| Objective:From two aspects of clinical and experimental observation,to observe the intervention effect of Chinese herbal compound(Cong Gui Yi Shen Capsule)improve clinical symptoms in patients with type 2 diabetic kidney disease(DKD) TNF-α and p38 MAPK mrna expression level of influence. To related inflammatory factors and possible pathways of gene action as the breakthrough point to study, by exploring the exact inspection index data to explore with the method of reinforcing the kodney and strengthening the spleen of Cong Gui Yi Shen Capsule on renal protection in DKD body mechanism.Methods: 1.clinical research : 60 patients of type 2 DKD earlier period with Kidney deficiency and blood stasis syndromein were randomly divided into the treatment group and the control group, The control group was given diabetes education, diet, moderate exercise, received basic treatment and oral benazepril(10mg, qd) for the foundation treatment scheme,the treatment group were treated add Chinese herbal compound Cong Gui Yi Shen Capsule(0.4g/ particle,each time 5,3 times a day). The course of the treatment was 8 weeks. Before and after treatment were recorded in patients with fasting blood glucose and postprandial 2H blood glucose, glycosylated hemoglobin, BUN, Scr, urine ACR, tumor necrosis factor alpha(TNF- alpha) changes of TCM syndrome total score level.2.Animal experiments:60 male SD rats were randomly selected 10 as sham operation group which feed with low fat feed, sutured the incision of sham operation group rats after incising the skin and muscle layer. other rats fed with high fat feed. The rest 50 rats which feeding high fat and high sugar, with the left kidney resection and injected with STZ. induce type 2 DKD in earlier period rats model. The model rats were randomly divided into three groups: model group、low dose group and high dose group.The sham operation group and the model group were given distilled water by garage, low dose group and high dose group were given Chinese herbal compound(Cong Gui Yi Shen Capsule)by garage with different dose. To the end of the experiment the sham operation group, model control group, the number of Chinese medicine low dose group, high dose of Chinese medicine group rats were: 8, 13, 13, 12. Observed the general condition of the rats after 8 weeks, and the samples were obtained by test and biochemical index, to detect the expression of RT-PCR TNF- alpha and p38 MAPKm RNA.Results: 1 Clinical Study:Gender, two groups of patients before treatment, age, duration, no difference in urinary ACR(P>0.05), comparable. Clinical observation show: After 8 weeks,treatment, the treatment group compared with the control group, the symptom score than the control group(P<0.01), with the same group improved compared with before treatment significantly(P<0.01).Treatment group and the control group, the total effective rate was 81.5% and 64.3%, respectively; after treatment, fasting blood glucose treatment group and the control group, 2h postprandial blood glucose, glycosylated hemoglobin compared with before treatment were significantly lower(P <0.05 or P<0.01), after treatmen the treatment group than the control group improvement(P<0.05)t; serum creatinine, urine albumin, blood urea nitrogen, creatinine and urine albumin than before treatment were decreased compared(P<0.05 or P<0.01)after treatment;compared with the control group, the treatment group improved significantly(P<0.05); The treatment group and the control group before and after treatment, serum levels of TNF-α were decreased, Significant difference was statistically significant(P<0.01). After 8 weeks of treatment time, the treatment group decreased serum TNF-α more obvious difference(P<0.05).2 Animal experiments:Animal experimental results show: DKD model of model rats compared with sham group, body weight increased(P<0.01); After the treatment of traditional Chinese medicine high, low dose group compared with the control group decreased(P<0.01) DKD model rats blood glucose, there was statistical significance of urea nitrogen and serum creatinine compared with the sham group(P<0.05 or P<0.01)。After the treatment of traditional Chinese medicine high, low dose group of blood glucose, urea nitrogen, creatinine, decreased compared with the model group(P<0.05 or P<0.01), The Chinese high and low dose group compared with model group, the expression level of rat renal cortex TNF-α and p38 MAPKm RNA were decreased(P < 0.01).Conclusions: the method of reinforcing the kodney and strengthening the spleen can effectively improve the clinical symptoms and can effectively reduce the blood glucose and protect renal tissue and function, improve the inflammatory reaction; reduce the related indexes of renal function TNF-α and p38 MAPK gene expression level. The level of its mechanism might be related to the down-regulation of inflammatory cytokines, inflammatory reaction, improve insulin sensitivity, improve oxidative stress reaction, to ease the body high glucose stimulation. |
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