| Diabetic nephropathy(DN) is one of the diabetic(DM) micro-angiopathy when it develops to certain phases.With the increasing incidence of DM,the incidence of DN is increasing year by year too which account for 47.66%of the DM and it is one of the mainly lethal reasons.DN has became the most important cause which lead to end-stage renal disease(ESRD).Pathological changes of DN are glomerulosclerosis and tubuloiterstitial fibrosis.According to the statistics of the United States Renal Data System(USRDS) in 1996,DN is the disease which lead to fibrosis easily among chronic kidney disease,therefor studying DN fibrosis has important significance to diagnosis and treatment of DN.Traditional Chinese Medicine(TCM) has more advantages in diagnosis,treatment and prevention of DN.TCM believes that the pathological basis of DN is the root deficiency and branch excess,deficiency-excess complex,deficiency of qi, blood,yin and yang;pathogenesis of DN is stagnation of qi,damp and blood stasis; and blood stasis syndrome which is proposed by Prof.Renhe Lv runs through modern DN.In the view of TCM,DN fibrosis belongs to the category of consumptive disease, Guange,etc.From the view of pathological property,DN belongs to aggregation-accumulation.The four pathological characteristics of DN are "deficiency","dampness","toxin" and "blood stasis","blood stasis" can induced by "deficiency","dampness" and "toxin",so there is a closed relationship between blood stasis syndrome and DN fibrosis,and blood stasis syndrome is considered as a most possible pathogenesis of DN fibrosis.AIM:Through analysis the difference of serum indexes between blood stasis syndrome group and none- blood stasis syndrome group of DN,to demonstrate the relationship between disease and syndrome,to study the relationship between blood stasis syndrome and DN fibrosis,and it may contribute to diagnosis of DN blood stasis syndrome.Methods:60 patients of department of endocrinology in DongFang Hospital from August 2008 to March 2009,according to TCM syndrome differentiation which divided into blood stasis syndrome group and none- blood stasis syndrome group, blood stasis syndrome group(Group A) involve 30 patients,male:17,female:13, age:25～70,average age:56.13:none-blood stasis syndrome group(Group B) involve 30 patients,male:16,female:14,age:30～70,average age:53.23; Moreover,a normal group of 30 cases was used for comparison from DongFang Hospital healthy people.Examing renal function indexes(BUN,Cr) and fibrosis indexes(tissue inhibitors to metalloproteinases-1,procollagen typeⅢ, hyaluronic acid),establishing database,using SPSS11.5 for t test and correlativity analyses to find out the difference between groups and correlation between renal function indexes and fibrosis indexes.Results:There was no significant difference between blood stasis syndrome group and none-blood stasis syndrome group in BUN and Cr;but significant difference between both of them and control group in HA,PCⅢ,TIMP-1(P＜0.01).The blood stasis syndrome group and none-blood stasis syndrome group showed significant difference in TIMP-1(P＜0.01),and insignificant difference in HA and PCⅢ.And significant correlation was found between HA,PCⅢ,TIMP-1 and BUN, Cr.Conclusion:HA,PCⅢand TIMP-1 are higher than the control group;there was significant difference between blood stasis syndrome group and none-blood stasis syndrome group patients in TIMP-1 who have similar renal dysfunction. The fibrosis degree of blood stasis syndrome is more serious than none-blood stasis syndrome;it justify that blood stasis is one of the important etiology and pathogenesis to cause organ fibrosis.The higher concentration of TIMP-1 can be used as a non-injurious diagnosis marker of renal fibrosis,and it has the advantages that renal function examine cannot substitute,especially suitable to the patient who has contraindication of renal biopsy. |
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