Clinical efficacy of Jiedu Huayu Hushen prescription in treatment of acute-on-chronic liver failure complicated by hepatorenal syndrome

Objective To investigate the clinical efficacy of Jiedu Huayu Hushen prescription in the treatment of acute‐on‐chronic liver failure（ACLF）complicated by hepatorenal syndrome（HRS）and its effect on endotoxemia. Methods Clinical data were collected from 96 patients with ACLF complicated by HRS who were diagnosed and treated in The First Affiliated Hospital of Guangxi University of Chinese Medicine from March 2020 to June 2022，and they were divided into observation group and control group using a random number table，with 48 patients in each group. In addition to comprehensive Western medicine therapy，the patients in the control group were given norepinephrine and albumin，while those in the observation group were given Jiedu Huayu Hushen prescription combined with norepinephrine and albumin，and the course of treatment was 2 weeks for both groups. The two groups were compared in terms of serum endotoxin level，traditional Chinese medicine（TCM）syndrome score，24‐hour urine volume，renal function，liver function，coagulation function，and clinical outcome. The independent‐samples t test was used for comparison of continuous data between two groups，paired t‐test was used for comparison before and after treatment within the group；and the chi‐square test was used for comparison of categorical data between two groups. Results Compared with the control group after 2 weeks of treatment，the observation group had a significantly lower TCM syndromes core （P<0.05），significantly lower levels of endotoxin，blood urea nitrogen，serum creatinine，cystatin C，and prothrombin time（all P<0.05），and significantly higher levels of glomerular filtration rate，24‐hour urine volume，serum albumin，and prothrombin time activity（all P<0.05）. After 2 weeks of treatment，the observation group had a significantly higher overall response rate than the control group （87.50% vs 66.67%，P<0.05）. Conclusion Based on comprehensive Western medicine therapy，Jiedu Huayu Hushen prescription can reduce serum endotoxin level，improve liver and renal function and coagulation function，and increase urine volume in patients with ACLF complicated by HRS，with a better clinical efficacy than Western medicine therapy alone.