| Diabetic nephropathy(DN) is a microvascular complication of diabetic mellitus, and DN has been the most common cause of death for diabetic patients. DN is the leading cause of end-stage renal disease(ESRD) in Western countries, the incidence of ESDR is rising at an alarming rate, almost 30% to 40% diabetic patients will develop DN and many will progress to ESRD. Now the main treatments are glycemic control, hypertension control,serum lipids reduction and control other factors which may cause renal function impairment, dialysis or renal transplantation is necessary for ESDR.While using Chinese medicine , in addition to ameliorating clinical symptoms, protecting renal function, reducing the rate of renal damage and improving quality of life, few side effects also may be important, so international researchers focus on finding effective measures and medications from Chinese medicine. XIAOKEKELIJI was made up from astragalus root, leech, fractus corni,ramulus euonymi,and so on. Astragalus root could invigorate the liver and kidney, promote diuresis to reduce edema; fractus corni could invigorate the liver and kidney, compatible application of two drugs could supplement the vital energy and nourish Yin, invigorate the liver and kidney. Leech had the effects of promoting blood circulation to remove stasis, and promoting diuresis; ramulus euonym had the effects of clearing away heat and toxic materials, cooling the blood, and was effective for diabetes.Combination of these two drugs could promote blood circulation and dredge meridian, clear heat and promote diuresis. In order to provide a theoretical basis and investigate the effects and mechaniam of XIAOKEKELIJI on treating DN,we observed the therapatic effects of XIAOKEKELIJI in DN rats, and its influences on proliferation of rat mesangial cells induced by hight ambient glucose concentrations and on expression of TGF-β1.Methods and results:1 experiments in vivo⑴ 3/4 nephrectomy was adopted firstly, three weeks later streptozotocin(STZ) was abdominal cavity administered to establish diabetic nephropathy model in SD rat. The DN rats showed hyperglycemia, high serum lipids ,proteinuria, high creatinine and blood urea nitrogen at 1w after STZ injection . No IgG deposition along the glomerular basement membrane(GBM) was explored in fluorescence microscopy. All rats were sacrificed at 2w and 6w after STZ injection, renal tissue samples were studied by lightmicroscope and transmission electron microscopy.The model group demonstrated different degree of GBM thicking, extracellular matrix accumulation, glomerular capillary expanding, exudates in Bowman's capsule and Bowman's capsule fibrosis.Hyaline and erythrocytic casts ,glycogen deposition in tublar epithelial cells ,and renal interstitial fibrosis also were observed in model rats. Even GBM rupture, glomerulosclerosis or necrosis ,cresent formation and interstitial abscesses appeared in part of pathological rats. Morphologic changes were discovered at 2w, at 6w the DN rats showed glomerular and interstitial sclerosis. All above mentioned lesions fitted changes of DN, and this method had advantages of short term and low cost, this model could be used as a good strategy for studing pathogenesis of renal sclerosis and observing therapatic effects.⑵ After duplicated DN model, all rats were radomly assigned into five groups:model group, XIAOKEKELIJI low, middle, high dose treatment group and posotive control group. XIAOKEKELIJI could control glycemia, lowing serum lipids,creatinine , blood urea nitrogen, alleviating proteinuria,respectively(P<0.05),for model group. Posotive control medicine had similar effects with XIAOKEKELIJI. Correlation analysis showed that glycemia was in positive correlation with serum triglyceride(R=0.643,P<0.05), serum cholestrol (R=0.261,P<0.05) , creatinine (R=0.556,P<0.05) and proteinuria(R=0.175,P<0.05). Proteinuria was in positive correlation with creatinine(R=0.221,P<0.05).⑶XIAOKEKELIJI treatment group and positive control group could alleviate GBM thicking, extracel...
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