Acupuncture And Herbs Optimize Liver Cirrhosis Treatment

06/19/2019

Researchers find acupuncture and herbs effective for the treatment of liver cirrhosis.
Researchers from the Third People’s Hospital of Yiwu City combined acupuncture and herbs
with standard drug therapy. Patients receiving both drug therapy and TCM (Traditional
Chinese Medicine) treatment in a combined treatment protocol had superior patient
outcomes compared with patients receiving only drug therapy. The researchers conclude
that the addition of acupuncture and herbs to conventional drug therapy can “effectively
improve liver function, control the development of the disease, promote the recovery of
gastrointestinal function, and reduce relevant complications.” [1]
Multiple subjective and objective instruments were used to measure patient outcomes. First,
liver fibrosis markers were measured, including laminin (LN), hyaluronic acid (HA), and type-
III procollagen (PCⅢ). Second, gastrointestinal symptoms were evaluated using the
gastrointestinal symptom scale. Higher gastrointestinal symptom scores are associated with
worsening gastrointestinal symptoms. Third, liver function markers were recorded, including
albumin (ALB), total bilirubin (TBil), alanine transaminase (ALT), and aspartate transaminase
(AST).
Fourth, the prognosis of liver cirrhosis was calculated using the Child-Pugh score. Higher
Child-Pugh scores are associated with poorer prognoses. Fifth, the recovery of
gastrointestinal function was quantified by measuring recovery time of bowel sounds, end
time of regurgitation and vomiting, and daily defecation frequency. Sixth, the incidence rate
of complications (ascites, pleural effusion, edema of both lower extremities, abdominal
varicose veins) in the two groups were compared.
After treatment, liver fibrosis markers (LN, HA, PCⅢ) and gastrointestinal symptom scores
improved significantly in the two groups (p＜0.01). Liver fibrosis markers, gastrointestinal
symptom scores, liver function markers (ALT, ALB, AST, TBil), Child-Pugh scores, and
gastrointestinal functions in the TCM treatment group were significantly better than those in
the drug monotherapy control group (p＜0.01). In addition, the TCM treatment group had a
10.7% complication rate, while the drug monotherapy control group had a 38.2%
complication rate (p＜0.05).
Design
Researchers (Li et al.) used the following study design. A total of 62 patients were treated
and evaluated in this study. They were all selected from the Third People’s Hospital of Yiwu
City. They were randomly divided into an acupuncture and herbs treatment group and a drug
monotherapy control group, with 28 and 34 patients in each group respectively. For the
control group patients, conventional drug therapy was administered. The treatment group
received acupuncture and herbs in addition to the identical drug therapy administered to the
drug control group.
The statistical breakdown for each randomized group was as follows. The treatment group
was comprised of 10 males and 18 females. The average age in the treatment group was 41
years. The average course of disease in the treatment group was 5.16 years. The control
group was comprised of 12 males and 22 females. The average age in the control group
was 41 years. The average course of disease in the control group was 5.16 years. There
were no significant statistical differences in gender, age, and course of disease relevant to
patient outcome measures for patients initially admitted to the study. For both groups,
patients received the following conventional drug therapy:

 Drugs to alleviate jaundice and protect liver function

 Drugs to relieve portal hypertension
 Intravenous therapy to correct fluid, electrolyte, and acid-base disorders
 Nutritional support
 Adefovir dipivoxil capsules were prescribed for viral liver cirrhosis
 Serum albumin (ALB) was prescribed for severe conditions

TCM Treatment
The treatment group patients received acupuncture and herbs in addition to drug therapy.
The following acupoints were selected bilaterally for the treatment group:

 ST25 (Tianshu)
 ST36 (Zusanli)
 ST37 (Shangjuxu)
 ST39 (Xiajuxu)
 CV4 (Guanyuan)
 CV12 (Zhongwan)

Acupuncture treatments commenced with patients in a supine position. After disinfection of

the acupoint sites, a 0.30 mm × 40 mm disposable filiform needle was inserted into each
acupoint with a high needle entry speed. A deqi sensation was obtained and the needles
were manually stimulated with Ping Bu Ping Xie (mild attenuating and tonifying) manipulation
techniques. The needles were retained for 30 minutes. Acupuncture sessions were
administered once per day, for a total of 30 consecutive days. The herbal formula used in
this study (modified Si Jun Zi Tang) contained the following ingredients:
  Huang Qi 30 grams
 Tai Zi Shen 30
 Ze Xie 15
 Da Fu Pi 15
 Fu Ling 12
 Sang Bai Pi 10
 Chao Bai Zhu 10
 Gan Cao 3

Additional herbs were prescribed based on differing diagnostic patterns. For blood stasis in
the liver and spleen, the following herbs were added:

 Xian He Cao 30 grams

 Dan Shen 20
 Bie Jia 15
 Di Yu 15
 Huai Hua 15

For damp-heat brewing and binding, the following herbs were added:

 Ji Gu Cao 30 grams
 Mian Yin 20
 Bai Hua She She Cao 20

For qi stagnation and damp obstruction, the following herbs were added:

 Mai Ya 30 grams
 Sha Ren 10
 Hou Po 10
 Chen Pi 8

For cold-damp encumbering the spleen, the following herbs were added:

 Mu Gua 10 grams
 Gan Jiang 6
 Cao Guo Ren 6
 Mu Xiang 6

The researchers note that the ingredients benefit the spleen and liver, free the
channels, drain pathogenic water, accelerate blood circulation, and help the body to
remove blood stasis. The prescribed dosage was one decoction daily. The above
ingredients were brewed with water to obtain a 350 ml decoction, which was then split into 2
servings, taken separately in the morning and at night. Patients consumed the TCM herbal
medicine at this rate for 30 consecutive days.
Results
The results indicate that acupuncture and herbs combined with drug therapy into an
integrated treatment protocol is more effective than drug monotherapy. Li et al. conclude that
acupuncture and herbs are safe and effective for the relief of liver cirrhosis.
Reference:
[1] Li J, Luo JC, Fu HM, Chen H, Feng LM. Clinical Study on Acupuncture plus Si Jun Zi
Decoction in Treating Hepatocirrhosis [J]. Shanghai Journal of Acupuncture and
Moxibustion, 2019,38(04):369-373.