Long Term Clinical Observation And Experimental Study On The Treatment Of Diabetic Kidney Disease With The Method Of Tonify Qi And Yin,activate Blood And Remove Stasis

Objective:To observe the Long-term clinical efficacy of tonify qi and yin,activate blood and remove stasis on the treatment of diabetic kidney disease(DKD) microalbuminuria stage, and the effect of the DKD rat kidney vascular endothelial growthfactor(VEGF) and extracellularmatrix(ECM), And to explore the action mechanismof Qizhi Jiangtang Capsule(QJC).Methods: 1After a washout period,82 patients meet DKD microalbuminuria period with digital table method were randomly divided into experiment group(n = 41)and the control group(n = 41). The pati ents of experiment group were treated by QJC(2.5g, tid), while Valsarttan capsule(80-160 mg, qd) was given to the patients of control group,the treatment of 18 months at least.micro Albumin(mALB) 、 mALB /Ucr,Cystatin-C(Cys-C),Retinol Binding Protein(RBP) 、 β2-microglobulin(β2-MG)were examined.Forth-eight male Wistar rats were randomly divided into normal control group(n=8), model group(n=10), Valsarttan capsule groups(n=10), low dose QJC(n=10), high dose QJC group(n=10).The rats diabetic nephropathy was established by right kidney removal with celiac STZ. Medicine was given to each group according to the designed concentration and dosage. Respectively on 4 and 8 weeks observation DKD rats 24 TP, UmALB, UmALB/Ucr,Scr,BUN, Cys-C、β2- MG,After 8 weeks,all the animals were puted to death, kidney tissues were performed with HE and SABC staining,Kidney lesions observed by optical microscope,the change of the kidney podocytes were observed with electron microscope.Immunohistochemical detection of the expression of VEGF,Ⅳ collagen(Col Ⅳ), fiber adhesion protein(FN), matrix metalloproteinase 9(MMP 9), matrix metal loproteinases inhibitory factor 1(TIMP-1).Results:1.(1)The control group with 36 cases with complete observation, five patients end point events; Group 39 cases with complete observation, 2 patients occurred at the end of events.(2) Two groups of patients with urinary mALB, mALB/Ucr in 18 months after treatment than before treatment significantly decreased and maintain in low level(P<0.01),kidney function was improved,Experimental group is better than the control group(P<0.05);Two groups of patients with clinical symptoms of TCM were already at the time of 3 months after treatment significantly improved, with the extension of treatment time in patients with symptoms all have varying degrees of ease, and qi and Yin deficiency, blood stasis, two group patients resistance winding TCM symptoms improved significantly better than the control grou(P<0.01-0.05).2.The 24 h TP, mALB, mALB/Ucr, Scr, BUN, Cys-C,β2- MG were obviously corrected by QJC. According to the results of HE staining, SABC staining and electron microscope,the three treatment group rats kidney lesions is corrected,VEGF, Col Ⅳ, FN, MMP- 9 and TIMP- 1 in the expression of renal tissue was adjusted(P<0.05- P<0.01),which showed that renal damage degree were positively correlated with VEGF, ECM expression, Reducing urinary protein can improve glomerular basement membrane thickening, ECM, the kidney podocytes were protect, the process of DKD were delayed.Conclusion: Long-term use of stilbene vermiculite hypoglycemic capsule, not only can reduce urine protein, more important is to have delay the role of DKD progress.2.DKD rat urine protein can be decreased and klidney lesions can be corrected by the QJC,its action is probably by inhibiting VEGF excessive synthesis and deposition in the kidney tissues, reduce accumulation of ECM in the kidney tissues,to correctedDKD rat renal pathological damage tissue and vascular structures.