| Diabetic nephropathy is one of the serious complications of diabetes which is the chief of cause death. Nowadays, diabetic nephropathy torment people and also threaten people's health and life, so it is urgent for researchers to find effective treatment methods or medicine for patients with diabetic nephropathy worldwild. Renal tubular epithelial-mesenchymal transition brings an important impact in tubulointerstitial fibrosis, and TGF-β1/Smad signaling pathway palys the main role in this procession. Traditional Chinese medicine has accumulated rich experiences in treats diabetic nephropathy, especially for early stage, it has better curative effect. But there is less researches of the mechanism of action of herbs. This paper gives an overview of understanding and treatment for diabetic nephropathy based on Chinese medicine and Western medicine at the beginning of paper, then to analyze the mechanism of Tang Nai Kang treats diabetic nephropathy through TGF-β1/Smad signaling pathway.1 Reference reviewThe reference review discussed the recent research progresses in prevention and treatment of diabetic nephropathy both from the aspects of Chinese medicine and modern medicine. Reference to the literature of traditional Chinese medicine, Chinese medicine on the diabetic nephropathy name, pathogenesis, diagnosis and treatment, clinical and experimental research are reviewd, while made in a summary of modern medicine on the diabetic nephropathy progresses, emphatically summarized pathogenesis, diagnosis, and treatment.2 Experimental studyObjective:Using spontaneously KKAy mice as the diabetic nephropathy model, in order to discuss the effect mechanism of Tang Nai Kang on diabetic nephropathy, which provides the foundation for for treating diabetic nephropathy.Methods:Using spontaneously KKAy mice as diabetic nephropathy model, divided the mice into normal group, model group, control group, small dose of Tang Nai Kang, Tang Nai Kang middle dose group, Tang Nai Kang high dose groups. We tested mice blood glucose, the level of insulin, TC, TG, BUN, and Scr, kidney tissues HE staining and electron microscope observation. Immunohistochemical detection ofα-SMA,E-cadherin protein expression; Using real-time fluorescent quantitatie polymerase chain reaction (PCR) method to test kidney TGF-β1 mRNA, TGF-βR1 mRNA,TGF-βR2 mRNA,Collagen I mRNA,CollagenⅢmRNA and Fn mRNA gene, western blot tested TGF-β1, Smad2, P-smad2, Smad3, P-smad3, Smad7 protin expression. All data were analyzed by SPSS 16.0 statistical package.Results:Experiment 1:Compared with the normal group, the weight of model group's mice has been significantly increased with the same ages (P<0.01). Groups with Tang Nai Kang weight gets down. Tang Nai Kang could decrease the level of fasting blood sugar and serum TC, TG, INS,24-hours proteinuria, compared to that of the model group remarkably, but there is no difference in renal function test between the groups. HE staining showed that enlargement of glomerulus and tubular, increased extra-cellular matrix, renal tubule was filled with the protein and cells in control group at 20 weeks, the treatment group pathological changes of mice kidney morfology were improved compared with model group. Experiment 2:Compared with the normal group, the model group showed a significant renal fibrosis (P <0.01), each Tang, Nai Kang group have a better condition than model group. Wstern blot showed that there is a high level of TGF-β1 in model group.In addition,compared with control group Tang Nai Kang high does group has a better treatment effect. Experiment 3:Real-time PCR showed that model group's TGF-β1 mRNA, Collagen I mRNA, CollagenⅢmRNA, FN mRNA were high than normal group. For TGFβ-R1 mRNA and TGFβ-R2 mRNA express, there is no difference between any groups.Western blot showed that smad2, p-smad-2, smad-3, p-smad-3 have a high level in model group (P< 0.01).Conclusion:1, Tang Nai Kang can decrease diabetic nephropathy mice weigh, blood glucose, and urine protein,, which means that it can prevente the occurrence of early diabetic nephropathy and development, and protect the renal function; 2, Tangnai-Kang can reduce renal fibosis and better than valsartan.3 Tangnai-Kang can improve the renal function,its proper mechanism that may inhibit and block TGF-β1/smads signaling pathway...
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