Objective: To evaluate the effects of Ruangan Lishui prescription combined with spreading umbilicus by Zhuishui prescription on liver function, main portal vein diameter (Dpv), and T-cell subsets in patients with refractory ascites due to cirrhosis with spleen deficiency and water retention syndrome. Methods: A total of 131 cirrhotic patients with refractory ascites was randomly divided into an observation group (66 patients) and a control group (65 patients). The control group was given routine treatment in western medicine, and the observation group was given a Ruangan Lishui prescription combined with spreading umbilicus by Zhuishui prescription on the basis of the control group. The course of treatment was eight weeks. The TCM syndrome scores, body mass, abdominal circumference, 24h urine volume, liver function, T cell subsets, maximum depth of ascites dark zone on color ultrasound, Dpv, coagulation function, and electrolyte changes were observed before and after treatment in both groups to evaluate the comprehensive efficacy. Results: The overall response rate of 86.37% in the observation group was higher than the 66.15% in the control group (P＜0.05). After treatment, TCM syndrome scores, body mass, abdominal circumference, 24 h urine volume, liver function indicators, maximum depth of the dark zone of ascites, Dpv, and coagulation function indicators were improved in both groups compared with before treatment, and the degree of improvement in the observation group was better than that in the control group (P＜0.05). Moreover, the electrolytes after treatment in both groups did not change significantly compared with those before treatment (P>0.05) and did not increase the occurrence of electrolyte imbalance in patients. Conclusion: Ruangan Lishui prescription combined with spreading umbilicus by Zhuishui prescription for the treatment of refractory ascites of spleen deficiency and water retention syndrome can improve the clinical effective rate, and it is safe and reliable.