Based On Microinflammation, The Study Of The Mechanism Of Qidi Tangshen Granules In Reducing The Proteinuria Of Diabetic Nephropathy

Objective1 Experimental partThere is no effective treatment for diabetic nephropathy.Proteinuria is an important factor in the development of diabetic nephropathy(DN).The clinical observation of the clinical observation of Qi di tang shen particles can significantly reduce the urinary protein level of diabetic nephropathy.More and more studies have shown that diabetic nephropathy is associated with microinflammation.In this study,we investigated the mechanism of lowering the urinary protein level of diabetic nephropathy from microinflamrnation(TNF alpha,il-6,il-18,CRP).2 Clinical partThrough the clinical observation of diabetic nephropathy patients inflammation levels,study of diabetic nephropathy micro inflammation in patients with diabetes has increased,and its relationship with the syndrome,and lay a foundation for further clinical intervention.Method1 The experimental partThe model of type 1 diabetic rats was made by single intraperitoneal injection of STZ 55mg/kg.The successful rats were randomly divided into six groups,namely,the control group,the model group,the high,medium and low dose group,and the western medicine valsartan group.Rats in each group were kept in cages,fed freely,and fed on the same volume as their weight.The model group and the normal control group were given equal dose of carboxymethyl cellulose(CMC).In the high,medium and low dose group,CMC was used to prepare three different concentrations of the drug in the concentration of 5.24g/kg,2.62g/kg weight and 1.31g/kg.The group was given a weight of 8mg/kg for 12 weeks.Blood glucose and weight were detected in 0,2,4,6,8,10 and 12 weeks.24h urine was collected from rats before and after administration for 24h urine.At the end of the 12th weekend,we tested the blood creatinine(Scr),triglyceride(TG),cholesterol(CHO),alanine aminotransferase(ALT),and AST.The pathological changes of renal tubules and interstitial lesions were observed in the Masson staining light microscope.Western-Blot method was used to detect the expression of TNF,il-6,il-18 and serum CRP in rat kidney.2 Clinical partRelying on the topic "diabetic nephropathy early decision tree establishment and validation of predictive diagnostics"(project number:JD2X2015305)into the group of 57 patients with diabetes diagnosis standard,collect into a group of patients with general information and the physical and chemical as a result,according to the TCM syndrome factor differentiation table will patients with TCM syndrome factor differentiation,according to the urine trace albumin/uric creatinine(ACR)into the group of patients can be divided into pure diabetes mellitus(DM)and diabetic kidney disease(DKD)groups,patients with Elisa method to detect the serum TNF alpha,IL-6,IL-18,CRP expression level.The differences of general data and serum TNF,il-6,il-18 and CRP expression levels were compared between DM group and DKD group.To investigate the correlation between the expression levels of TNF,il-6,il-18 and CRP in patients with kidney deficiency,phlegm and blood stasis.Results1 Experimental part1.1 The rat urine protein quantitative aspects of model group significantly higher than normal group(P<0.01)suggested building success,13 weeks Chinese medicine high dose,middle dose group of urine protein decreased significantly in the model group(P<0.01),suggesting the traditional Chinese medicine has obvious therapeutic effect on diabetic nephropathy rats model,and the effect of high dose group was obviously better than that of valsartan(P<0.05).1.2 In terms of inflammatory cytokines,model group significantly increased the inflammation factor in the normal group(P<0.05),Chinese medicine group is better than CRP in the model group(P<0.01),dose group of TNF a have significantly decreased in the model group(P<0.05),IL-6,IL-18,TNF a three indicators not seen obviously improved.Valsartan group and dose of IL-6 levels lower in the model group was statistically significant(P<0.05),middle dose group and low dose group of IL-18 levels significantly lower compared with model group,the dose group of TNF a level decreased significantly in the model group.2 Clinical part2.1 Compared with diabetes group,diabetic nephropathy group of Ccr value comparison was statistically significant(P<0.05),glycosylated hemoglobin,fasting blood glucose,serum creatinine,blood urea nitrogen,triglycerides,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol is no statistical difference(P>0.05).2.2 Compared with diabetes group,diabetic nephropathy group of interleukin 6 is a statistically significant(P<0.05),interleukin,tumor necrosis factor 18 α is no statistical difference(P>0.05).2.3 In all(including diabetes kidney disease)patients with diabetes,IL-6,IL-18,TNF α,CRP respectively with kidney Yang deficiency,kidney deficiency,kidney deficiency,damp and hot,blood stasis and phlegm retention scores related inspection,found that IL-18 scores were positively correlated with the hot and humid,difference have statistical significance;TNF α scores were positively correlated with hot and humid,difference is statistically significant.In patients with simple diabetic nephropathy,there was no significant correlation between inflammatory markers and TCM syndrome scores.Conclusion1 The experiment part"Tip" Qi di tang shen particles on diabetic nephropathy rats model has the effect of significantly lower the urine protein,at the same time,the micro level of inflammation also has a certain degree of improvement,therefore,Qi di tang shen particles improve the role of diabetic nephropathy urine protein may be associated with inflammation by improving the micro levels.2 The clinical partCompared with diabetic patients,diabetic nephropathy patients had higher levels of microinflammation.Correlation analysis showed that the level of microinflammation was related to the deficiency of TCM and dampness and heat.