Curative Effect Observation Of Chen’s Yishen Jianpi Decoction On Diabetic Kidney Disease (CKD Stage 2) With Spleen-kidney Qi Deficiency And Its Effect On Serum AGEs

ObjectiveThis study observes the clinical curative effect of Chen’s Yishen Jianpi decoction of spleen-kidney Qi deficiency in patients with diabetic kidney disease(CKD stage2),and changes of advanced glycation end product(AGEs)and urinary protein quantity before and after treatment.The study also explores the possible mechanism of Chen’s Yishen Jianpi decoction in trervening early diabetic kidney disease.Methods76 patients with diabetic kidney disease(CKD stage2)who met the inclusion criteria of both Chinese and Western medicine were enrolled,and randomly divided into control group(n=38)and test group(n=38).The control group was treated with conventional western medicine,and the test group were treated with Chen’s Yi Shen Jian Pi decoction combined with conventional western medicine.The course of treatment in both groups was 8 weeks.Then,the changes of TCM syndrome and clinical symptoms before and after treatment in each group were observed and the changes of serum AGEs,urine microalbumin/creatinine,24-hour urinary protein quantity and renal function were compared before and after treatment.Results were analyzed by SPSS.Results1.After statistic treatment,general data from both groups of patients before treatment including gender,age,course of diabetes,observing index and TCM symptoms scores,was not statistically different(P>0.05).2.After treatment,the UACR,24 hUP,Scr,TC,TG,LDL-C in two groups decreased while eGFR increased,which represented significant statistical difference(P<0.01),and the therapeutic effect on the test group was better than that of the control group in reducing UACR,24 hUP,Scr,TC,TG,LDL-C,but there was no significant difference in the increase of eGFR between two groups(P>0.05).3.The levels of serum AGEs in the two groups were significantly higher than those in the healthy group(P<0.01).After treatment,the serum AGEs levels in two groups were significantly decreased(P<0.05),and the effect on test group was superior to the control group(P<0.05).4.AGEs’ correlation with other observing index: serum AGEs has a positive correlation with 24 hUP,UACR,SCR(P<0.01),which meanwhile has a negative correlation with eGFR(P<0.01).5.The total effective rate of TCM syndrome in test group and control group were 91.66% and 69.44% respectively.Compared with the control group,the curative effect of the treatment group was significant,and the difference was significant(P<0.01).6.The total effective rates of test group and control group were 86.11% and 66.66%,respectively.There was a significant difference between the two groups(P<0.05).Conclusion1.Chen’s Yishen Jianpi decoction combined with western medicine has a significant curative effect on patients with diabetic kidney disease(CKD stage2),can improve their symptoms better than only using western medicine.2.After treatment,the blood lipid,urinary protein level and renal function of the two groups were all improved,and the improvement of the test group was superior to the control group,suggesting that Chen’s Yishen Jianpi decoction could regulate the lipid metabolism disorder and reduce the excretion of urine protein as well as protect renal function in a certain extent.3.The level of serum AGEs in patients with diabetic nephropathy has a positive correlation with renal function.suggesting that the inhibition in formation of AGEs may improve renal function and delay the progression of DKD.It can also be used to evaluate the damage of renal function in early stage.4.After treatment,the level of serum AGEs in the test group was lower than that in the control group.Which suggests that Chen’s Yishen Jianpi decoction could adjust immunity and down-regulate the expression of AGEs in the kidney by interfering with the glycosylation process of protein,then reduce the damage of renal tissue and the excretion of urine protein,as well as improve renal function.