| Objective:To observe the clinical efficacy of Yi Shen Jiang Tang Decoction in the treatment of G3A2-3 Diabetic Nephropathy with deficiency of both qi and yin and blood stasis;and observe the changes of serum allograft inflammatory factor-1(AIF-1)before and after treatment To explore the relationship between AIF-1 and diabetic nephropathy,and the possible mechanism of Yishen Jiangtang Decoction in the treatment of diabetic nephropathy,in order to provide a reference for the clinical application of Yi Shen Jiang Tang Decoction.Methods:The 62 patients with G3A2-3 stage DKD who met the inclusion criteria of this subject were randomly divided into a control group of 31 cases and a test group of 31 cases.The control group was treated with conventional western medicine,and the test group was treated with Yishen Jiangtang Decoction on the basis of the control group.The treatment course of the two groups was 8 weeks.The serum allograft inflammatory factor-1(AIF-1)was observed before and after treatment in the two groups.),C-reactive protein(CRP),glycosylated hemoglobin(Hb Alc),fasting blood glucose(FPG),24 h urine protein quantification(24h UTP),urine albumin/creatinine ratio(ACR),serum creatinine(Scr),estimated glomerulus Changes in filtration rate(e GFR),total cholesterol(TC),triglycerides(TG)and TCM syndrome scores.At the same time,20 healthy people were included as the healthy control group and compared with the relevant laboratory indicators of the DKD group.Results:1.Before treatment,the differences in general data(gender,age,BMI),related laboratory indicators,and TCM syndrome scores of the control group and the test group were not statistically significant(P>0.05),and they were comparable.2.AIF-1 in the DKD group was significantly higher than that in the healthy control group(P<0.01),and there was a significant statistical difference.3.Yi Shen Jiang Tang Decoction combined with conventional western medicine in the treatment of G3A2-3 stage Qi and Yin deficiency and blood stasis type diabetic nephropathy has a total clinical effective rate of 86.67%,compared with 73.33% in the control group.The experimental group is better than the control group,and the difference is statistically significant.Significance(P<0.05);the total effective rate of TCM syndromes in the experimental group was 96.67%,and that in the control group was 83.33%.The experimental group was better than the control group,and there was a statistical difference(P<0.05).The TCM syndrome scores of the two groups were significantly improved compared to before treatment(P<0.01),and the improvement range of the experimental group was better than that of the control group,with significant statistical difference(P<0.01).4.ACR,24 h UTP,AIF-1,CRP,TC,TG and other indicators in the two groups were improved compared to before treatment.The improvement of the experimental group was better than that of the control group,and the difference was significant(P<0.01).5.AIF-1 is positively correlated with ACR,24 h UTP,CRP,Hb A1 c,FPG(P<0.05),partial correlation analysis shows that AIF-1 is more closely related to CRP,24 h UTP,ACR(P<0.01),AIF-1 The relationship with ACR,24 h UTP,and CRP can be expressed by the regression equation as: AIF-1=-70.497+0.096ACR+302.965(24h UTP)+23.775 CRP.The total effect of the three variables on AIF-1 is 91.8%.Conclusion:1.Yi Shen Jiang Tang Decoction combined with conventional western medicine has a significant effect on the treatment of G3A2-3 stage DKD patients with deficiency of both qi and yin and blood stasis.Compared with conventional western medicine,it has a better effect in improving the curative effect of TCM syndromes.2.After treatment,ACR,24 h UTP,AIF-1,CRP,TC and TG in the experimental group were lower than before,suggesting that Yi Shen Jiang Tang Decoction has a certain effect on reducing proteinuria,regulating lipid metabolism and improving micro-inflammatory state.3.AIF-1 is significantly correlated with 24 h UTP,ACR,CRP,or may reflect the early DKD micro-inflammation to a certain extent.4.No obvious side effects of Yi Shen Jiang Tang Decoction combined with conventional western medicine were found in the course of this study in a short period of time.The safety is good,and it can be used in clinical promotion. |
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