| ObjectiveTo compare the therapeutic effect of Zhibai Dihuang Decoction on early acute kidney injury in patients with liver-kidney yin deficiency after liver transplantation,and to explore the clinical therapeutic effect of this prescription on promoting renal function recovery after acute liver injury following liver transplantation.It provides clinical evidence for the application of Chinese medicine in promoting the recovery of renal function after acute kidney injury after liver transplantation.MethodThe method of propensity score matching and cohort study were adopted.Clinical variables of 82 patients who developed early acute kidney injury after orthotopic liver transplantation in Nanjing Military Command Fuzhou General Hospital from January 2014 to January 2018 were collected.Twenty-two pairs were matched successfully in 82 patients by using propensity score matching method.Twenty-two patients who received conventional western medicine treatment and Zhibai Dihuang Decoction were set as treatment group.Twenty-two patients who only received routine western medicine were set as control group.1.In control group,patients were treated routindy of controlled infusion,maintenance of urine volume,enhancement of anti-infection,improvement of microcirculation,maintenance of parenteral nutrition,improvement of cardiorespiratory function,etc.2.In treatment group,in addition to the routine western medicine treatment,patients were treated regularly with Zhibai Dihuang Decoction via jejunostomy fistulae tube from the first day to the tenth day after LT with dosage of 200ml/day.3.Pre-and Intraoperative baseline characteristics,volume of urine,serum creatinine concentration,blood urea nitrogen,cystatin-c,alanine aminotransferase,glutamic oxalacetic transaminase on first,second,third,fourth,fifth,sixth,seventh,fourteenth,twenty-eighth days after LT were recorded.Result1.the result that the scores of TCM syndromes in the two groups were statistically different between the observation group and the control group(P<0.05),and the scores of the observation group were lower than the control group after treatment were found by T test and Ridit analysis.2.The two-factor repeated-measures analysis of variance revealed that after two groups of treatment had significant changes with time(P<0.05).The control group and the observation group included urine volume,alanine aminotransferase,and aspartate aminotransferase.The difference was not statistically significant(P>0.05).3.The variance analysis of two factors showed that the blood urea nitrogen index of the two groups had a significant change with time(P<0.05).There was a statistically significant difference in blood urea nitrogen between the observation group and the control group(P<0.05).The blood urea nitrogen recovery observation group was superior to the control group.4.Through analysis of two factor repeated measures variance,the significant differences were existed in comparison with serum creatinine and cystatin C between the treatment group and control group(P<0.05).each time point difference also had statistical significance(P<0.05).at the same time,groups and time had cross effect(P<0.05).So,the treatment group is superior to the control group in the early AKI treatment after liver transplantation.5.Through T test,the postoperative ICU hospitalization time in the treatment group was shorter than that in the control group,and there was a statistical difference between two groups(P<0.05).Conclusion1.Zhibai Dibuang Decoction can accelerate recovery of renal function in Liver and kidney Yin deficiency patients who developed early acute kidney injury after liver transplantation and shorten the hospitalization time in ICU.2.Zhi bai Dihuang pill may have a positive effect on liver function recovery after liver transplantation. |
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