Stilbene Who Particles Intervention Is Part Of The Action Mechanism And Clinical Study Of Diabetic Nephropathy

Objective:The part of the clinical study of the subject evaluates Qi Wei Qi that Yin deficiency, kidney collateral stasis patients with diabetic nephropathy efficacy and safety;The experimental part observes that Qi Wei impact on the DN mice renal pathology and Qi Wei impacts on the AGEs, RAGEmRNA, P38MAPK, p-P38MAPK protein expression, explore the Qi Wei particles intervention DN mechanism provides a theoretical basis for clinical treatment.Method:Clinical research:Use of randomized, double-blind, controlled trial programs, placebo-controlled trial group and the placebo group a ratio of3:1, to study included a total of44patients with diabetic nephropathy Ⅲ, Ⅳ of Qi and Yin Deficiency, patients with kidney collateral stasis,for a period of84days of observation, by observing the TCM symptom scores, urinary albumin,24h urine protein, liver and kidney function, and other indicators to evaluate the clinical efficacy and security.of diabetic nephropathy with Qi and Yin Deficiency,kidney collateral stasis type.Experimental research:308-week-old Kkay mice,6the same week-old C57BL/6J mice, adaptive feed for four weeks, after measuring FBG>13.9mmol/L, were randomly divided into model group, Western medicine group, low-dose group,dose group and high dose group5groups. Mice body weight,24-hour urine protein test were recorded. Test at the12th weeks:we measured kidney weight,urea nitrogen, creatinine and kidney tissue pathological slices, HE staining and Masson staining, immunohistochemical detection of AGEs, Real time PCR detection of mRNA levels, protein imprinting testing of the expression of p38MAPK and p-p38MAPK protein, using SPPSS17.0software to analysis them.ResultsClinical research:①After we used Qi Wei for12weeks of treatment, the urinary albumin of the treatment group declined significantly comparing with the24-hour urinary albumin level of the control group, the difference was statistically significant (P<0.01); The urinary protein were significantly lower in Qi Wei group after treatment and statistically significant (P<0.01).②Fast plasma glucose,2-hour postprandial blood glucose, glycosylated hemoglobin, creatinine, urea nitrogen, blood pressure did not change significantly after treatment;③Qi Wei group of30patients after12weeks of treatment, according to TCM syndrome score table,8cases were clinical controled,12cases were markedly effective and10cases were effected,5cases were ineffective. The total effective rate was83.3%. In the control group,. The clinical control number and the number of cases which were markedly improved were0. There are3valid cases,7ineffective cases.The total efficiency rate is30%. There is no significant adverse reactions in the treatment of the the Qi Wei.Experimental part:①Compared with the normal group,the weight gain of other groups were significantly increased (P<0.01); Compared with the model group, the body weight of the western medicine group has no statistical significance. The low dose group has statistically significant changes in the6th and8th week(P<0.05), and has meaningful statistically significant changes in the10th and12th week,(P<0.01).②Compared with normal group, the first12weeks of model mice’s kidney weight was significantly increased (P<0.01).③Compared with normal group, the impaired fasting glucose in the model group has a difference.Compared with model group, the fasting glucos in eirbesartan group and Qi Wei group has a downward trend under the therapeutic intervention of low middle and high does.The difference after6weeks was statistically significant comparing with the model group in the same time period (P<0.05).④The urine protein in the mice in the model group increased obviously after the4th week, which has a big difference compared with the normal group,(P<0.01),the24-h urine protein in the model group increased with time. The middle dose western medicine group had a decrease of urine protein from the4th week, while the low dose group and the high dose team show no significant difference and had no statistical significance. The dose in the8th week has statistical significance (P<0.05).The western medicine group and the middle dose group had a decline (P<0.01),⑤while there were no significant changes in renal function with Treatment groups, Compared with model group, the treatment groups BUN, Scr decreased (P<0.05);⑥western medicine group and Chinese medicine in the treatment groups glomerulosclerosis index and renal tubular injury score decreased significantly (P<0.01);⑦immune staining showed the AGEs content of the model group increased significantly, the remaining treatment groups AGEs expression was significantly (P<0.01);⑧display PCR results, the relative expression amount of the model group AGE mRNA the increased significantly (P<0.05), the rest of the treatment groups with the model group were lower (P<0.()5). WB results show that with the rest of the group was significantly higher than in the normal group P-p38MAPK expression (P<0.O1), compared with model group in varying degrees the rest of the set of p-p38MAPK (P<0.05) reduction.Conclusion:①The Qi Wei can reduce Ⅲ or Ⅳ of patients with diabetic nephropathy (TCM syndromes of Qi and Yin deficiency, blood stasis.) Urinary albumin, urinary protein excretion trends, improve the clinical symptoms, with good effect, treatmentno significant adverse reactions.②The Qi Wei particles can improve the mouse renal pathology and function,p38MAPK pathway may be achieved by down-regulating the content of AGEs.