| Diabetic nephropathy (DN) is the familiar syndrome of DM and it is themain season of the DM patients death. With the improvement of modern people living, the incidence of DN is rising year by year and will become the leading causeof ESRD in the future 20 years. So how to treat and prevent the DN effectively is becoming the common concerned problem among international researcher. The pathogenesis of DN is still not very clear today. Western medicine still was short of perfect treatment measure. So it will be a concerned hotspot to explore efective treatment actively by the way of traditional chinese midicine (TCM). Although people has made some achievement in reporting the clinic curative effect observation and experience about treating DN with TCM and their some related curative mechanism researching, they are still far from making clear of complicated mechanism of TCM, especially for compound, in treating DN. The pathogenesis of DN is very complicated and involves many factors, which can act independently or interact each other resulting in the incidence of DN.Objective:We observed systematically curative effect of preventing and treating diabetic nephropathy(DN) by modified Zhenwu decoction through clinical and experiment researches. We inquired into mechanism of traditional Chinese medicine(TCM) on DN and mechanism of modified Zhenwu decoction on preventing and treating DN.Methods:1,Theoretical Research: consulting the traditional Chinese medicine literature records on DN, make research to source,name,etiopathogenisis,pathogenesis,clinical treatment,experiment researches of DN.2,Clinical researches:75 patients with overt DN were randomly divided into treatment group of modified Zhenwu decoction and contrast group of Captopril. After 8 weeks, we observed two groups the index of fasting blood glucose(FBG),blood glucose post breakfast, glycosylated hemoglobin, excretion rate of.the 24h uric protein and albumin, creatinine clearance rate(Ccr),serum creatinine(SCr),blood urea nitrogen(BUN),cholesterol (TC),triglyceride(TG), blood pressure and the change of clinical symptom.3,Experiment researche: The rat models were established by the abdominal injection of streptozotocin. STZ-induced diabetic rats were divided randomly into normal control group, diabetic control group, positive control group (DM+ Captopril), Chinese herbal group (DM+ modified Zhenwu Decotion).The course of treatment lasted 8 weeks. The rats general status(psychosis, diet, hair color weight amplitude, etc), blood glucose, glycosylated hemoglobin (HbAlc), excretion rate of the 24h uric protein and albumin, UAER, serum creatinine (Scr), blood urea nitrogen(BUN), renal weight/body weight ratio, serum lipid(total holesterol, triglyceride) were monitored. The renal pathological lesions were also investigated with opticalmicroscope and electron microscope.Results:1,DN is relate to Shenxiao of Xiaokou TCM. From of old, many doctors think it was due to weakness of lung, spleen and kidney. Its basic mechanism of TCM is Yinxuzaore. Based on lots of research on document and advisor's clinic experience, it was thinked that the important pathogenesis of overt DN was deficiency of spleen and kidney, as well as phlegmatichygrosis,turbid poison and blood stasis appearing in the whole process of DN. So the major treatment principle should be strengthening qi and warming yang, and the secondary treatment principle should be removing the stasis and detoxication, promoting blood circulation and clear water. Classical prescription—modified Zhenwu decoction is be choosed to treat this disease.2,Modified Zhenwu decoction-treated groups total ratio of efective is 86.84%, Captopril-treated group is 64.86%.Compared with twogroups, Modified Zhenwu decoction-treated group is obviously excel to Captopril(P<0.05).Modified Zhenwu decoction can obviously improve clinical symptom of patients with overt DN, reduce FBG,PBG,HbAlc,Ccr,Scr,BUN, improve the index of TC,TG,blood pressure and so on.3,The model rats blood glucose are exceed to 16.7mmol/L. Scr,Bun,Upro and renal weight/body weight ratio were increasing than normal control group. Their symptom are energy cachexia, slowness reaction, slow action, hair stand and lackluster, their back arch and body crouch, urinate anifold, eating water and food increase. Renal slices can be seen a majority of glomerulus increasing, swelling, GBM incrassation, part of glomerulus MC hyperplasia, mesangial width increasing, cell hypertrophy and vacuole denaturalization in tubulo. Modified Zhenwu Decotion was better for the rats' general condition and had a certain effect on reducing blood sugar. Besides it could decrease the experimental rats' higher secrum blood urea nitrogen, creatinine, creatinine clearance, urinary protein amounts in 24h,and ameliorate pathologic change of nephridial tissue in experimental diabetic rats obviously by light microscope and electron microscope.Conclusion:1,Modified Zhenwu Decotion has better function of therapy and protection to the overt DN patients in the clinic. It can improve clinical symptoms, protect renal function, reduce protein of urine, improve blood fats level and lower blood pressure of Diabetic Nephropathy of lesser yin disease. It also defer and prevent the development and depravation of Diabetic Nephropathy. As is shown above, Traditional Chinese Medicine has a preferable advantage in treating Diabetic Nephropathy.2,Modified Zhenwu Decotion was benefit for regulating glucose and lipid metabolism, and inhibiting renal hypertrophy and high filtration of renal glomerulus, reducing the urinary protein excretion, improving renal funcition, safeguard the diabetic kidney.
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