The clinical curative effect of warming yang for diuresis of traditional Chinese medicine combined with blood purification for treatment of acute renocardiac syndrome / 中国中西医结合急救杂志

ABSTRACT

Objective To explore the effect of warming yang for diuresis method combined with blood purification on the clinical therapeutic effect of patients with acute renocardiac syndrome (ARCS).Methods Sixty ARCS patients admitted to the Department of Intensive Care Unit (ICU) of Affiliated Hospital of Tianjin Institute of Chinese Medicine from May 2013 to October 2016 were enrolled, they were divided into an observation group and a control group by random number table, 30 cases in each group, one case died of multiple organ failure due to aggravation of infection, thus the actual observation number was 29 patients in the control group. The continuous vein-vein hemofiltration (CVVH) was applied in the two groups, 6-13 hours each time, and according to the disease situation, the continuous ultrafiltration time was determined, generally about 3-7 days; the observation group was additionally treated with warming yang for diuresis oral herbal decoction, 1 dose daily, 2 times a day, once 100 mL orally taken. The changes of cardiac and renal function indexes, traditional Chinese medicine (TCM) syndrome score and clinical efficacy were observed before and after treatment in the two groups.Results After treatment, the heart and renal function indexes were significantly improved, serum creatinine (SCr), urea nitrogen (BUN), N-terminal pro-brain nitric peptide (NT-proBNP) were all significantly lower than those before treatment in both groups, glomerular filtration rate (GFR), urine output, left ventricular ejection fraction (LVEF), cardiac output index (CI) were all significantly higher than those before treatment in both group; 7 days after treatment, BUN was significantly lower in observation group than that in control group (mmol/L:10.38±1.02 vs. 13.68±2.67), GFR, urine output, CI were significantly higher in observation group than those in control group [GFR (mL/min): 62.02±4.47 vs. 52.95±1. 92, urine output (mL/24 h): 875.41±44.26 vs. 537.82±79.65, CI (L·min-1·m-2): 3.12±0.51 vs. 3.07±0.17, allP < 0.05]; the effective rate of TCM syndrome score and clinical efficacy were significantly higher in observation group than those in control group [total effective rate of TCM syndrome score: 80.0% (24/30) vs. 55.17% (16/29), total effective rate: 93.33% (28/30) vs. 72.41% (21/29), both P < 0.05].Conclusions The warming yang for diuresis TCM decoction intake combined with CVVH can improve the cardiac and renal functions and clinical symptoms, and increase urine output for patients with ARCS.