Clinical Study Of Gualou Qumai Decoction On DKD And Its Effect On AGEs In DKD Model Rat

Diabetic kidney disease(DKD)is a secondary renal microangiopathy caused by diabetes.It is a serious diabetic complication characterized by glomerulosclerosis.Recently,the inflammatory response and oxidative stress mechanisms in DKD patients have become the research hotspots of DKD pathogenesis,and the correlation between the advanced glycosylation end products(AGEs)and the pathogenesis of DKD has has drawn increasing attention.Through previous experiments,we found that Gualou Qumai Decoction(GLQM)can effectively improve the pathological changes of kidney in DKD rats.This study is based on the theory of traditional Chinese medicine and the ancient book of"HuangDiNeiJing".It starts from two parts of clinical research and experimental research.By observing the clinical efficacy of Gualou Qumai Decoction and the effects of advanced glycation end products in model rats.To explore the possible mechanisms of inflammation and oxidative stress.In order to better understand the target of Gualou Qumai Decoction in the intervention of DKD and delay the pathological process of DKD.Clinical study:Clinical study of Gualou Decoction for Diabetic Kidney DiseaseObjectives:1.To observe the general conditibns of patients with type 2 diabetic kidney disease,fasting plasma glucose,glycated hemoglobin,serum creatinine,blood urea nitrogen,microm-albumin,and blood lipids.To explore its clinical efficacy and safety analysis.2.To observe the effect of Gualou Qumai Decoction on TCM syndromes of DKD patients,observe its effects and characteristics on different types of TCM.Explore the related laws.Methods:A total of 60 DKD patients from Baoying County Hospital of Traditional Chinese Medicine were collected and randomly divided into treatment group and control group.The control group received health education,diet control,and routine clinical treatment.Based on the control group,the treatment group was given Gualou Qumai Decoction twice a day,150ml each time,4 weeks is a course of treatment,taking 3 courses in total.Observe changes in related indicators and TCM syndromes before and after treatment,record data and analyze statistically.Observe its clinical effect.Results:1.There was no significant difference between the two groups of patients before treatment,including gender,age,duration of diabetes,duration and range of blood glucose control(P>0.05).2.TCM Syndrome points show that the Gualou Qumai Decoction can effectively improve the TCM syndromes of patients,especially the improvement of symptoms such as thirst and heavy drinking,increased nocturia at night and afraid of cold conditions,which are statistically significant(P<0.05).3.After treatment,the hemoglobin and blood lipids in the two groups changed to different degrees before treatment.Compared with the control group,the four levels of blood lipid reduction in the treatment group were statistically significant(P<0.05).4.The fasting blood glucose,glycated hemoglobin,blood creatinine,and urine microalbumin in both groups decreased to varying degrees compared with before treatment,with a significant difference(P<0.05).Compared with the control group,the decrease of blood creatinine and urine microalbumin in the treatment group were statistically significant(P<0.05).5.The clinical efficacy showed that the total effective rate of the treatment group was 76.67%,and the total effective rate of the control group was 43.36%.The curative effect of the treatment group was better than the control group,and the difference was statistically significant(P<0.05).6.There were no serious adverse events during the test,and the safety of the test was good.Conclusions:Taking Gualou Qumai Decoction according to the course of treatment can effectively reduce the serum creatinine and microalbuminuria in patients with DKD,and improve the TCM syndromes such as thirst and heavy drinking,increased nocturia at night and afraid of cold conditions,and delay the course of DKD and improve the quality of life of patients.The Gualou Qumai Decoction is safe.Experimental Study:Effect of Gualou Qumai Decoction on AGEs in Diabetic Kidney Disease Model RatsObjectives:1.To observe the unilateral nephrectomy combined with injection of streptozotocin to replicate the DKD rat model.2.To observe the changes in general conditions such as body weight and fasting blood glucose of rats.To observe the effect of Gualou Qumai Decoction on serum AGEs and RAGEs in kidney tissue of model rats.3.To explore the inflammatory mechanism of Gualou Qumai Decoction in diabetic kidney disease,To provide more theoretical and experimental basis for clinical prevention and treatment of diabetic kidney disease.Methods:85 male SPF SD rats were selected,and 80 were randomly selected for DKD modeling.The rats were divided into normal group,model group,Gualou Qumai high-dose group,GLQM middle-dose group,GLQM low-dose group and positive drug(valsartan)group by random number method,and were treated with corresponding drugs.After 12 weeks of treatment,observe the general condition of DKD rats such as body weight and fasting blood glucose.The content of AGEs in serum and RAGEs in renal cortex were detected,and the results of different groups were analyzed and compared.Results:1.Rats in the normal group had no change in fasting blood glucose before the experiment,and the weight gain was consistent with the age of the week.In the model group,the body weight decreased significantly,the fasting blood glucose continued to increase,urine increased,and some rats were accompanied by severe ocular albinism.2.Compared with the model group,each treatment group showed different degrees of symptom relief.Among them,the weight and blood glucose status of the GLQM-H group was significantly improved.The GLQM-H group was better than the valsartan group,P<0.05.3.The content of AGEs in the normal group was the lowest and the content in the model group was the highest.Serum AGEs in each treatment group were significantly lower than the model group,P<0.05.The content of GLQM-H group was significantly lower than that of other treatment groups,the difference was statistically significant,P<0.05.4.The content of RAGEs in kidney tissue of normal group was the lowest,and that of model group was the highest.The content of GLQM-H and GLQM-M dose groups was significantly lower than that of other treatment groups,and there was a certain correlation in the GLQM groups.Conclusions:1.Unilateral nephrectomy combined with injection of streptozotocin can effectively replicate the DKD rat model.2.Gualou Qumai Decoction can improve the symptoms of diabetic nephropathy rats,and the GLQM-H dose group have more significant effects than the GLQM-M and GLQM-L dose groups.3.Gualou Qumai Decoction can effectively reduce the serum AGEs in DKD model rats.In addition,Gualou Qumai Decoction can effectively reduce the RAGEs in kidney tissues.It may delay the development of the disease by inhibiting ages-rage and reduce the mortality of rats.