Clinical Effect Of Yi Shen Jiangtang Decoction On Patients With Type2Diabetic Nephropathy At The Stage Of Ⅳ And Their Interleukin-18、Intercellular Adhesion Molecule-1

Objectives:To observe Yi Shen JiangTang decoction’s clinical effect on patients with type2diabetic nephropathy at the stage of IV,whose syndrome differentiation of TCM is both Qi-Yin deficiency with blood stasis. And to observe its effect on Interleukin-18(IL-18) and Intercellular adhesion molecule-1(ICAM-1).Thereby to evaluate the value of Yi Shen JiangTang decoction to DN of this type.And tried to explore the mechanism of Yi Shen JiangTang decoction in treating DN based on the level of inflammation.Method:1. Sixty patients with DN were randomly divided into two groups,with30cases in each.2. The cases in control group were treated by simple western medicine. The cases in treatment group were treated by Yi Shen Jiang Tang decoction and western medicine.The treatment course is2month.3.Observe the changes of IL-18、ICAM-1、renal function urinary albumin urine microalbumin and symptom integral.Results:1.The level of IL-18and ICAM-1in the group of DN was higher than the group of health(P<0.01).2.Albumin increased in treatment group after treatment(P<0.05),while it didn’t increased in control group(P>0.01).3.HbA1c、Scr、FPG、2h PG and TG decreased in both group after treatment(P<0.01).But there was no significant difference between them.4. UAER、TC、LDL、24h urinary albumin、IL-18、ICAM-1decreased in the two groups after treatment.And the treatment group is more effective than the control group(P<0.01).5.Bivariate correlation analysis:Any two of them which are IL-18in blool、 IL-18in urine、ICAM-1in blood and ICAM-1in urine is positive correlation(P<0.01).And they are positive correlated with HbA1c、FPG、24h urinary albumin UAER(P<0.01).Partial Correlation analysis:In the condition of limiting IL-18in urine、ICAM-1in blood and ICAM-1in urine, IL-18in blool is positive correlated with24h urinary albumin、UAER、FPG and2hPG(P<0.01); In the condition of limiting ICAM-1in blood and ICAM-1in urine, IL-18in blool and IL-18in urine is positive correlation (P<0.01);In the condition of limiting IL-18in blool and IL-18in urine, ICAM-1in blood and ICAM-1in urine is positive correlation (P<0.01);In the condition of limiting IL-18in urine and ICAM-1in urine, IL-18in blool and ICAM-1in blood is positive correlation (P<0.01).6. The total effective rate of the treatment group was93.3%,while the control group’s was70%from the view of TCM syndrome.There were significant differences between the two groups(P<0.01).7. The total effective rate of the treatment group was80%,while the control group’s was56.67%.There were significant differences between the two groups(P<0.01).Conclusion:1.IL-18and ICAM-1of patients with DN is higher than the healthy people.2. IL-18in blood has an influence on the disease progression of DN. IL-18and ICAM-1promot each other.3.The therapeutic effect on ALB、24h urinary albumin、UAER、TC and LDL of the treated group is better than that of the control group.4.Treatment with YiShenJiangTang decoction is more effective on patients with type2diabetic nephropathy at the stage of IV,whose syndrome differentiation of TCM is both Qi-Yin deficiency with blood stasis. And it is better than the treatment of simple western medicine.5.YiShenJiangTang decoction is effective on decreasing IL-18and ICAM-1.The mechanism maybe that it can alleviate inflammation of kidney,impove the function of vascular endothelial cell and then decrease the urinary albumin and UAER.It is worth of further research.