| Objective:Observation with Supplementing Qi and nourishing Yin, promoting blood circulation and removing blood stasis of Chinese medicine compound Danzhi Jiangtang Capsule on early type 2 diabetic kidney disease patients TCM syndrome improvement and effects of traditional Chinese medicine on the improvement of traditional Chinese medicine syndromes in patients with early type 2 diabetic nephropathy and the related indexes of blood glucose and renal function:the fasting blood glucose, postprandial 2hours blood glucose, glycosylated hemoglobin, serum cystatin C, interleukin- 18, 24 hours urine protein, urine albumin, serum creatinine, urinary albumin than creatinine,systolic blood pressure, diastolic blood pressure(DBP). At the same time, observation of Danzhi Jiangtang Capsule in type 2 diabetic rats blood glucose, kidney disease,kidney weight ratio.Function and protective mechanism of Chinese herbal compound Danzhijiangtang Capsule in the prevention of type 2 diabetes kidney disease from the perspective of inflammatory factors, providing new experimental research methods,clinical data and theoretical basis for the prevention and treatment of type 2 diabetic nephropathy with traditional Chinese medicine.Methods:1.Clinical research:taking the early diabetic nephropathy patients from20014 October to2015 June in Anhui University of traditional Chinese medicine of Endocrinology, the first affiliated hospital inpatient and outpatient with 2013 edition "Chinese type 2diabetes prevention guide" [1] promulgated the diagnostic criteria for diagnosis of early patients with early diabetic nephropathy(DKD) in 60 cases, were randomly divided into western medicine group and Western medicine group, including 30 cases of Western medicine, traditional Chinese and Western medicine group of 30 cases, two groups are used to Benazepril Hydrochloride(10 mg-d Po, at) based treatment scheme, on the basis of the integrated traditional Chinese and Western medicine group plus with Supplementing Qi and nourishing yin and activating blood circulation effect of Danzhi Jiangtang Capsule(3#PO, TID). Were recorded before treatment and after treatment in patients with TCM syndromes, Cys C, bun, SCR and EGFR, m Alb, ACR, SBP, DBP,FPG, 2h PG, Hb A1 c index, and leave serum samples were collected to detect serum IL-18 and observed after treatment in the two groups before and after treatment between the two groups curative effect difference. To reduce the loss of the subjects as far as possible.2.Animal experiments:60 rats were randomly divided into normal group, high fat diet group and normal control group with 12 rats in the normal control group, 48 in normal control group and in normal control group. Normal group were given normal diet, high fat diet group were fed with high fat diet. 28 days later, 48 rats in the high fat diet group received intraperitoneal injection of STZ, induced diabetic rat model, and the model rats were excluded. After making a successful model rats divided into according to the blood glucose and body weight were evenly divided into 4 groups: model group, Danzhi Jiangtang Capsule high dose group Dan Gaozu, Danzhi Jiangtang Capsule low dose group(Dan low group), pioglitazone group(imidacloprid lattice group), 12 rats in each group. All rats were administered once a day for 12 weeks. General situation of diabetic rats and blood glucose, serum creatinine, urea nitrogen, renal pathology.Results:1.Clinical Study:Clinical observation results show that the same group before and after treatment of TCM syndrome score was significantly different(P < 0.01), western medicine group after treatment with traditional Chinese medicine and Western medicine compared with significant difference(P < 0.01). Integrated traditional Chinese and Western medicine group total effective rate was 90.0%. The western medicine group total efficiency was76.7%; group of integrated traditional Chinese and Western Medicine on the treatment,the fasting blood glucose, postprandial 2H plasma glucose, Hb A1 c and urine albumin,urinary albumin creatinine, e-gfr, Cys C, IL-18 treatment before were significantly or decreased(P < 0.01, P < 0.05), and Western medicine group and Western medicine group improved better than western medicine group(P < 0.05 or P < 0.05); the difference of SBP in the integrated traditional Chinese and Western medicine group before and after treatment significantly(P < 0.05).2. Animal experiments:Experimental results show that: compared with the normal group, after modeling, the rats blood glucose, serum creatinine(SCR), m Alb, bun were significant difference(P <0.01); after treatment of Danzhi high, low dose group and model group compared blood glucose, serum creatinine(SCR), m Alb and BUN levels were decreased significantly(P< 0.01); after treatment of Danzhi Jiangtang Capsule high, compared with the model group, low dose group and pioglitazone group Rat Kidney Pathological Morphology significantly improved.Conclusions:1. Danzhi Jiangtang Capsule can improve diabetic nephropathy early in patients with TCM syndrome integral, FPG, 2h PG, Hb A1 c, EGFR, m Alb, ACR, Scr、BUN、TC、TG and BP.2. Danzhi Jiangtang Capsule can reduce diabetic kidney disease patients in the early stage of the serum Cys C and IL-18 levels, reduce inflammation, protect renal function.It is suggested that IL-18 may be involved in the pathogenesis of diabetic nephropathy,and it also suggests that inflammatory factors play an important role in the pathogenesis of diabetes.3. Danzhi Jiangtang Capsule can reduce the diabetes rats blood glucose, mAlb, SCR,bun, and improved STZ induced diabetic nephropathy rats with protection and reverse diabetic rat kidney disease damage.4. Danzhi Jiangtang Capsule in preventing and treating diabetic nephropathy damage mechanism may be by lowering blood glucose, SCR, BUN,reduce urinary albumin excretion and inhibit the release of inflammatory cytokines, down IL-18 levels and inhibition of Cys C expression, improve the renal pathological damage. |
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