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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 9
Sep.  2022
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Article Contents

Integrated traditional Chinese and Western medicine diagnosis and treatment of hepatorenal syndrome

DOI: 10.3969/j.issn.1001-5256.2022.09.005
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  • Corresponding author: LIU Wen, lwsxp2@126.com(ORCID: 0000-0003-1669-4855)
  • Received Date: 2022-05-31
  • Accepted Date: 2022-07-01
  • Published Date: 2022-09-20
  • As a common complication of end-stage liver disease, hepatorenal syndrome (HRS) is functional acute renal failure that occurs on the basis of severe liver diseases and is a group of clinical syndromes characterized by renal insufficiency, abnormal endogenous vascular substances, and hemodynamic changes of arterial circulation. The ideal treatment method for HRS is liver transplantation or simultaneous kidney transplantation, and optimization of drug and non-drug therapies is the key to the treatment of HRS. This article reviews the current status of the integrated traditional Chinese and Western medicine diagnosis and treatment of HRS.

     

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  • [1]
    GINÈS A, ESCORSELL A, GINÈS P, et al. Incidence, predictive factors, and prognosis of the hepatorenal syndrome in cirrhosis with ascites[J]. Gastroenterology, 1993, 105(1): 229-236. DOI: 10.1016/0016-5085(93)90031-7.
    [2]
    Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the management of ascites and complications in cirrhosis[J]. J Clin Hepatol, 2017, 33(10): 1847-1863. DOI: 10.3969/j.issn.1001-5256.2017.10.003.

    中华医学会肝病学分会. 肝硬化腹水及相关并发症的诊疗指南[J]. 临床肝胆病杂志, 2017, 33(10): 1847-1863. DOI: 10.3969/j.issn.1001-5256.2017.10.003.
    [3]
    ANGELI P, GINES P, WONG F, et al. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites[J]. Gut, 2015, 64(4): 531-537. DOI: 10.1136/gutjnl-2014-308874.
    [4]
    OJEDA-YUREN AS, CERDA-REYES E, HERRERO-MACEDA MR, et al. An integrated review of the hepatorenal syndrome[J]. Ann Hepatol, 2021, 22: 100236. DOI: 10.1016/j.aohep.2020.07.008.
    [5]
    FRANCOZ C, DURAND F, KAHN JA, et al. Hepatorenal syndrome[J]. Clin J Am Soc Nephrol, 2019, 14(5): 774-781. DOI: 10.2215/CJN.12451018.
    [6]
    ANGELI P, GINÈS P, WONG F, et al. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites[J]. J Hepatol, 2015, 62(4): 968-974. DOI: 10.1016/j.jhep.2014.12.029.
    [7]
    FRANCOZ C, NADIM MK, DURAND F. Kidney biomarkers in cirrhosis[J]. J Hepatol, 2016, 65(4): 809-824. DOI: 10.1016/j.jhep.2016.05.025.
    [8]
    FACCIORUSSO A, CHANDAR AK, MURAD MH, et al. Comparative efficacy of pharmacological strategies for management of type 1 hepatorenal syndrome: a systematic review and network meta-analysis[J]. Lancet Gastroenterol Hepatol, 2017, 2(2): 94-102. DOI: 10.1016/S2468-1253(16)30157-1.
    [9]
    TANOUE A, ITO S, HONDA K, et al. The vasopressin V1b receptor critically regulates hypothalamic-pituitary-adrenal axis activity under both stress and resting conditions[J]. J Clin Invest, 2004, 113(2): 302-309. DOI: 10.1172/JCI19656.
    [10]
    WONG F, PAPPAS SC, BOYER TD, et al. Terlipressin improves renal function and reverses hepatorenal syndrome in patients with systemic inflammatory response syndrome[J]. Clin Gastroenterol Hepatol, 2017, 15(2): 266-272. DOI: 10.1016/j.cgh.2016.07.016.
    [11]
    WONG F, CURRY M, REDDY R, et al. LO5: The CONFIRM study: A North American randomized controlled trial (RCT) of terlipressin plus albumin for the treatment of hepatorenal syndrome type 1 (HRS-1)[J]. Hepatology, 2019, 70(Suppl 1): 10.
    [12]
    ALESSANDRIA C, OTTOBRELLI A, DEBERNARDI-VENON W, et al. Noradrenalin vs terlipressin in patients with hepatorenal syndrome: a prospective, randomized, unblinded, pilot study[J]. J Hepatol, 2007, 47(4): 499-505. DOI: 10.1016/j.jhep.2007.04.010.
    [13]
    CAVALLIN M, KAMATH PS, MERLI M, et al. Terlipressin plus albumin versus midodrine and octreotide plus albumin in the treatment of hepatorenal syndrome: A randomized trial[J]. Hepatology, 2015, 62(2): 567-574. DOI: 10.1002/hep.27709.
    [14]
    NANDA A, REDDY R, SAFRAZ H, et al. Pharmacological therapies for hepatorenal syndrome: A systematic review and meta-analysis[J]. J Clin Gastroenterol, 2018, 52(4): 360-367. DOI: 10.1097/MCG.0000000000000913.
    [15]
    SIMONETTO DA, GINES P, KAMATH PS. Hepatorenal syndrome: pathophysiology, diagnosis, and management[J]. BMJ, 2020, 370: m2687. DOI: 10.1136/bmj.m2687.
    [16]
    BORTOLUZZI A, CEOLOTTO G, GOLA E, et al. Positive cardiac inotropic effect of albumin infusion in rodents with cirrhosis and ascites: molecular mechanisms[J]. Hepatology, 2013, 57(1): 266-276. DOI: 10.1002/hep.26021.
    [17]
    FERNÁNDEZ J, MONTEAGUDO J, BARGALLO X, et al. A randomized unblinded pilot study comparing albumin versus hydroxyethyl starch in spontaneous bacterial peritonitis[J]. Hepatology, 2005, 42(3): 627-634. DOI: 10.1002/hep.20829.
    [18]
    BAÑARES R, NEVENS F, LARSEN FS, et al. Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure: the RELIEF trial[J]. Hepatology, 2013, 57(3): 1153-1162. DOI: 10.1002/hep.26185.
    [19]
    GINÈS P, URIZ J, CALAHORRA B, et al. Transjugular intrahepatic portosystemic shunting versus paracentesis plus albumin for refractory ascites in cirrhosis[J]. Gastroenterology, 2002, 123(6): 1839-1847. DOI: 10.1053/gast.2002.37073.
    [20]
    WONG F, PANTEA L, SNIDERMAN K. Midodrine, octreotide, albumin, and TIPS in selected patients with cirrhosis and type 1 hepatorenal syndrome[J]. Hepatology, 2004, 40(1): 55-64. DOI: 10.1002/hep.20262.
    [21]
    SONG T, RÖSSLE M, HE F, et al. Transjugular intrahepatic portosystemic shunt for hepatorenal syndrome: A systematic review and meta-analysis[J]. Dig Liver Dis, 2018, 50(4): 323-330. DOI: 10.1016/j.dld.2018.01.123.
    [22]
    ZHANG Z, MADDUKURI G, JAIPAUL N, et al. Role of renal replacement therapy in patients with type 1 hepatorenal syndrome receiving combination treatment of vasoconstrictor plus albumin[J]. J Crit Care, 2015, 30(5): 969-974. DOI: 10.1016/j.jcrc.2015.05.006.
    [23]
    STARRT-AKI Investigators; Canadian Critical Care Trials Group; Australian and New Zealand Intensive Care Society Clinical Trials Group, et al. Timing of initiation of renal-replacement therapy in acute kidney injury[J]. N Engl J Med, 2020, 383(3): 240-251. DOI: 10.1056/NEJMoa2000741.
    [24]
    European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis[J]. J Hepatol, 2010, 53(3): 397-417. DOI: 10.1016/j.jhep.2010.05.004.
    [25]
    NADIM MK, DINORCIA J, JI L, et al. Inequity in organ allocation for patients awaiting liver transplantation: Rationale for uncapping the model for end-stage liver disease[J]. J Hepatol, 2017, 67(3): 517-525. DOI: 10.1016/j.jhep.2017.04.022.
    [26]
    SNOWDON VK, LACHLAN NJ, HOY AM, et al. Serelaxin as a potential treatment for renal dysfunction in cirrhosis: Preclinical evaluation and results of a randomized phase 2 trial[J]. PLoS Med, 2017, 14(2): e1002248. DOI: 10.1371/journal.pmed.1002248.
    [27]
    STINE JG, WANG J, CORNELLA SL, et al. Treatment of type-1 hepatorenal syndrome with pentoxifylline: A randomized placebo controlled clinical trial[J]. Ann Hepatol, 2018, 17(2): 300-306. DOI: 10.5604/01.3001.0010.8660.
    [28]
    GARG V, GARG H, KHAN A, et al. Granulocyte colony-stimulating factor mobilizes CD34(+) cells and improves survival of patients with acute-on-chronic liver failure[J]. Gastroenterology, 2012, 142(3): 505-512. DOI: 10.1053/j.gastro.2011.11.027.
    [29]
    TANG SX, LI Y. Integrated traditional Chinese and Western medicine treatment of hepatorenal syndrome[J]. Shanxi J Tradit Chin Med, 2012, 28(5): 59-61. DOI: 10.3969/j.issn.1000-7156.2012.05.037.

    唐世霞, 李勇. 中西医结合救治肝肾综合征探讨[J]. 山西中医, 2012, 28(5): 59-61. DOI: 10.3969/j.issn.1000-7156.2012.05.037.
    [30]
    ZONG YL, YIN YY, LIN YH. Understanding of hepatorenal syndrome, a complication of liver failure, based on the theory of "toxin and evil"[J]. J New Chin Med, 2012, 44(4): 5-7. https://www.cnki.com.cn/Article/CJFDTOTAL-REND201204004.htm

    宗亚力, 尹燕耀, 林云华. 从"毒邪"理论认识肝衰竭并发肝肾综合征[J]. 新中医, 2012, 44(4): 5-7. https://www.cnki.com.cn/Article/CJFDTOTAL-REND201204004.htm
    [31]
    China Association of Chinese Medicine. Guidelines for Chinese Internal Medicine Diagnosis and Treatment (Volume 3)[M]. Beijing: China Press of Traditional Chinese Medicine, 2020.

    中华中医药学会. 中医内科临床诊疗指南(第三册)[M]. 北京: 中国中医药出版社, 2020.
    [32]
    ZHU BB. Establishment of a predictive model for HRS in patients with decompensated liver cirrhosis and the effect of traditional Chinese medicine on prognosis[D]. Beijing: Beijing University of Chinese Medicine, 2019.

    朱冰冰. 失代偿期肝硬化患者发生HRS预测模型的建立及中医药对其预后的影响[D]. 北京: 北京中医药大学, 2019.
    [33]
    WANG JY, ZHANG H, LYU J, et al. Clinical study on Octreotide combined with Yiguanjian and Zhuling decoction in treating liver and Kidney Yin deficiency type hepatorenal syndrome[J]. The Medical Forum, 2021, 25(25): 3680-3682. DOI: 10.19435/j.1672-1721.2021.25.064.

    王箭焱, 张慧, 吕婕, 等. 奥曲肽联合一贯煎合猪苓汤治疗肝肾阴虚型肝肾综合征临床研究[J]. 基层医学论坛, 2021, 25(25): 3680-3682. DOI: 10.19435/j.1672-1721.2021.25.064.
    [34]
    YAO Y, CHAI M, CAO YJ, et al. Effects of self-made Wenyang Xiaoyin decoction on liver and kidney function protection, hemodynamic indexes and peripheral blood TNF-α, NO and sICAM-1 levels in treating spleen-kidney Yang deficiency syndrome patients with liver cirrhosis and hepatorenal syndrome[J]. World Chin Med, 2019, 14(7): 1748-1752. DOI: 10.3969/j.issn.1673-7202.2019.07.026.

    姚耀, 柴梅, 曹玉鹃, 等. 自拟温阳消饮汤对脾肾阳虚证肝硬化合并肝肾综合征患者肝肾功能保护、血流动力学指标及外周血肿瘤坏死因子-α、一氧化氮、可溶性细胞黏附因子-1的影响[J]. 世界中医药, 2019, 14(7): 1748-1752. DOI: 10.3969/j.issn.1673-7202.2019.07.026.
    [35]
    QU ZW, YU MJ, FENG L, et al. Clinical researches of hepatorenal syndrome treated with methods of reinforcing kidney and strengthening spleen[J]. J Beihua Univ (Natural Science), 2019, 20(1): 99-102. DOI: 10.11713/j.issn.1009-4822.2019.01.021.

    曲智威, 于明俊, 冯雷, 等. 补肾健脾法治疗肝肾综合征临床研究[J]. 北华大学学报(自然科学版), 2019, 20(1): 99-102. DOI: 10.11713/j.issn.1009-4822.2019.01.021.
    [36]
    CAO YJ, CHAI M, YAO Y, et al. Effect of liver cirrhosis 1 decoction combined with ascites ultrafiltration reinfusion on the micro inflammatory state and the protection of liver and kidney function in patients with hepatorenal syndrome[J]. J Sichuan Tradit Chin Med, 2018, 36(1): 119-121. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY201801045.htm

    曹玉鹃, 柴梅, 姚耀, 等. 肝硬化1号汤加减联合腹水超滤回输对肝肾综合征患者微炎症状态及肝肾功能保护的影响[J]. 四川中医, 2018, 36(1): 119-121. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY201801045.htm
    [37]
    YI GD, TAN J. Protective effects of schisandrin B on rat model of hepatorenal syndrome and its possible mechanism[J]. J Med Res, 2018, 47(9): 172-175. DOI: 10.11969/j.issn.1673-548X.2018.09.041.

    易国栋, 谭静. 五味子乙素对肝肾综合征大鼠的保护作用及其机制研究[J]. 医学研究杂志, 2018, 47(9): 172-175. DOI: 10.11969/j.issn.1673-548X.2018.09.041.
    [38]
    QIE LX, FAN R. Clinical effect of traditional Chinese medicine retention enema in treatment of hepatorenal syndrome: An analysis of 37 cases[J]. Hebei J TCM, 2014, 36(10): 1482-1483. DOI: 10.3969/j.issn.1002-2619.2014.10.023.

    郄兰霞, 范蓉. 中药保留灌肠治疗肝肾综合征37例临床观察[J]. 河北中医, 2014, 36(10): 1482-1483. DOI: 10.3969/j.issn.1002-2619.2014.10.023.
    [39]
    LI SQ. Clinical effect of traditional Chinese medicine combined with acupuncture in treatment of hepatorenal syndrome: An analysis of 36 cases[J]. Chin J Integ Trad Western Nephrol, 2006, 7(6): 358-359. DOI: 10.3969/j.issn.1009-587X.2006.06.018.

    李双全. 中药配合针灸治疗肝肾综合征36例[J]. 中国中西医结合肾病杂志, 2006, 7(6): 358-359. DOI: 10.3969/j.issn.1009-587X.2006.06.018.
    [40]
    DENG CQ, GE LA, PAN LM, et al. Clinical effect of traditional Chinese medicine external application in treatment of hepatorenal syndrome[C]//Collected papers from the 31st National Academic Conference on Integrated Traditional Chinese and Western Medicine Therapy for Digestive Diseases, 2019.

    邓长卿, 葛来安, 潘丽敏, 等. 中药外敷治疗肝肾综合征的疗效观察[C]//第三十一届全国中西医结合消化系统疾病学术会议论文集, 2019.
    [41]
    ZHU CQ, CHEN EJ. Clinical effect of traditional Chinese medicine acupoint application combined with intravenous drip of octreotide in treatment of hepatorenal syndrome: An analysis of 27 cases[J]. Jiangsu J Traditi Chin Med, 2012, 44(11): 66-67. DOI: 10.3969/j.issn.1672-397X.2012.11.043.

    朱长权, 陈二军. 中药穴位外敷联合奥曲肽静滴治疗肝肾综合征27例临床研究[J]. 江苏中医药, 2012, 44(11): 66-67. DOI: 10.3969/j.issn.1672-397X.2012.11.043.
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