The Clinical And Empirical Study Of TangShenFang Particles Reverse The Kidney-Impaired On Early-Stage Diabetic Nephropathy

ObjectiveTo investigate the effects of TangShenFang particles reversing the kidney-Impaired in Early-Stage Diabetic Nephropathy,especially,To observe the change of uro-21-NAG,renal cortex-NAG,expression of nephrin protein and glomerular basement membrane(GBM),podocyte,and to explore its therapeutic mechanism.Methods1,In clinical research,96 cases of patients with early-stage DN,were selected and randomly divided into treating group(n=48)and control group(n=48).2 groups were given the same basal treatment including education course for diabetes,diabetic diet,and hypoglycemic and hypotension agent in routine.Patients in the control group attended to the Captopril(25mg, per os),twice a day.And to those in the treating group,TangShenFang GRN was given 2 sackes in twice a day.After 8 week' s treatment,the curative effect and Chinese medical syndromes were observed.Moreover,fasting blood glucose(FBG),post-prandial 2-hour blood glucose(P2hBG),mALB and 24hUpro(24-hour urine protein),CRE,BUN,Ccr,uro-21-NAG were measured and compared before and after treatment.2.In experimental study,SPF male Sprague Dawley(SD)rats were selected, The diabetic model rats were made by a single intraperitoneal injection of 55mg/kg streptozotocin(STZ).The rats were randomly assigned to two sets: The DN early intervention group(the next day after being model)and The DN late intervention group(two-week after being model).Two sets were same randomly assigned to normal group,model(early-stage DN)group,western medicine(WM)group with Captopril and traditional Chinese medicine(TCM)group with TangShenFang GRN low dose and high dose.The course of treatment lasted 8 weeks.The rats general status(psychosis,diet,hair color,weight amplitude, etc),renal weight/body weight ratio,blood glucose and 24hUpro,CRE,BUN,uro-NAG and cortex renis-NAG by ultraviolet spectrophotometry,expression of nephrin by immunohistochemicl staining and GBM podocyte were measured electron microscopy.Results1.Based on controlling the blood glucose availability,the total ratio of effective of TCM group was 58.33%,western medicine group is 47.92%(P＞0.05). The total effective ratio of traditional Chinese medicine syndrome of TCM group was 91.67%,western medicine group is(54.17%)(P＜0.05).The clinical symptom score,FBG,P2hBG,24hUpro,mALB,Ccr,uro-NAG reduced in both groups.Compared with two groups,TCM group is obviously excel to western medicine group in the clinical symptom score,FBG,P2hBG,CRE(P＜0.05).There are no toxicity and side-effect in tow groups.2.The normal control group rats' mental state is Well,reaction sensitiveness,color pattern burnish,food intake common.The model and treatment groups rats' symptoms are energy cachexia,drinking water increased, urinate manifold and loose stool,lowness reaction,slow action,hair stand and lackluster.With advancement,above appearance gradually improved, treatment groups are obviously excel to the model group.the body weight of normal group increased obviously(P＜0.05);The body weight of model and treatment group was relieved obviously(P＜0.05)after model,but,with the progress of intervention and course of disease,gradually increased.non-significant difference compared between groups.The kidney weight and Ratio of kidney weight(KW)to Body weight(BW)and blood glucose were non-significant difference compared between groups.But the blood glucose of post-treatment was relieved obviously(P＜0.05)compared with pretherapy.uro-NAG increased obviously in model group compared with the rests,but, in cortex renis-NAG,there was no marked change.Compared with MD,KO group and with pretherapy.The 24hupro of post-treatment was relieved obviously P＜0.05.Compared with the rest groups,expression of nephrin and glomerular basement membrane(GBM)podocyte of KI group was relieved obviously P＜0.05; and there was no marked change between TNI,TGO,TNO and ND groups,but,compared with TGI,MD and KO,there was obvious decrease.TEM(Transmission Electron microscope)showed rats glomerular vascular loop,the basement membrane and the Podocyte were improved in different degrees after treatment by each TangShenFang particles group;Captopril groups was no obvious improvement,or even add to the performance, especially in the late Captopril intervention.Conclusions:1,There is the close correlation of Diseases- syndrome among ShaoYin disease-yang asthenia syndrome and diabetic nephropathy.2,TangShenFang particles can significantly improve the clinical symptoms and the quality of life,Delay or reverse kidney damage of patients of Early-Stage Diabetic Nephropathy patients.3,There are no toxicity and side-effect about TangShenFang particles.it can be safety used in clinical4,Experimental studies show that TangShenFang particles is well able to adjust DN abnormal expression of nephrin,to be closer to the normal control group Both early and advanced applications,but it also suggests that in the early large doses can not be applied.5,TangShenFang particles can significantly improve in the DN proteinuria. There was no significant difference on early intervention among TangShenFang particles and Captopril,on the late intervention TangShenFang particles is better than Captopril.6,the NAG of Rat' s urine and renal cortex is adjusted by TangShenFang particles,so that it is closer to normal,with the protection of tubular, and thus play a role in the protection of kidney function7,TangShenFang particles can downturn and protect early renal damage By improving the changes of the DN Rat' s GBM and Podocyte.To sum up,TangShenFang particles has full protection of renal function through the impact of the DN rat glomerular nephrin expression,rat urine and renal cortex of the NAG adjustments,such as the reduction of proteinuria and improving the changes of GBM and Podocyte.