The Effect Of Jianpi Bushen Huayu Tongluo Recipe On Serum VEGF And ET-1 In Diabetic Nephropathy Patients With Spleen And Kidney Deficiency And Blood Stasis Syndrome

Objective: To observe the effects of Jianpi Bushen Huayu Tongluo Recipe on traditional Chinese medicine(TCM)syndrome features,relevant inspection indexes,serum vascular endothelial growth factor(VEGF)and endothelin-1(ET-1)in diabetic kidney disease(DKD)patients with spleen and kidney dificiency and blood stasis syndrome,and to explore the mechanism of Jianpi Bushen Huayu Tongluo Recipe on the treatment of DKD patients with spleen and kidney deficiency and blood stasis syndrome,which provide a theoretical basis for clinical treatment of this kind of disease by TCM.Methods: A total of 60 DKD patients with spleen and kidney deficiency and blood stasis syndrome treated were selected and randomly divided into a treatment group and a control group,30 cases in each group.4 cases were lost during treatment,including 2cases in the treatment group,2 cases in the control group,and 56 cases were completed the treatment.Another 10 normal people(all healthy volunteers from the Physical Examination Center)were set as the normal group..The differences in serum VEGF and ET-1 levels between DKD patients and normal people were observed,both groups of patients were given lifestyle intervention and basic treatment.In the treatment group,Jianpi Yishen Huayu Tongluo Recipe was added on the basis of the above treatment,and all were observed for 8 weeks.The changes in TCM syndrome features,urine microalbumin/ creatinine ratio(UACR),24 h urinary protein(24 h Upro)quantification,blood glucose,renal function indicators,serum VEGF and ET-1 before and after treatment were observed.Results: The clinical disease efficacy,TCM syndrome features of spleen-kidney deficiency and blood stasis syndrome in the treatment group were significantly better than the control group,and the differences were statistically significant(P<0.05 ? P<0.01).The TCM syndrome scores in the treatment group of 4 weeks and 8 weeks treatment were significantly lower than that before the treatment(P<0.01).There was asignificant decrease at 8 weeks of treatment(P<0.01).Compared with the same period of the two groups,the decrease of TCM syndrome scores in the treatment group was significantly better than that in the control group(P<0.01).The UACR and 24 h Upro of the two groups of patients were significantly improved after treatment for 4 weeks and 8 weeks(P<0.01);The UACR and 24 h Upro of the treatment group for 8 weeks improved more significantly than the control group over the same period(P<0.05 ? P<0.01).After treatment,the blood urea nitrogen(BUN),serum creatinine(Scr),uric acid(UA),and estimated glomerular filtrate rate(e GFR)of the two groups were not significantly improved compared with those before treatment,and fasting plasma glucose(FPG),2 hours plasma glucose(2h PG),and glycosylated hemoglobin(Hb A1c)were not significantly improved than before treatment(P>0.05).Before treatment,the levels of VEGF and ET-1 in the two groups were significantly higher than those in the normal group(P<0.01).After treatment,the levels of serum VEGF and ET-1 in both groups were significantly lower than before treatment(P<0.05 ? P<0.01),and the decrease degree in the treatment group was significantly better than that in the control group(P<0.05 ? P<0.01).During the study,no adverse events occurred in the two groups,and there were no abnormalities in security indexes such as blood routine,liver function,and electrocardiogram before and after treatment.Conclusion: Jianpi Bushen Huayu Tongluo Recipe can significantly improve the clinical efficacy of DKD patients with spleen and kidney deficiency and blood stasis syndrome,and can significantly reduce the serum VEGF and ET-1 expression in such patients.The latter may be one of the clinical efficacy mechanisms of Jianpi Bushen Huayu Tongluo Recipe in the treatment of DKD.