Western Diagnosis Hepatitis B, decompensated cirrhosis.

Case 3: Mr. Feng, male, 45 years old. Chief complaint: Persistent black stools for 15 days accompanied by abdominal distension for one week. Fifteen days ago, the patient began experiencing persistent black stools, and in the past week, both flanks have been distended, with fatigue, loss of appetite, bitter taste in the mouth, dry throat, dark tongue with ecchymoses, swollen tongue, greasy coating, and a taut, fine pulse. Physical examination: Pale, sallow complexion, slight yellowing of the sclera, normal liver dullness, spleen palpable 4 cm below the ribs. Ultrasound shows cirrhosis with ascites, spleen thickness 50 mm. Upper gastrointestinal barium meal shows esophageal varices. Gastroscopy shows severe esophageal varices. Laboratory tests show Hb 80 g/L, OB (++), normal liver function. HBSAg positive, HBV-DNA 2 × 10^5 copies/ml, total protein 74 g/L, albumin 32 g/L, globulin 42 g/L.
[Western Diagnosis] Hepatitis B, decompensated cirrhosis.
[TCM Differentiation] Liver depression and spleen deficiency, excessive dampness and water, qi stagnation and blood stasis.
[Treatment Principle] Soothe the liver and strengthen the spleen, promote diuresis and drain dampness, regulate qi, activate blood circulation and remove stasis.
[Prescription] Danzhi Xiaoyao San combined with Wupi Yin with modifications: Danpi 6g, Shan Zhi Zi 10g, Baishao 10g, Danggui 10g, Chaihu 10g, Fuling 12g, Baizhu 10g, Gancao 6g, Danshen 30g, Huangqi 30g, Huangjing 20g, Gegen 15g, Sanleng 10g, Heshouwu 20g, E Shu 10g, Sheng Mu Li 15g, Biejia 10g, Dafupi 15g, Hulu Pi 15g, Cheqian Zi 10g. Decocted in water, one dose per day, totaling 30 doses, taken orally.
Western medicine was used to stop bleeding and supplement albumin. After 40 days of hospitalization, abdominal distension disappeared, along with other accompanying symptoms. Follow-up stool occult blood test was negative. Barium meal re-examination showed significant improvement in esophageal varices. Ultrasound re-examination showed disappearance of ascites, improvement of the liver, and no enlargement of the spleen (thickness 40 mm).

Case 4: Mr. Yang, male, 47 years old. Chief complaint: Suffering from hepatitis B for two years, with aggravation for over a month. The patient was diagnosed with hepatitis B two years ago and underwent Western antiviral and immunotherapy, with liver function basically returning to normal, but HBSAg remained positive. In the past month, he has felt mentally sluggish, with hidden pain in the liver area, accompanied by bitter taste in the mouth and dry throat. Physical examination: Slight yellowing of the sclera, liver palpable 2 cm below the ribs, soft in texture, tender to pressure, with percussion tenderness in the liver area, spleen not palpable below the ribs, flat abdomen, mobile dullness in the abdomen (-), no edema in the lower limbs. Tongue coating yellow and greasy, pulse taut and slippery.

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