| Objective:To investigate the therapeutic mechanism of Tangshenkang Granule on patients with blood stasis syndrome of Qi and Yin deficiency in diabetic kidney disease(DKD)by observing the clinical efficacy of Tangshenkang Granule on patients with blood stasis syndrome of Qi and Yin deficiency in diabetic kidney disease(DKD)and the intervention effect on Blood mononuclear cells Bcl-2 and Bax,and to further provide clinical basis for the prevention and therapy of DKD by orthodox Chinese medicine.Methods:Seventy subjects who met the level of DKD ailment of Qi and Yin deficiency and blood stasis were capriciously divorced into therapeutics set and contrast set with35 illustrations in each set.Moreover,10 typical The crowd were selected as the ordinary set.Among them,the ordinary control set was given ordinary life style intervention and western medicine essential therapy,In the therapy set,Tangshenkang granules were added on the basis of lifestyle intervention and essential therapy of western medicine.The allusion of Tang shenkang is 10 g per bag;Usage: 1 bag/this,3times/day,rinse with warm boiling water.The vicissitude of TCM malady inventory,Urinary albumin/urinary creatinine ratio(UACR),24-hour urinary protein ration(24h Upro),renal performance,blood glucose,Blood mononuclear cells Bcl-2 and Bax were recorded before and after therapy in therapy set and control set.In the ordinary set,we only detected the Blood mononuclear cells Bcl-2 and Bax in the ordinary population.Results:1.Efficacy of the disease:the therapy group and the control group were 82.86%and 57.14% respectively,and there was a meaningful discrepancy in efficacy between the both sets(P<0.05).2.Therapeutic effect of TCM syndromes: 88.57% in the therapy set and 62.86% in the control set respectively,and there was meaningful discrepancy between the both sets(P<0.05).3.TCM syndrome scores:Before therapy,there was no meaningful amendment between both passel(P>0.05);Following therapy,both sets were tremendously subtracts(P<0.05 and P<0.01);The moderation of the point valuation worth in the therapy set was noticeably superior than that in the control set(P<0.01).4.UACR and 24 h UPR:Before therapy,the nuance between the both sets was not evident and not statistically meaningful(P>0.05);after therapy,both sets were meaningful reduced(P<0.05 and P<0.01),and the decrease in the therapy set was taller than that in the matched set,showing a clear advantage(P<0.01).5.Serum creatinine(SCR),glomerular filtration rate(EGFR),fasting blood glucose(FPG),and 2h postprandial blood glucose(2HPBG):Before therapy,among were no meaningful disparity in the above indexes between 2 sets(P>0.05);There were no meaningful modification in the above indexes in 2 sets after therapy(P>0.05).6.Blood mononuclear cells Bcl-2 and Bax: Measured up against the ordinary set,blood mononuclear cells Bcl-2 was meaningful reduce(P<0.01),and Bax was pronounced ascend(P<0.01),in the 2 sets before therapy,while there was no meaningful disparity between the 2 sets(P>0.05).After therapy,Blood mononuclear cells Bcl-2 was pronouncedly ascend(P<0.05 and P<0.01),while bax was meaningfully diminsihed in2 sets.(P<0.05 and P < 0.01)7.Safety indicators: Subjects in the therapy set had no distinct adverse reactions after therapy,and there were no obvious changes in blood routine,stool routine,alanine aminotransferase(ALT),electrocardiogram and other items from before therapy.Conclusion:1.Tangshenkang granules can meaningfully assuage the clinical pathology of DKD subjects and reduce urinary protein.2.Blood mononuclear cells Bax in DKD subjects was meaningfully taller than that in healthy subjects,while Bcl-2 was meaningfully lower than that in healthy subjects,which probably is one of The onset of principle of DKD.3.Tangshenkang granules can meaningfully decay the expression level of blood mononuclear cells Bax and increase the expression level of Bcl-2 in patients with blood stasis syndrome of Qi and Yin deficiency in DKD,which may be one of the means of Tangshenkang crumb intervention in the therapy of DKD.Objective:To observe the regulatory effect of Tangshenkang granules on B-cell lymphoma-2(Bcl-2)and Bcl2-associated X Protein(Bax)in the kidney of rats with diabetic kidney disease(DKD),to further clarify the mechanism of the therapeutic effect of Tangshenkang granules on DKD,and to provide evidence for its clinical application.Methods:Forty adult SD rats were erratically assigned into 4 sets,containing natural set(n=10),model set(n=10),Tangshenkang group(n=10)and valsartan group(n=10).Except for the normal group,the remaining 30 rats underwent surgery to remove the single kidney,and were fed with high sugar and high fat diet and prepared with streptozotocin(STZ)method to develop DKD model.After building the model prosperously,they were erratically assigned into model set,valsartan group and Tangshenkang group.Tangshenkang group was given Tangshenkang granules aqueous solution by gavage.Valsartan group was given valsartan capsule suspension by gavage.Rats in the Tangshenkang group and the Valsartan group were given the drug on the first day after the successful establishment of the DKD model,and the normal set and the model set were given the same amount of normal saline intragastric administration.Duration of administration was 8 weeks.The urinary albumin/urinary creatinine ratio(UACR),24-hour urinary protein quantification(24h Upro),serum creatinine(Scr)and urea nitrogen(BUN)were determined.The expression levels of Bcl-2and Bax in renal tissues were detected by Western blot.The pathological histology discriminate of kidney in each set were remarked under electron microscope.Results: 1.contrast of UACR and 24 h Upro: Contrast with the normal set,the model set was meaningfully higher,showing a meaningful difference(P<0.01);Contrast with model set,both valsartan set and Tangshenkang set were diminsihed,and thediscrepancy were meaningful(P<0.01);There was no meaningful discrepancy between Tangshenkang set and valsartan set(P>0.05).2.Comparison of BUN and SCR: there was no meaningful discrepancy among all sets(P>0.05).3.The expression of Bcl-2 and Bax in renal tissues(Western blot): Contrast with the normal set,Bcl-2 was decreased and Bax was increased in the model set,with meaningful discrepancy(P<0.01);Contrast with model set,the expression of Bax in kidney tissues of Tangshenkang set and Valsartan set was meaningfully diminished,while Bcl-2 was meaningfully increased,with meaningful discrepancy(P<0.01).There was no meaningful discrepancy between Tangshenkang set and valsartan set(P>0.05).4.The differences between the 4 sets were pathologic discrepancy:(1)The gross observation of kidney tissue: the left kidney of ordinary set was dark red with no obvious abnormality in size.The solidity of left kidney in model set was meaningfully bigger.Tangshenkang set and valsartan set were both larger than ordinaryl set,but smaller than model set.(2)Electron microscopy: Contrast with the normal set,GBM in the model set was meaningfully thickened,and the foot processes were fused or even disappeared.GBM was slightly thickened in the Tangshenkang set and the Valsartan set,and the foot process was slightly fused,Contrast with the duplicate set,the pathological modification were meaningfully diminished.There was no meaningful discrepancy between the Tangshenkang set and the Valsartan set.GBM was slightly thickened and the foot process was slightly fused in the two sets Contrast with the ordinary set.Conclusion:1.Tangshenkang can significantly improve the quality of life of DKD.rats and reduce the.levels of UACR and urinary protein in DKD rats.2.The standard of Bcl-2 protein in kidney texture of DKD rats was meaningfully lower than that of ordinary set,while the level of Bax protein was meaningfully taller than that of ordinary set,indicating that Bcl-2 and Bax were involved in the pathogenesis of DKD.3.Tangshenkang granules can significantly increase the protein expression of Bcl-2 and decrease the protein expression of Bax in renal tissues,which may be one of the mechanisms of Tangshenkang granules in the therapy of DKD.4.Tangshen.kang granules can improve renal pathological manifestations in DKD rats. |
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