Clinical Efficacy of Huangkui Capsule plus Methylprednisolone in the Treatment of Nephropathy and the Effect on Urinary Protein and Serum Inflammatory Factors in Patients.

Objective: The study aimed to assess the clinical efficacy of Huangkui capsule plus methylprednisolone in the treatment of nephropathy and the effect on urinary protein and serum inflammatory factors in patients. Methods: Between June 2017 and July 2020, 90 patients with nephropathy admitted to our hospital were recruited after assessment of eligibility and assigned via the random number table method (1 : 1) to receive either methylprednisolone tablets (observation group) or methylprednisolone tablets plus Huangkui capsules (experimental group). All eligible patients were also given dipyridamole and valsartan. Outcome measures included clinical efficacy, urine protein, hematuria, serum inflammatory factor levels, and adverse reactions. Results: A higher clinical efficacy was observed in the experimental group versus the observation group (P < 0.05). Huangkui capsules resulted in significantly lower levels of urine protein and hematuria in the experimental group versus the observation group after treatment (P < 0.05). The serum tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and monocyte chemoattractant protein-1 (MCP-1) levels in the experimental group were significantly lower than those in the observation group after treatment (P < 0.05). Huangkui capsules plus methylprednisolone were associated with a lower incidence of adverse events versus methylprednisolone (P < 0.05). Conclusion: The clinical efficacy of Huangkui capsule plus methylprednisolone in the treatment of patients with nephropathy is remarkable. It can effectively mitigate the inflammatory responses and enhance renal function, with reliable clinical safety, so it is worthy of clinical application.

Chinese herbal medicine reduces mortality in patients with severe and critical Coronavirus disease 2019: a retrospective cohort study.

This study aimed to evaluate the efficacy of Chinese herbal medicine (CHM) in patients with severe/critical coronavirus disease 2019 (COVID-19). In this retrospective study, data were collected from 662 patients with severe/critical COVID-19 who were admitted to a designated hospital to treat patients with severe COVID-19 in Wuhan before March 20, 2020. All patients were divided into an exposed group (CHM users) and a control group (non-users). After propensity score matching in a 1:1 ratio, 156 CHM users were matched by propensity score to 156 non-users. No significant differences in seven baseline clinical variables were found between the two groups of patients. All-cause mortality was reported in 13 CHM users who died and 36 non-users who died. After multivariate adjustment, the mortality risk of CHM users was reduced by 82.2% (odds ratio 0.178, 95% CI 0.076-0.418; P < 0.001) compared with the non-users. Secondly, age (odds ratio 1.053, 95% CI 1.023-1.084; P < 0.001) and the proportion of severe/critical patients (odds ratio 0.063, 95% CI 0.028-0.143; P < 0.001) were the risk factors of mortality. These results show that the use of CHM may reduce the mortality of patients with severe/critical COVID-19.

[The effect of enteral nutritional support and growth hormone on critical patients].

OBJECTIVE: To explore the effect of early enteral nutritional support and growth hormone (GH) on critical patients. METHODS: Sixty-eight critical patients were divided into enteral nutrition (EN) group and EN+GH group, with 34 patients in each group, by random number table. All the patients in both group received early enteral nutritional support, at the same time, the patients in EN+GH group received GH 5 U, once a day for 10 days. The intake was isonitrogenous and isocaloric in both groups. Body weight, blood biochemistry examination, nutrition state and lactulose/mannitol test were performed before and 5 days and 10 days after nutritional support. Immune function was performed after 10 days. Nitrogen balance was measured daily. RESULTS: The changes in body weight, albumin and transferring levels were more obvious in the EN+GH group than those in the EN group before and 5 days and 10 days after nutritional support, but the difference was not significant between the two groups. On the 5th and 10th day after treatment, the level of prealbumin [the 5th day:(25.34+/-4.26) g/L vs. (20.62+/-3.58) g/L; the 10th day: (27.34+/-4.25) g/L vs. (23.87+/-2.96) g/L] and that of fibronectin [the 5th day: (2.68+/-0.37) mg/L vs. (2.01+/-0.27) mg/L; the 10th day: (2.74+/-0.31) mg/L vs. (2.44+/-0.19) mg/L] in the EN+GH group were significantly higher than those in the EN group (all P<0.05). However, the level of lactulose/mannitol was significantly lower in EN+GH group than that in the EN group (the 5th day: 0.065+/-0.004 vs. 0.087+/-0.005, the 10th day: 0.027+/-0.002 vs. 0.053+/-0.004, both P<0.01). On the 10th day after treatment, the level of IgA in the EN+GH group was significantly lower than that in the EN group [(2.10+/-0.09) g/L vs.(3.45+/-0.25) g/L], but the levels of CD3 (0.682+/-0.049 vs. 0.606+/-0.046), CD4 (0.456+/-0.039 vs. 0.372+/-0.032), CD4/CD8 ratio (1.66+/-0.11 vs. 1.41+/-0.12), and the natural killer cell (NK cell, 0.139+/-0.011 vs.0.107+/-0.004) in the EN+GH group were significantly higher than those in the EN group (all P<0.05). The gut barrier function in the EN+GH group was superior to that in the EN group during nutritional support period. Nitrogen balance was positive in the EN+GH group [(27.54+/-23.15) mg/kg] and negative in the EN group [-(5.13+/-4.26) mg/kg]. CONCLUSION: Early enteral nutritional support can improve state of nutrition, and it is combined with GH composition of protein may be improved and the immune function may be enhanced.