Sun Chuanxiu's Empirical Formula Qi Zhu Er Gen Tang for Cirrhotic Ascites
Sun Chuanxiu of Shandong University of Traditional Chinese Medicine reported that he conducted a controlled clinical trial using his empirical formula "Qi Zhu Er Gen Tang" for cirrhotic ascites, with effective results. The formula consists of: Baimaogen (Imperatae Rhizoma) 45 g, Lugen (Phragmitis Rhizoma) 30 g, Dafupi (Arecae Pericarpium) 15 g, Sharen (Amomi Fructus) 9 g, Sheng Baizhu (raw Atractylodis Macrocephalae Rhizoma) 30 g, Sheng Huangqi (raw Astragali Radix) 50 g, Chushizi (Broussonetiae Fructus) 30 g, Zelan (Lycopi Herba) 15 g, Chao Shengdi (fried Rehmanniae Radix) 15 g, Jiegeng (Platycodi Radix) 12 g, Chao Wangbuliuxing (fried Vaccaria Semen) 30 g, Zhechong (Eupolyphaga) 9 g, Chao Shuizhi (fried Hirudo) 9 g, Shuihonghuazi (Polygoni Orientalis Fructus) 9 g, Lulutong (Liquidambaris Fructus) 9 g, Tongcao (Tetrapanacis Medulla) 6 g.
Sun Chuanxiu enrolled 60 patients meeting the diagnostic and pattern-differentiation criteria for cirrhotic ascites and randomly divided them into two groups: a control group of 30 and an experimental group of 30. The control group received standardized Western treatment, including removing the cause, restricting water intake, using diuretics, infusing albumin, and anti-infective treatment. The experimental group, on top of the control treatment, additionally took the water-decocted "Qi Zhu Er Gen Tang" orally.
The results showed that the total effective rate of the experimental group (93.33%) was significantly higher than that of the control group (83.33%). The conclusion was: on the basis of standardized Western treatment, combined use of "Qi Zhu Er Gen Tang" has a definite effect in treating cirrhotic ascites of the yin deficiency and blood stasis type; it can effectively improve the patient's quality of life, has no side effects, and is highly safe.
According to traditional TCM theory, Sun's empirical formula was composed following the approach of nourishing yin and promoting diuresis, cooling blood and invigorating blood, resolving stasis and unblocking collaterals, and tonifying the spleen and diffusing the lung. In Sun's formula, Sheng Huangqi and Sheng Baizhu both strengthen the spleen and boost qi; Shengdi, Baimaogen, and Lugen clear heat and cool blood; Sharen and Jiegeng regulate qi; Shuizhi, Zhechong, and Wangbuliuxing activate blood and resolve stasis; Shuihonghuazi reduces swelling and dissipates nodules; and the remaining herbs are basically all diuretic and detumescent drugs.
So overall, this formula is also mainly diuretic while simultaneously supporting the healthy root, nourishing yin and lowering fire, activating blood and resolving stasis, and regulating qi and dissipating nodules. This formula avoids purgatives with relatively strong side effects, so it is highly safe and suitable for frail patients needing integrated Chinese-Western treatment. But the Shuizhi and Zhechong in the formula have blood-activating effects; in particular, the hirudin contained in Shuizhi is one of the strongest thrombolytic agents, so patients with coagulation disorders or a bleeding tendency should not use it.
When liver disease has progressed to the stage of cirrhotic ascites, it is already very serious. In the current medical environment, all available Chinese and Western methods of treating hepatic ascites should be used to alleviate the patient's suffering as much as possible and prolong life. Sun's formula approach has low risk and high safety and is worth learning from.