The potential benefit managing ascites due to cirrhosis using an integrative medicine approach
While ascites are the most common complication of cirrhosis, and can be easily upon first appearance managed by simple clinical (i.e.diuretics) and behavioral (i.e.low-salt diet) interventions, the persistent cirrhotic state and treatment resistance makes recurrent ascites a long-term challenge to the patient's quality of life and prognosis.Such "refractory" ascites due to cirrhosis have been associated with increased risk of intra-abdominal infections, kidney failure, and progressive cirrhosis.The shortcomings of Western medicine to appropriately manage ascites due to cirrhosis has led to a research interest in whether an integrated approach with traditional Chinese medicine (TCM) will benefit these patients.In this article, we summarize the current reports and outcomes of integrated approaches to treat ascites due to cirrhosis.Specifically, we first discuss the pathophysiological process of the disease.The standard Western treatments and their mechanisms, including the various modulated strategies that have been designed according to the putative etiologies of refractory ascites, such as delivery of antibiotics and vasoactives, are then introduced.Finally, the patterns of Qi associated with refractory ascites and cirrhosis are detailed, along with the various promising TCM-specific applications to address each.The use of a Western medicine and TCM integrative approach for managing refractory ascites due to cirrhosis should continue to be researched and developed.
Gerbes AL, Bertheau-Reitha U, Falkner C, et al.Advantagesof the new loop diuretic torasemide over furosemide in patientswith cirrhosis and ascites.A randomized, double blind cross-over trial[J].J Hepatol, 1993, 17 (3) :353-358. European Association for the Study of the Liver.EASL clinicalpractice guidelines on the management of ascites, spontane-ous bacterial peritonitis, and hepatorenal syndrome in cirrho-sis[J].J Hepatol, 2010, 53 (3) :397-417. Runyon BA.Management of adult patients with ascites dueto cirrhosis:an update[J].Hepatology, 2009, 49 (6) :2087-2107. Cárdenas A, Ginès P, Marotta P, et al.Tolvaptan, an oralvaso-pressin antagonist, in the treatment of hyponatremiain cirrhosis[J].J Hepatol, 2012, 56 (3) :571-578. Krag A, Bendtsen F, Pedersen EB, et al.Effects of terlip-ressin on the aquaretic system:evidence of antidiureticeffects[J].Am J Physiol Renal Physiol, 2008, 295 (5) :1295-1300. Yan XC, Liu CH.Analysis of traditional Chinese medicine syn-drome types of ascites due to cirrhosis[J].Chin J Basic MedTradit Chin Med, 2008, 14 (1) :49-50. (in Chinese) 闫秀川, 刘成海.肝硬化腹水的中医证型分析[J].中国中医基础医学杂志, 2008, 14 (1) :49-50. Speciality Committee of Digestive Diseases, Chinese Associ-ation of Integrative Medicine.Consensus on integrative med-ical diagnosis and treatment of ascites due to cirrhosis[J].Chin J Integr Tradit West Med (Chin) , 2011, 31 (9) :1171-1174. (in Chinese) 中国中西医结合学会消化疾病专业委员会.肝硬化腹水的中西医结合诊疗共识意见[J].中国中西医结合杂志, 2011, 31 (9) :1171-1174. Gu SW, Jiang ZR, Shang MY, et al.Thirty-one times oftransfusion of ultrafiltrated and concentrated self-ascitecombined with excessive intraperitoneal injection of furose-mide in treatment of one case of advanced cirrhosis[J].Chin Hepatol, 2012, 17 (3) :218. (in Chinese) 顾生旺, 蒋兆荣, 尚明月, 等.腹水浓缩腹腔回输31次联合超量速尿腹腔注射治疗晚期肝硬化1例[J].肝脏, 2012, 17 (3) :218. Zeng Z, Xing F, Zhao G, et al.Research progress of Chinesemedicine application in treating cirrhosis ascites[J].J Extern T-her Tradit Chin Med, 2009, 18 (5) :45-47. (in Chinese) 曾贞, 邢枫, 赵钢, 等.中药敷脐治疗肝硬化腹水研究进展[J].中医外治杂志, 2009, 18 (5) :45-47. Pan CF, Zhang YL, Cai JP, et al.Umbilical compress thera-py of ascites due to cirrhosis[J].Chin J Integr Tradit WestMed on Liver, 2004, 14 (2) :126-128. (in Chinese) 潘传芳, 张雅丽, 蔡俊萍, 等.肝硬化腹水的敷脐疗法[J].中西医结合肝病杂志, 2004, 14 (2) :126-128. Liu CH, Zhang YL, Feng NP, et al.Effects of syndrome de-pendent umbilical sticking with Shizhang Cataplasm andXuzhang Cataplasm in treating liver cirrhosis caused ascites[J].Chin J Integr Tradit West Med, 2006, 26 (5) :411-414. (in Chinese) 刘成海, 张雅丽, 冯年平, 等.实胀方与虚胀方辨证敷脐对肝硬化腹水的作用[J].中国中西医结合杂志, 2006, 26 (5) :411-414. Xing F, Tan Y, Yan GJ, et al.Effects of Chinese herbal cata-plasm Xiaozhang Tie on cirrhotic ascites[J].J Ethnopharma-co, 2012, 139 (2) :343-349.
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