Clinical Evaluation Of Nourishing Qi And Yin,removing Phlegm And Blood Stasis Circulation On Treating Patients With Early Diabetic Nephropathy And Effect On NF-?B And MCP-1

Objective: In this study,we observed the clinical effects of nourishing qi and yin,removing phlegm and blood stasis on early diabetic nephropathy patients with Qi Yin deficiency and phlegm stasis syndrome and the intervention of NF-? B and MCP-1,and evaluated its safety through clinical trial.At the same time,the action mechanism of Erhuang Shenling mixture was discussed from the angle of inflammation factor,which had the function of nourishing qi and yin,removing phlegm and blood stasis.Methods:From February 2017 to December 2017,60 cases of early diabetic nephropathy with Qi Yin deficiency and phlegm stasis syndrome in Department of Endocrinology of Anhui Traditional Chinese Medicine Hospital were randomly divided into treatment group and control group,30 cases in each group.The control group was treated with epalita tablet on the basis of basic treatment,while the treatment group combined with Erhuang Shenling mixture on the above basis.The course of treatment in both groups was 12 weeks.The changes of TCM syndromes,blood glucose,blood lipids,UAER,UACR,NF-? B and MCP-1 were observed before and after treatment,and the safety indexes and adverse reactions were monitored.Results:?Comparison of curative effect of TCM Syndrome:The total effective rate of the treatment group and the control group were 83.33% and 36.67%,The difference between the two groups was statistically significant(P<0.01).After treatment the total score of TCM syndromes in both groups was lower than that before treatment,and the treatment group was more obvious than the control group.The difference was statistically significant(P<0.01).?Effect on blood glucose:The levels of blood glucose(FPG,2hPG and HbA1c)in both groups after treatment were significantly lower than those before treatment(P< 0.05),and the treatment group decreased compared with the control group.There was statistical significance(P<0.05 or P<0.01).?Effect on blood lipids:The levels of blood lipids(TG,TC,HDL-C and LDL-C)in the two groups were improved after treatment,with statistical significance(P<0.05 or P<0.01).TC,HDL-C and LDL-C in the treatment group improved significantly compared with the control group.The difference was statistically significant(P<0.05 or P<0.01),but there was no significant difference in TG(P>0.05).?Effect on UAER and UACR:The UAER and UACR of two groups decreased after treatment,the differences were statistically significant(P<0.05 or P<0.01).The decrease was more obvious in the treatment group than in the control group,and there was statistical difference between the two groups(P<0.05).?Effect on NF-?B and MCP-1:The levels of NF-?B in both and MCP-1 in treatment group decreased after treatment compared with those before treatment(P<0.05).The level of NF-? B in the control group was lower than that before treatment,but the difference was not statistically significant(P>0.05).Compared with the two groups,the NF-? B and MCP-1 levels in the treatment group decreased significantly(P<0.05 ? P<0.01).?Comparison of total clinical efficacy:The total effective rate was 83.33% in the treatment group and 56.67% in the control group,with significant difference between the two groups(P<0.05).The curative effect in the treatment group was better than that in the control group.? Security comparison:During the experiment period,there was no obvious abnormality in hematuria fecal routine,liver and kidney function,and electrocardiogram and other related examinations,and no adverse reactions occurred.Conclusion:The method of nourishing qi and yin,removing phlegm and blood stasis can improve the symptoms and signs of early diabetic nephropathy,reduce the integral of TCM syndrome,reduce the levels of blood sugar,blood lipids,UAER and UACR,correct the disorder of glucose and lipid metabolism,and reduce the excretion of proteinuria.Reduce the degree of renal damage,delay the appearance of end-stage nephropathy.At the same time it can let down the levels of NF-?B and MCP-1 in the patients,and may reduce the occurrence of inflammatory reaction by inhibiting the expression of NF-?B and MCP-1 inflammatory factors to protect the kidneys.There were not significant abnormality in safety indicators and adverse events in patients with early diabetic nephropathy.It indicated that the drug is safe and reliable clinical application.