The Effects Of Tang-shen-kang Granule On Serum TNF-α, ICAM-1, MCP-1of Diabetic Kidney Disease Patients With Qi-yin Deficiency And Blood Stasis Syndrome

Objective To observe the clinical effects of Tang-shen-Kang granule in DiabeticKidney Disease(DKD) patients with Qi-Yin Deficiency and Blood Stasis Syndrome andthe changes of blood plasm Tumor necrosis factor-α(TNF-α),Intercellular adhesionmolecule(ICAM-1) and Monocyte chemoattractant protein-1(MCP-1) between twogroups before and after treatment.And to investigate its mechanism from theinflammatory response.Methods66DKD patients with Qi-Yin Deficiency and Blood Stasis Syndrome duringJanuary2012to July2014in anhui province hospital Department of Nephropathy andDepartment of Endocrinology were randomly assigned to the treatment group (33cases)and the control group (33cases).In the course of treatment,a total of6patients were lossof follow-up,and treatment group with3patients and control group with3patients,finally the actual completion of60patients.And established the normal control groupwith20patients.Patients in both groups were received basic treatments includingcontrolling diet,blood glucose,blood pressure and so on.Additionally,patients in thetreatment group orally took Tang-shen-Kang granule, Once a bag,three times a day.Thetwo groups were treated for8weeks. Observed the changes of the two groups patientswith Qi-Yin Deficiency and Blood Stasis syndrome scores,urinary albumin excretionrate,the renal function,the blood glucose,adverse reaction and so on.Tested serumTNF-α,ICAM-1and MCP-1levels in two groups of patients before and after treatment.Tested only serum TNF-α,ICAM-1and MCP-1levels in normal control group.Results The treatment group were better than the control group significantly inclinical efficacy,Chinese medicine syndrome and other main symptoms clinicalefficacy,and the difference was statistically significant(P<0.05or P<0.01).Aftertreatment in4weeks and8weeks,Chinese medicine syndrome scores were reducedsignificantly in two groups(P<0.05or P<0.01).Comparison with after treatment in4weeks,Chinese medicine syndrome scores were also improved significantly after treatment in8weeks in two groups(P<0.01).Comparison with after treatment in thesame course of treatment,the treatment group was lower than the control groupsignificantly(P<0.01).Comparison with before treatment,the urine protein (UAER,24hUPr) were improved significantly after treatment in4weeks and8weeks ontreatment group(P<0.05or P<0.01),were not improved significantly after treatment oncontrol group (P>0.05).Comparison with after treatment in4weeks,the urine protein(UAER,24hUPr) were also improved significantly after treatment in8weeks in twogroup(P<0.05or P<0.01).After treatment in8weeks,the treatment group showedsignificant difference when compaerd with those in the control group(P<0.01).Comparison with before treatment,the renal function (BUN,Scr,eGFR),the bloodglucose (FPG,2hPG,HbA1C) were not improved significantly after treatment ontreatment group(P>0.05).After treatment,no statistical difference existed between thetreatment group and the control group(P>0.05).Before treatment,the two groups patientswere higher than normal control group patient with serum TNF-α,ICAM-1and MCP-1levels (P<0.01),but there was not significant difference between the two groups patients(P>0.05).Compared with before treatment in the same group,the levels of serumTNF-α,ICAM-1and MCP-1increased(P<0.05or P<0.01),and treatment group waslower than control group significantly (P<0.01).Used the method of Pearson analysis inthe two groups patients before treatment,there was positively correlated between UAERand serum TNF-α,ICAM-1, MCP-1with statistical significance(r＝0.411,P＜0.01;r＝0.426,P＜0.01;r＝0.589,P＜0.01).Conclusions The clinical symptoms and relevant test index of DKD patients withQi-Yin Deficiency and Blood Stasis Syndrome were improved significantly byTang-shen-Kang granule,it has good clinical efficacy.The high expression levels ofinflammatory factors such as serum TNF-α,ICAM-1and MCP-1were reduced in DKDpatients with Qi-Yin Deficiency and Blood Stasis Syndrome significantly byTang-shen-Kang granule.This is likely to be one of the main mechanism of clinicalcurative effect of Tang-shen-Kang granule.