Clinical Observation: Opposing Herbal Remedies Gan Cao (Radix Glycyrrhizae) And Gan Sui (Radix Gan Sui) In The Treatment Of Liver Cirrhosis With Ascites

Objectives: 1, To examine the clinical effectiveness of opposing herbalremedies Radix Glycyrrhizae (Gan Cao) and Radix Gan Sui (Gan Sui) for thetreatment of liver cirrhosis with ascites. 2,To evaluate the function,synthesis and effectiveness of opposing herbal remedies Radix Glycyrrhizae(Gan Cao) and Radix Gan Sui (Gan Sui) for the treatment of liver cirrhosiswith ascites.Method: Twenty-one (21) patients with liver cirrhosis and ascites wererandomized and allocated into two groups, the Treatment Group and the ControlGroup. 1. Treatment Group 11 patients; Control Group 10 patients. The TreatmentGroup received 1 to 2 grams of combined Gan Cao and Gan Sui orally in capsuleform in a single daily dose. Dosage was dependent upon the number of bowelactions per day (3-4 times/day). Following the administration of combinedGan Cao and Gan Sui, Radix Ginseng (Ren Shen) and Radix Astragali (Huang Qi)were also used to stimulate the vital energy (Qi). Following the diagnosis,an analysis of the signs and symptoms was undertaken. Western Medicinedimensions included liver protection, supportive therapy and supplementalalbumin. Diuretics were not used. The Control Group just received Westernroutine therapy. Dosage and supplemental therapy was the same as for theTreatment Group. The symptoms were scored and biological markers such as liverfunction tests, Cancer Antigen125(CA125)were measured. 2. The Child-Pughscoring system was used to evaluate the effectiveness of opposing herbalremedies Gan Cao and Gan Sui on patients' liver function. 3. Ultrasonographyand girth measurement before the treatment and after 15 days evaluated theeffectiveness following treatment.Results: 1. In the Treatment Group total effectiveness was 90.9%. Nil patientswere completely cured; three patients showed marked improvement, sevenpatients showed moderate improvement whilst one patients had no improvement.In the Control Group total effectiveness was 80.0%. Nil patients were completely cured;nil patients showed marked improvement;eight patients showedmoderate improvement whilst two patients showed no improvement. No significantdifferences were exhibited between the Treatment Group and the Control Group(p＞0.05) before treatment. 2. Both groups, pre and post-treatment, recordedurine volume, girth measurement and weight. All exhibited significantdifferences (p＜0.01) but the Treatment Group showed an increase in urine volumeand a decrease in girth measurement in comparison to the Control Group(p＜0.05). 3. Prior to treatment the symptoms of both groups were notsignificantly different (p＞0.05). In the Treatment Group, comparisons pre andpost-treatment revealed symptoms such as abdominal discomfort, flankdiscomfort, fatigue, anorexia, peripheral oedema and jaundice. There weresignificant differences in symptoms (p＜0.05 or p＜0.01). In the Control Group,comparisons pre and post-treatment revealed abdominal discomfort, fatigue,anorexia and peripheral oedema. There were significant differences in symptoms(p＜0.05 or p＜0.01). However for flank discomfort and jaundice there were nosignificant differences (p＞0.05). There were significant differencespost-treatment between both groups for abdominal discomfort, fatigue andjaundice (p＜0.05).4. Both groups pre-treatment showed abnormal levels ofcancer antigen125(CA125), platelets(PLT), alkaline phosphatase(ALP), glutamicoxaloacetic transaminase(AST),glutamic pyruvic transaminase(ALT),totalbilirubin(TB) and albumin(ALB). However between both groups there were nosignificant differences. The Treatment Group post-treatment showedsignificantly higher levels of platelets and albumin(p＜0.01). The Ca-125,ALP, AST, ALT, TB was significantly lower(p＜0.01).The Control Grouppost-treatment showed significantly higher levels of platelets and albumin(p＜0.05 or p＜0.01). The Ca-125, ALT was significantly lower (p＜0.05 orp＜0.01). Both groups post-treatment showed significant differences in levelsof Ca-125, PLT, ALT, TB(p＜0.05).Conclusion: Combined Gan Cao and Gan Sui capsules and simple Western routinetherapy can ameliorate the symptoms of patients with liver cirrhosis andascites. However, to improve the volume of urine, decrease in girth measurement,decrease the Ca-125, ALT and total bilirubin levels the combined Gan Cao andGan Sui capsules showed a better result. For short-term therapy bothdemonstrated enhanced results. Further research is required to explore thesemechanisms.