourishes blood. It is used for chronic hepatitis, hepatic fibrosis, and early cirrhosis presenting as stasis obstructing the collaterals with qi-blood deficiency and lingering heat-toxicity, with symptoms such as dull pain in the hypochondrium, or a palpable mass below the ribs, a dim complexion, epigastric and abdominal fullness, poor appetite and loose stools, fatigue and lack of strength, dry and bitter mouth, and spider nevi.

Biejia is a specialty herb for treating liver diseases. Modern pharmacological research has confirmed that Biejia has a certain inhibitory effect on liver tumors, though its effect is not as strong as fresh turtle blood. As early as the Han dynasty, Zhang Zhongjing created Renshen Biejia Jian Wan, a formula specifically for "nue-mu" (resembling hepatosplenomegaly, cirrhosis, and liver tumors), in which Biejia is likewise the chief herb; some manufacturers still produce Renshen Biejia Jian Wan today.

Fufang Biejia Ruangan Pian is a modern TCM formula that integrates traditional Chinese medicine with modern pharmacological research. Besides Biejia, which softens the liver and disperses nodulation, it contains the righteous-supporting Huangqi, Dangshen, Danggui, and Cordyceps; the blood-activating and stasis-resolving Sanqi and Ezhu; and the heat-clearing and toxicity-resolving Banlangen and Lianqiao. It is therefore a comprehensive formula.

Besides its common use in hepatitis, hepatic fibrosis, and early cirrhosis, Fufang Biejia Ruangan Pian is also often used as an adjunctive treatment for gastrointestinal cancers such as liver, gallbladder, bile duct, and pancreatic cancer. In cancer treatment, it may be used together with Chinese patent medicines such as Xihuang Wan, Fufang Banmao Jiaonang, Pingxiao Jiaonang, Huachansu, and Fule. This regimen can prolong survival in patients with primary or secondary liver tumors, though the cure rate is very low. Thus, if a patient has the opportunity for surgery, interventional therapy, or chemotherapy, a comprehensive treatment plan should be adopted to achieve better outcomes.