| This paper is composed of two parts,the clinic and the animal research.1 Clinic researchPurpose:Finding the regular law of development and the characteristics of Traditional Chinese Medicine(TCM) syndrome of stageⅢ,Ⅳ,Ⅴof diabetic nephropathies(DN) so as to provide the clinical evidence to standardized and objective diagnosis of TCM syndromes in clinic,and provide the strong evidence for diagnosis and treatment of DN and clinic research of DN.Method:According to the diagnostic criteria of《TCM Diabetes Prevention and Treatment Guideline》issued by Chinese Medical Association and published TCM of China Press.This study collects 125 cases of in—patients from July 2007 to June 2008 retrospectively and analyzes them by dint of the cluster-analysis method throughout SPSS13.0,here who were suffering fromⅢ,ⅣandⅤstage of DN secondary onset caused by type 2 diabetes mellitus in the endocrinopathic department of the affiliated hospital of Liaoning University of TCM.Results:Along with the progress of DN,the symptom of extreme heat due to yin deficiency is decreasing and yang deficiency is increasing progressively. The characteristic of stageⅢDN is qi and yin deficiency,sometimes accompanied by blood stasis.The pathogenetic condition begins to get complicated from the stageⅣ,and the characteristic of the stage is mainly to express qi and yin deficiency,the blood stasis syndrome is obviously than before, and yang deficiency begin to appear as well.The most complex stage is the stageⅤ,the characteristic of this stage is yin and yang deficiency mainly, accompanied with deficiency mingling with excess.As an accompanied symptom, the blood stasis comes and aggravates with the progress of disease from stageⅢto stageⅤ.During the process of DN development,the syndrome of qi and yin deficiency and blood stasis account for a large percentage in each stage Ⅲ,ⅣandⅤof DN.Hypertension has positive correlation with DN,in this case, patients with dyslipidemia constitute a large proportion in DN patients.BMI of DN patients is more than 25kg/m~2.There is no statistical difference in age and the course of DM among stages of DN.Conclusion:1 Qi and yin deficiency with blood stasis,as a major syndrome,runs through stageⅢ,stageⅣand stageⅤof DN.2 DN has diverse characteristics of the syndrome in different stages,and its essence is the pattern of deficiency-excess complex.Based on the pathogenesis-related evolution,it develops from qi and yin deficiency of stageⅢ,yin impairment involving yang,to yin and yang deficiency in stageⅤ.In this process,syndrome is combined with blood stasis,damp-turbidity, and so on,in which blood stasis is the main accompanying symptom through the whole course of DN.3 As related factors of DN,hypertension,dyslipidemiaand obesity affect the development of DN.2 Animal studiesPurpose:To explore the protective effect of the method of benefiting qi-nourishing yin-promoting blood flow to diabetic rat' s kidney.Material and method:The diabetic animal models were induced by the intraperitoneal injection of streptozotocin.Then the rats were randomly divided into normal group,diabetic group without intervention,diabetic group with Tang shen' an decoction and diabetic group with Tang shen' an decoction combined with Irbesartan.After eight weeks,observing the 24-hour urinary protein excretion of the rats and the levels of SOD,GSH-PX and MDA in serum.Results:Compared to diabetic group without intervention,diabetic group with Tang shen' an decoction and diabetic group with Tang shen' an decoction combined with Irbesartan can decrease the excretion of urine protein,cut down the content of MDA in evidence,but increase the activity SOD and GSH-PX significantly.Conclusion:The therapy of benefiting qi-nourishing yin-promoting blood flow can decrease the excretion of urine protein.In addition,anti-oxidative stress may be one of mechanism that protected the function of kidney by Tang shen' an decoction and delay the deterioration of DN. |
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