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Ruangan is a traditional Chinese medicine formula investigated for the treatment of liver fibrosis and early-stage cirrhosis, particularly in patients with chronic hepatitis B (CHB). The formula, whose name translates to "soften the liver", is composed of multiple herbal ingredients including Vinegar-baked turtle shell (醋鳖甲), Red peony root (赤芍), and Astragalus root (黄芪). Research suggests its therapeutic effects are multifactorial, involving anti-inflammatory and antioxidant activities, inhibition of hepatic stellate cell activation (a key event in fibrosis), and modulation of signaling pathways like PI3K-Akt. [2, 6] Clinical trials have demonstrated that Ruangan granules, when used in combination with the antiviral drug entecavir, can significantly improve the regression of advanced liver fibrosis and early cirrhosis in CHB patients and lower the long-term risk of developing hepatocellular carcinoma. [7] It is often prepared by hospitals for their patients. [1]
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