One dosage of Chinese herbal medicine by oral administration per day for 8 weeks. For patients who cannot take oral medicine can be switched to colon route by the colonic therapy system（IMS-100A produced by Sunny Medical in Beijing China).

Patients in the control group only receive the standard medical treatment (SMT), no control drug with CHM.

Acute on Chronic Liver Failure

Traditional Chinese Medicine

Hepatitis B

One dosage of CHM includes Artemisiacapillaris Thunb (30g), Salvia miltiorrhiza Bge (30g), Rhizoma Atractylodis Macroce- phalae (30g), Rubia cordifolia L (30g), Sieyesbeckiaorientalis L (30g). Paeoniae Radix Rubra (60g), Gardenia jasminoides Ellis (9g), Hedyotis diffusa Willd (30g) and Bletilla striata (15g) are involved for excess syndrome, and Astragalus membranaceus (30g), Radix Pseudostellariae (15g), Radix Aconiti Lateralis Praeparata (10g), Galli Gigeriae Endothelium Corneum (20g), Polygonum cuspidatum Sieb.et Zucc (15g) are involved for deficiency syndrome.

Chinese herbal medicine

SMT therapy includes a high-calorie diet; nucleoside analogues for HBV DNA-positive patients; sodium restriction, diuretics and paracentesis combined with albumin infusion for ascites; lactulose and L-ornithine aspartate and lactulose for HE and hyper-ammonia; hemostatic treatment for gastrointestinal hemorrhage; antibiotics for infections and renal replacement for HRS and uremic symptoms.

Control (blank)

302 military hospital of China

Beijing Ditan hospital

Beijing youan hospital

Fuzhou infectious hospital

Xiamen hospital of traditional Chinese medicine

Hubei hospital of traditional Chinese medicine

Tongji hospital, Huazhong university of science and technology

The first affiliated hospital of Hunan university of traditional Chinese medicine

Jilin hepatology hospital

The sixth people's hospital of Shenyang

Shanghai public health clinical center

Shuguang hospital, Shanghai university of traditional Chinese medicine

Chengdu public health clinical center

The second people's hospital of Tianjin

Hangzhou Xixi hospital

Study on the Optimal Strategy for Acute-on-chronic Liver Failure With Integrative Treatment

Study on the Optimal Strategy for Acute-on-chronic Liver Failure Combined With Traditional Chinese and Modern Medicine: a Multi-center, Randomized and Controlled Study

transplant free survival at the time point of week 12

transplant free survival at the time point of week 24

compare the MELD score between the two arms. MELD is the abbreviation of model for end-stage liver disease involving serum bilirubin, creatinine, international normalized ratio (INR) and sodium.

compare the Child-Pugh score between the two arms. Child-Pugh score is the panel involving the serum bilirubin, coagulation function, albumin and the complication of hepatic encephalopathy and ascites.

compare the life quality based on WHOQOL-BRIEF between the two arms

incidence of liver related complications of the two arms including infections, encephalopathy, hepatorenal syndrome (HRS), and gastrointestinal bleeding.

salvia iodantha/albumiin

Study on the Optimal Strategy for Acute-on-chronic Liver Failure With Integrative Treatment

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