Protective Effect Of Yishen Jiedu Tongluo Capsule On The TGF-β1 In Patients With Early Diabetic Nephropathy

Objective:The extracellular regulated protein kinase（extracellular regulated protein kinase,ERK）signal pathway as the starting point,to observe the Yishen Jiedu Tongluo Capsule on early clinical outcome in patients with diabetic nephropathy,and to further investigate its mechanism,study whether can be reduced by TGF-β1,expression,inhibit excessive activation of ERK signal transduction pathway.Delay the progression of renal fibrosis,and thus play a role in renal protection,provide a new method for the early treatment of DN.Methods:This study used a randomized,open,experimental research methods of control.A total of 64 cases included in the sample volume,sample cases were from March 2015 to2016 09 Henan University of traditional Chinese Medicine Second Affiliated Hospital Department of Endocrinology outpatient and ward with three patients with diabetic nephropathy（Qi and yin deficiency two,phlegm heat stasis type）,using random the number table method are selected to meet the inclusion criteria of 64 cases,were randomly divided into control group and treatment group,32 cases in each group.The control group uses the conventional treatment of diabetes;treatment group on the basis of conventional therapy plus Yishen Jiedu Tongluo capsule,a total of 90 days of observation.The detection of two groups before and after treatment in patients with changes of 24HALB,UACR,L-FABP,TGF-β1,p-ERK,and the improvement of Chinese medicine syndrome（integral quantitative form）was used to evaluate the curative effect.Results:1.The basic clinical data:two groups of patients with clinical data were statistically compared between groups in gender,age,disease duration,serum creatinine,fasting blood glucose（FBG）,2 hour postprandial blood glucose（PBG）,glycosylated hemoglobin（HbA₁c）,the quantitative scores of TCM symptoms had no significant difference（P>0.05）.Taking the drug in the differences between the two groups was not statistically significant（P>0.05）,comparable.2.Comparison of the clinical curative effect of two groups of patients before and after treatment.The results showed that treatment group,treatment group total effective rate93.3%,the control group was 73.3%,compared with the difference between the two groups（z=-1.943,P=0.028<0.05）.Comparison of TCM symptom score:two groups after treatment of TCM syndrome integral than before treatment were decreased,there was statistical significant differences（P=0.001<0.05）;the treatment group decreased more significant than the control group,the difference was statistically significant（z=3.126,P=0.002<0.05）.3.Before 24HALB,UACR treatment group two patients,urinary L-FABP was not statistically significant（P>0.05）;the two groups of patients after treatment of 24HALB,UACR,L-FABP and urine before treatment were significantly different（P<0.01）;after24halb treatment,UACR treatment group and the control group with significant difference（P<0.01）.after treatment of urinary L-FABP;trea-tment group compared with the control group（P<0.05）,the difference was statistically significant.4.Two groups of patients before and after treatment p-ERK,TGF-β1 levels:the two groups before and after treatment p-ERK,TGF-β1 levels compared with before treatment were statistically significant（P<0.01）;the two groups after treatment TGF-β1,p-ERK group,tgf-beta 1 level（t=-5.474,P=0.001<0.05）,with statistical significance;the level of p-ERK（t=1.662,P=0.029<0.05）,the difference was statistically significant.5.There was no significant difference in the incidence of adverse events between the two groups（P>0.05）Conclusion:1.Yishen Jiedu Tongluo capsule can obviously improve the clin-ical symptoms of patients with diabetic nephropathy（Qi deficiency and yin deficiency,phlegm heat and blood stasis type）2.Yishen Jiedu Tongluo capsule can effectively reduce the level of 24halb,UACR and urinary L-FABP in patients with DN,indicating that it can protect the renal function of early DN3.The Yishen Jiedu Tongluo capsule can reduce the serum DN in patients with early TGF-β1,the expression level of p-ERK,suggesting that it may be through inhibition of ERK signal transduction pathway,and then inhibit the renal fibrosis,delaying the progression of diabetic nephropathy.