| Diabetic nephropathy(DN) is one of the chronic complications of diabetes mellitus(DM) and the common reason leading to chronic renal failure ,one third of which is caused by DN. Systematic research on prevention and treatment of DN by TangKeJianJi (TangKe decoction) has been performed from the whole ,organ, cell and molecule levels in this essay which was composed of the reference review and experimental study.1. Theory reviewThe theoretical review including five sections mainly discussed the recent research progresses in prevention and treatment of DN both from the aspects of traditional Chinese medicine (TCM) and modern medicine. In detail, the five sections were made up of the skeleton review of TCM and modern medicine on DN, the relationship between transforming growth factor-P (TGF- β ) , transforming growth factor- P receptor (TGF- βR) and DN , the relationship between apoptosis and DN. In the theoretical research, we have referred to the related ancient and modern TCM literature in order to explore the source of disease name of TCM for DN, etiology and pathogenesis of TCM, selection of therapeutic methods by different stages or according to the differential syndrome diagnosis, advance on the clinical and experimental research as well as the problems lying in the research of TCM and corresponding strategies. In the meanwhile ,we also have summarized the tutor's ( professor Li Jingling) academic point of view on the differentiation and treatment of DN, moreover further exploited the pathologic characteristics ,pathogenesis , pathologic stages and treatment of DN as well as the function of TGF- P and apoptosis on DN.2. Experimental studyThe experimental rat models at first were fed by a diet enriched with sucrose ,cholesterol and cholic acid for a month in order to induce the models' obesity and result in insulin resistance, and then injected the low dosage of 35mg/kg streptozotocin(STZ) through vein of the rat's tail to develop hyperglycemia. This kind of model closely simulated the metabolic abnormalities of the human type 2 diabetes mellitus and its renal structural lesion with microalbuminuria, mild mesangial matrix expansion, thickening of glomerular basement membrane and so on. The experimental rats were randomly divided into 6 groups: normal contrast group, pattern group, prevention group, high dosage group, low dosage group and Lotension group. Drug was delivered daily by gavage for 8 weeks in the therapeutic groups except for the prevention group for 12 weeks. We have detected, BUN, Scr, hemoglobin Aic (HbAic), body weight, kidney weight, urinary albumin excretion (UAE) and renal pathologic lesion through light microscopy and electron microscopy and further observed mRNA and protein expression of TGF- β 1, TGF- β R, Collagen IV and fibronection through RT-PCR, western blot and immunohistochemistry methods to investigate the effects of TangKe decoction on the experimental rat models of DN. The results showed that TangKe decoction possessed the following functions: (1)decreasing blood glucose (BG), ameliorating glucose and lipid metabolic disorders, improving nonenzymatic glycation, attenuating urinary albumin excretion and protecting renal function. (2)ameliorating glomerular hypertrophy, mesangial matrix expansion and thickening of glomerular basement membrane.(3)inhibitingmRNA and protein expression of TGF-3 i, TGF-P R, Collagen IV and fibronection and synthesis of extracellular matrix(ECM),decreasing abnomal accumulation of ECM and preventing the glomerular sclerosis.It has been reported that the number of apoptotic cells increased obviously in the renal cortex of the DN rats and glomerular apoptosis was concerned with deterioration of renal function. Apdptotic cells in renal cortex were evaluated by terminal-deoxynucleotidyl transferase mediated d-UTP nick end labeling (TUNEL) and the protein expression of BAX and BCL-2 relating to apoptosis was detected by means of immunohistochemistry to investigate the effects of bax and bcl-2 on DN as well as the influence of them on apoptosis. The e...
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