Temperature Reducing Method On Chronic Hepatic Encephalopathy The Deficiency Folder Empirical Clinical Studies

Hepatic Encephalopathy(HE), also called hepatic coma, derives from diverse etiologies that lead to liver dysfunction and severe liver failure, which disrupts the brain's central nervous system metabolism causing a complex nervous system syndrome. HE can be classified as acute, chronic, and progressive. Clinical features are of severe acute or chronic recurring attacks, usually with a poor prognosis. HE clinically presents with varying levels of mental impairment and nervous system dysfunction. Based on the clinical presentations of HE, in traditional Chinese medicine(TCM) this condition can be classified as "coma," "mental confusion," "stupor," "delirium," and "sudden onset'unconsciousness," and "mania."Objective: To objectively evaluate the clinical efficacy of the "warm-releasing method" by using dahuang(大黄) and adding the heat herbs of fuzi(附子) and dried ginger(干姜) (Si Ni Tang四逆汤), accompanying the selection of herbs based on pattern identification for treating chronic HE cold deficiency replete pattern patients with the purpose of studying the clinical value of the "warm-releasing method."Method: This study integrates the TCM fundamental concepts of pattern identification and diagnostic differentiation with modern Western medicine. Utilizing many years of clinical experience researching and treating this disease, I reveal that the root cause of chronic HE derives from liver and kidney deficiency injury and that phlegm, damp, stasis, and toxins are exterior manifestations—a pathogenesis rooted in deficiency and manifesting exteriorly in replete symptoms. The "warm-releasing method" is applied in the treatment of chronic HE cold deficiency replete pattern stageⅠand stageⅡpatients, prescribing dahuang (大黄) and adding the heat herbs of fuzi(附子) and dried ginger(干姜) (Si Ni Tang四逆汤), accompanying the selection of herbs based on pattern identification. Patients' mental state in relation to changes in serum ammonia and liver function indicators are then closely monitored and analyzed.Results: The "warm-releasing method" was applied to the treatment of eight chronic HE cold deficiency replete pattern stageⅠand stageⅡpatients, prescribing dahuang(大黄) and adding the heat herbs of fuzi(附子) and dried ginger(干姜) Si Ni Tang(四逆汤) to Chai Ling Tang(柴苓汤) and Xiang Sha Liu Jun Zi Tang (香砂六君子汤). Seven patients showed a marked reduction in their serum ammonia and liver function indicators, which resulted in a full recovery of mental function and consciousness.Conclusion: The focus of this clinical study evaluates the treatment of chronic HE cold deficiency replete pattern patients applying the "warm-releasing method" purely consisting of the TCM herbs of dahuang(大黄) and adding fuzi(附子) and dried ginger(干姜) Si Ni Tang (四逆汤), accompanying the selection of other herbs based on pattern identification. The main challenge of clinical treatment is to dissolve and eliminate masses formed in the brain by cerebral nerve metabolic wastes, and recovery of cerebral nerve function. In cases of acute HE in which TCM herbal treatment is administered to clear heat and eliminate toxins, after the heat toxin has been resolved or following long-term TCM herbal treatment and Western medicine treatment of chronic HE, the disease is then considered to have entered the chronic cold deficiency replete pattern stage. At this time, the "warm-releasing method" treatment should be initiated. Results of this study reveal the following conclusions: the "warm-releasing method" can relieve symptoms and induce recovery of chronic HE cold deficiency replete pattern mental impairment and nervous system dysfunction. The clinical efficacy is definitively proven. This research is based on substantiated theoretical foundation and has extensive clinical application value.