Clinical Efficacy and Mechanism of Modified Shengjiang Powder(升降散)in the Treatment of Cirrhotic Ascites
Objective:To evaluate the clinical efficacy and safety of modified Shengjiang Powder(升降散)combined with routine western medicine symptomatic treatment in the treatment of cirrhosis ascites and explore its theoretical basis and mechanism of traditional Chinese medicine(TCM).Methods:A total of 120 patients with cirrhosis ascites who were admitted to the outpatient department of Jiujiang Traditional Chi-nese Medicine Hospital from September 2020 to February 2022 were selected as the research objects.According to the random number table,the patients were divided into the treatment group(60 cases,four cases dropped out)and the control group(60 cases,three cases dropped out).The control group was given symptomatic and supportive treatment,while the treatment group was given modified Shengjiang Powder on the basis of symptomatic and supportive treatment for four weeks.The body weight,abdominal circumference,24 h urine volume,and TCM symptom scores of the two groups of patients were analyzed.Abdominal B-ultrasound was used to detect the dark area of ascites,splenic ve-nous blood flow,and portal venous blood flow.The hepatic and renal function,four indicators of liver fibrosis,and the expression levels of chitinase 3-like protein 1(CHI3L1)and related inflammatory factors were determined,so as to explore the clinical efficacy and mechanism of action,as well as the adverse reactions and long-term efficacy.Results:After treatment,the body weight,abdominal circumference,TCM syn-drome score,ascites dark area,splenic venous blood flow,portal venous blood flow,liver function,total bilirubin(TBIL),blood urea nitrogen(BUN),four indicators of liver fibrosis,serum CHI3L1,transforming growth factor-β1(TGF-β1),interleukin-6(IL-6),interleukin-22(IL-22),and content of tumor necrosis factor-α)were significantly decreased(P＜0.05),the 24 h urine volume and albumin(ALB)were signif-icantly increased(P＜0.05),and the expression level of serum creatinine(Cr)in the treatment group was significantly decreased(P＜0.05).After treatment,the body weight,abdominal circumference,TCM syndrome score,ascites dark area,splenic venous blood flow,portal venous blood flow,liver and liver function,TBIL,Cr,hyaluronic acid(HA),and the expression levels of laminin(LN),serum CHI3L1,IL-6,and TNF-α were significantly lower than those in the control group(P＜0.05),the 24 h urine volume and ALB were significantly higher than those in the control group(P＜0.05).The total effective rate of clinical efficacy in the treatment group was 85.71％,which was higher than 66.67％in the control group(P＜0.05).The adverse reaction rate in the treatment group was 5.36％,lower than 14.04％in the control group(P＜0.05).The recurrence rate in the treatment group was 10.42％,which was lower than 35.29％in the control group(P＜0.05).Conclusion:Modified Shengjiang Powder combined with routine western medicine symptomatic treatment has definite clinical efficacy and good safety in the treatment of cirrhosis ascites.It can effectively improve the body weight,abdominal circumference,24 h urine volume,TCM symptom score,abdominal ultrasonography,hepatic and renal function,four indicators of liver fibrosis,CHI3L1,and inflammation-related indi-cators and can enhance long-term efficacy.Its mechanism may be related to reducing the pressure of the portal vein and hepatic sinusoid,im-proving blood circulation in liver tissue,increasing the volume of renal blood flow,and inhibiting the inflammatory injury of hepatocytes,thus repairing some incompletely damaged hepatocytes,improving tissue fluid re-absorption,increasing urine output,and achieving the purpose of protecting hepatocytes and reducing ascites.
Modified Shengjiang Powder(升降散)Traditional Chinese medicineCirrhosis ascitesClinical efficacy
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