| Objective:Diabetic nephropathy (DN) is the most common complications of DM, diabetes is one of the major causes of death in patients with DN in Chinese patients with end-stage renal failure in recent years has risen to 15%. in recent years with the high living standard DN has the tend on the increase. Glomerular sclerosis is the micro-vascular complications of DN and the progression of the disease leading to renal failure. The incidence of diabetes have been proposed theory is considered inflammatory etiology and pathogenesis of DM significant progress, inflammation can lead to DN, and DN progress in the whole process played an important role in the anti-inflammatory treatment is expected to be slow progress by one of the effective methods to chronic DN. In this study, Chinese medicine theory, to explore the tonificating qi and nourishing yin, removing blood stasis of Chinese medicine (kang shen fang) the clinical efficacy of treatment of DN and DN were observed on serum levels of high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNFα), interleukin-6 (IL-6) and other effects, aiming to find an effective prescription treatment of DN and the Chinese medicine in prevention and treatment of DN to provide ideas.Methods:A randomized, controlled the principle of inclusion criteria to 45 patients according to DN in patients with a 2:1 ratio were randomly divided into treatment group 30 cases and control group 15 cases. Two groups correspondingly control of blood glucose, blood pressure, blood fat, high-quality low-protein diet, correcting water, electrolyte, acid-base balance disorders, prevention treatment of complicated infections. On this basis, the treatment group use of tonificating qi and nourishing yin, removing blood stasis and regeneration promoting of Chinese medicine (kang shen fang) (Astragalus memeranaceus(Fisch), Pseudostellaria heterophylla(Miq), zea mays L each one 30 gram, Morus alba L 20 gram, Angelica sinensis (Oliv) Diels 10 gram, Scrophularia ningpoensis Hemsl 15 gram, Ligusticum chuanxiong Hort 10 gram, Rheum palmatum L 6～10 gram, Cordycep sinensis 3 gram) to treat. Decoction of the medicine in water,2 times oral, every day. Two groups were treated for 08 weeks. Observed clinical effects and changes in clinical symptom score, fasting blood glucose (FBG) testing before and after treatment, renal function (BUN, Cr), lipids (Chol, TG),24-hour urine protein, serum TNFα, IL-6, hs-CRP of change.Results:1.The symptom scores after treatment compared with before treatment significantly decreased, the difference was significant (P<0.01), showed that two groups can improve the clinical symptoms of DN. The study group improved more significantly in clinical symptom score, compared with the control group, the difference was statistically significant (P<0.01).2. After treatment, renal function indexes BUN, Cr were improved, compared with before treatment, the difference was significant (P<0.05); in comparison with the control group after treatment, the difference was significant (P<0.05)3. After treatment, FBG decreased significantly, compared with before treatment, the differences were highly significant (P<0.01); after treatment between the two groups, the difference was not statistically significant (P> 0.05), suggest two glucose observation throughout the treatment are control within the specified scope. After treatment, the 24h urinary protein decreased in varying degrees, compared with before treatment, the difference was significant or very significant (P<0.05, P<0.01); the study group decreased significantly better than the control group, the difference was significant (P<0.05).4. After treatment, TC, TG values decreased in varying degrees, compared with before treatment, the difference was significant or very significant (P<0.05, P<0.01); and the study group decreased more significantly than the control group The difference was significant (P<0.05). 5. After treatment, Hs-CRP values were significantly decreased compared with before treatment, the differences were highly significant (P<0.01); and the study group than the control group decreased obviously out, the difference was significant (P<0.01). Study group, IL-6, TNF-αwere significantly reduced after treatment, compared with before treatment, the difference was significant (P<0.05); compared with the control group after treatment, differences were also significant (P<0.05). Control group, although the index decreased after treatment, but in comparison with the before the difference was not statistically significant (P> 0.05).6. After 08 weeks of treatment, the study group,8 of 30 cases are markedly effective,18 of 30 cases are effective and 4 of 30 cases are not effective, total effective rate was 86.7% in the control group that 1 of 15 case is markedly effective,7 of 15cases are effective, 7 of 15 cases are not effective, total effective rate was 53.3%. The study group in comparison with controlled group the total effective rate, the difference was significant (P<0.05).Conclusion:1.Use of qi-tonifficating and yin-nourishing, blood stasis-removing and new regenerating the new Chinese herbal medicine (tangshenan) to treat DN patients after treatment the results showed that improving clinical symtoms and decreasing clinical symptom scores, reducing fasting 24-hour urine protein and improve kidney function, lipid metabolism2. Diabetic nephropathy serum Hs-CRP, TNF-a, IL-6 levels increased abnormally, qi-tonifficating and yin-nourishing, blood stasis-removing and new regenerating, the new Chinese herbal medicine reduced significantly the lvel of inflammatory cytokines in patients such as Hs-CRP, TNF-a, IL-6 and improved the micro-inflammatory state DN3. qi-tonifficating and yin-nourishing, blood stasis-removing and new regenerating, the new Chinese herbal medicine treated with good clinical efficacy of DN, through multi-link to delay DN progression of glomerular sclerosis, in which lower levels of inflammatory factors, inhibit or improve the inflammatory response may be the law anti-DN one of the mechanisms of glomerular sclerosis.
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