The Effects Of Tang-shen-kang Granule On Urinary Podocyte Marker Protein Of Disbetic Nephropathy Patients With Qi & Yin Deficiency And Blood Stasis Syndrome

Objective1.To prove the important role played by the damage of glomerulus sertoli cell in DN pathogenesis,by observing the expression differences of sertoli cell labeled protein,like PCX,Nephrin,Podocin,etc.between urine of patients who suffer from DN deficiency of both Qi & Yin with blood stasis syndrome and that of normal individuals.2.To investigate the protection effects of Tang-sheng-kang granules on glomerulus sertoli cells,by observing the intervention effects on urine protein level and sertoli cells labeled protein of patients who suffer from DN deficiency of both Qi & Yin with blood stasis syndrome rendered by Tang-sheng-kang granules.Methods72 patients who suffered from DN deficiency of both Qi & Yin with blood stasis syndrome and standard can be fulfilled,from inpatients of nephrology department and endocrinology department in our hospital from January of 2016 to January of 2017,of which 44 male patients and 25 female ones.These patients will be divided into two groups randomly with 36 patients for each group.One is treatment group and the other is the control group.Then one more group with 20 normal individuals will be set as normal group.During the research,3 patients leaves,one from treatment group and two from the control group.Finally 69 patients are observed during the research,35 from treatment group and 34 from the control group.Patients from treatment group and the control group will be both treated on the basis of western medicine.Meanwhile for treatment group,Tang-sheng-kang granules are taken orally with warm boiled water,three times daily,10 g each time.Course of treatment is 8 weeks.Observe Traditional Chinese Medcine syndrome integral change and curative effect before and after treatment;examine variation of UACR,24 h UPr,Scr,BUN,e GFR as well as PCX,Nephrin,Podocin protein in urine before and after treatment in two groups.Results1.Total curative effective rate of clinic disease in treatment group is 88.57% while that of the control group is 67.65%.After 4-week treatment,Total curative effective rate of Traditional Chinese Medcine syndrome in treatment group is 91.43% while that of the control group is 55.88%.After 4-week treatment,Total curative effective rate of Traditional Chinese Medcine syndrome in treatment group is 94.29% while that of the control group is 64.71%.Curative effect of clinic disease and Traditional Chinese Medcine syndrome in treatment group are both superior to that in the control group.The difference has statistical significance.(P<0.05).2.Before treatment,syndrome integral difference of the treatment group and the control group has no statistical significance(P>0.05).After 4-week and 8-week treatment,syndrome integral of treatment group is obviously lower than that before treatment,which has statistical significance(P<0.01);After 8-week treatment,syndrome integral of the control group is obviously lower than that before treatment,which has statistical significance(P<0.01);syndrome integral descending range of treatment group is obviously superior to that of the control team.3.After 8-week treatment,UACR?24h UPr of both treatment group and the control group are lower than that before treatment and the difference is significant(P<0.01 or P<0.05);and UACR?24h UPr of the treatment group is obviously lower compared with the control group,the difference has statistical significance(P<0.01 or P<0.05).4.Scr,BUN and e GFR has no obvious difference before and after treatment in both treatment group and the control group,so the difference has no statistical significance(P>0.05).5.Before treatment,PCX,Nephrin,Podocin integral in urine of the treatment group and the control group are both higher than the normal group,so the difference has statistical significance(P<0.01);However,PCX,Nephrin,Podocin integral difference in urine of the treatment group and the control group have no statistical significance(P>0.05);After 8-week intervention treatment by medicines,PCX,Nephrin,Podocin integral in urine of both the treatment group and the control group lower to some extent,so the difference has statistical significance(P<0.01 or P<0.05);besides,the treatment group is superior to the control group,so the difference has statistical significance(P<0.05).6.There is no obvious change of security index,like blood routine,stool routine,ALT,AST,electrocardiogram,etc.in patients of both groups before and after the treatment.Conclusion1.PCX,Nephrin,Podocin protein level in urine of patients who suffer from DN deficiency of both Qi & Yin with blood stasis syndrome are obviously higher than normal individuals,which shows the damage of glomerulus sertoli cell is involved in the occurrence and development of DN.2.Tang-sheng-kang granules can improve the clinical symptoms,body sign and relevant lab index of patients who suffer from DN deficiency of both Qi & Yin with blood stasis syndrome in an effective manner,lower Traditional Chinese Medicine syndrome integral and has proper clinical curative effects.Besides,it can lower high expression of sertoli cell labeled protein,like PCX,Nephrin,Podocin in urine of the patients.Its mechanism might be relevant to the fact that Tang-sheng-kang granules can alleviate damage of sertoli cells.