Objective To explore the effects and possible mechanism of Wenyang Zhenshuai Granules（温阳振衰颗粒） on cardiac and renal function. Methods A total of 40 SD rats were randomly divided into blank group

model group

Wenyang Zhenshuai group

and enalapril group

with 10 rats in each group. Rat except for the blank group were injected intraperitoneally with 3 mg/kg doxorubicin

once a week for 6 weeks to establish rat model of cardio-renal syndrome. After 3 weeks of modeling

rats in the blank and model groups were given 1 ml/100 g of saline by gavage each time

the Wenyang Zhenshuai group was given Wenyang Zhenshuai Granules by gavage 0.72 g/kg every time

and the enalapril group was given enalapril tablets intragastrically 0.9 mg/kg each time for gavage. All the groups were administrated twice a day for 4 weeks. HE staining was used to observe the pathological changes of renal tissue. The positive rate of apoptosis in myocardium and renal tissue was detected by TUNEL method. Heart function

renal function

serum N-terminal pro-brain natriuretic peptide（NT-pro BNP） and renal injury molecule 1（KIM-1） content were detected

heart and kidney p38 mitogen-activated protein kinase（p38 MAPK）

phosphorylated p38 mitogen-activated protein kinase（p-p38 MAPK） protein and mRNA expression were detected. Quantitation of plasma exosomes

expression of plasma exosome miR-155 in the heart and kidney were detected. Results Compared with the blank group

damaged heart function and kidney function

increased positive rates of apoptosis in myocardium and kidney tissue

increased serum NT-pro BNP and KIM-1 levels

increased p-p38 MAPK protein and p38 MAPK mRNA in the heart and kidney was increased

and decreased exosomes miR-155 in the heart

kidney and plasma were found（P<0.05 or P<0.01）. Compared with the model group

the above indicators were improved to different degree in the Wenyang Zhenhuai group and the enalapril group（P<0.01）. Conclusion Wenyang Zhenshuai Granules can improve the cardiac and renal function of rats with cardio-renal syndrome. The action may be related to increasing exosome miR-155 to inhibit the expression of p-p38 MAPK

thus exerting anti-apoptotic effects.