Effect Of Diabetes Nephropathy On Proteinuria,NF-κB、OPN And IL-18 Of Patients With Diabetic Nephropathy

Objective: The purpose of this study is on early diabetic nephropathy proteinuria patients for clinical research, mainly to observe the treatment of early diabetic nephropathy in diabetes nephropathy in the conventional treatment based on Western Medicine(deficiency of both qi and Yin, damp heat stasis type) the clinical curative effect and the security, especially decreasing urinary albumin, and compared with the routine treatment of Western medicine group, and then discuss the therapeutic effect of diabetes nephropathy party, provides a new, can be used for reference in the treatment of ideas and methods for the clinical treatment of work; At the same time, the detection of nuclear factor-κB(NF-κB), interleukin-18(IL-18), osteopontin(OPN), in order to explore possible treatment mechanism of this decoction.Methods:70 patients met the inclusion criteria of the 3rd stage diabetic nephropathy patients as the research object, all cases were from Shanxi Province Hospital of traditional Chinese and Western medicine kidney Department of internal medicine inpatient and outpatient patients. The patients were numbered according to the random number table, randomly divided into treatment group and control group, 35 cases in each group. The control group were treated with routine treatment, while the treatment group based on conventional treatment of Western medicine combined with diabetes nephropathy. The total course of treatment for 8 weeks, urinary albumin excretion(UAE)rate of the two groups,the main clinical symptoms and signs, the changes of TCM clinical syndrome integral,the changes of NF-κB, OPN, IL-18, adverse reaction were observed before and after treatment, thus to make an objective evaluation of clinical efficacy of self-designed diabetes nephropathy party.Results:1) The total curative effect and the total efficiency of TCM syndromes of patients in the observation group were 94.3%(33/35) and 85.7(30/35), which were better than the control group, the difference was statistically significant(P<0.05);2) After the treatment, the blood sugar index(FPG, 2h PG, Hb Alc) in observation group decreased significantly, the difference was statistically significantcompared with the control group(P<0.05); BUN did not change significantly between the two group(P >0.05); The level of Scr and UNE, beta 2-MG in observed group were significantly lower than the control group P<0.05; before treatment, the normal SCr in the treatment and follow-up of SCr were maintained normal, no case of SCr increased more than the basic value of 30%;3) Before the treatment,the level of NF-κB, OPN, IL-18 in the two group were not statistically significant(P > 0.05),and were significantly higher than those in normal range; after treatment, the level of NF-κB, OPN, IL-18 did not change significantly in control groups, the comparison had no significant difference(P > 0.05); each index level in the observation group, improved significantly, which were better than those of the control group(P < 0.05);4) The change of blood routine, liver function, electrocardiogram before and after treatment in the groups before and after treatment:The liver function, renal function and blood routine of the patients did not change significant(P> 0.05). Electrocardiogram in patients with no abnormal change before and after the treatment, 1 cases of female patients in the observation group had menstrual disorders. One patients suffered from gastrointestinal reaction,with abdominal distention and poor appetite,who was untreated and alleviated by himself.Conclusion:1) Nuclear factor-κB(NF-κB), interleukin-18(IL-18), osteopontin(OPN) may be involved in the process of the formation of early diabetic nephropathy renal fibrosis.2) Diabetes nephropathy can effectively improve the clinical symptoms in patients with early diabetic nephropathy, reduce urinary albumin excretion rate, achieve good clinical effect, provide a new way for the treatment of early diabetic nephropathy;3) Diabetes nephropathy may regulate NF-κB, IL-18 levels, inhibit inflammatory reaction, and has a certain role in the regulation of OPN levels, thus delaying the process of renal fibrosis, may be one of the mechanisms of diabetes nephropathy party, available for clinical reference study.