| Clinical ResearchDistribution characteristics of TCM syndrome and syndrome elements in early diabetic nephropathyObjectiveTo study the distribution characteristics of TCM syndromes and syndrome elements of early diabetic nephropathy,and further explain the etiology and pathogenesis of this disease,so as to provide a basis for the treatment of early diabetic nephropathy and timely intervention in the early stage.MethodsThis research established a clinical data base of 155 patients with early diabetic nephropathy.It takes the study of TCM syndromes and syndrome elements of distribution characteristics and general information of early diabetic nephropathy,with the ues of descriptive analysis,clustering analysis.Results1.General information:A total of 155 patients were included in the study,including 90males and 65 females.The proportion of males was greater than that of females,with males accounting for.68%and females accounting for 45%.The average age is 58.65:10.61 years old,among which 51-60 years old and 61-70 years old are the most,accounting for 59%.The number of overweight people is the highest,accounting for 41%,and the proportion of obese people and normal weight people is close to 27%and 30%respectively.The average duration of diabetes was14.39±7.26 years.The patients with hypertension and dyslipidemia in early diabetic nephropathy accounted for 78.1%and 68.5%respectively.2.Comparison of BMI,age and course of disease between men and women:There were significant differences between male and female in age and course of disease,and the differences were statistically significant(P<0.01).There was no difference in BMI between male and female,and the difference was not statistically significant(P>0.05).3.Among the four diagnostic information,thirst and polydipsia(78.2%),mental fatigue(70.5%),dry eyes(68.6%),polyphagia and hunger(59.6%),and numbness of limbs(56.4%)were the most frequent.Deficient syndromes in early stage of diabetic nephropathy were mainly deficiency of both qi and yin(62.6%),dry heat of Yin(19.3%).The excessive syndromes were wind(29.6%)and phlegm and blood stasis(29%)4.According to the cluster analysis,symptoms elements of disease location are liver,kiDKDey,spleen and stomach,and the nature of the disease syndrome elements are Qi deficiency,Yin deficiency,Yang deficiency,wind,blood stasis,phlegm,dampness and heat.Conclusions1L Age and course of disease are the uncontrollable risk factors of early diabetic nephropathy.early detection,timely treatment.2.The features of diabetic kidney disease are deficiency and excess in ea rly stage.Through the cluster analysis of DKD,we can conculde its main symptoms elements of disease location are liver,spleen,stomach and kidney,the nature of the disease syndrome elements are Qi deficiency,Yang deficiency,Yin deficiency.,Pathogen syndrome elements are mainly about wet,heat,blood stasis,damp,wind pathogen.The pathogenesis of early diabetic nephropathy was summarized as the combination of deficiency with phlegm,dampness,heat,wind and blood stasis.The elements of wind-pathogenic syndrome appear in the early stage of diabetic nephropathy,therefore,the wind-dispelling method can be used to treat early diabetic nephropathy microalbuminuria.Experimental Research Study on the mechanism of YiQiZiShenQuFeng method on proliferation and autophagy of mesangial cells induced by high glucoseObj ectivesTo explore the inhibitory effect of YiQiZiShenQuFeng method on proliferation and extracellular matrix accumulation of mesangial cells with high glucose condition,and its role on mesangial cell autophagy.MethodsThe drug-containing serum of YiQiZiShenQuFeng and telmisartan was prepared.The proliferation model of mesangial cells was established by cck-8 method,and it was observed at 24h,48h and 72h,respectively,with 30mmo/L high glucose conditio.The expression of extracellular matrix protein FN and LN in the supernatant was detected by ELISA.Western blot was used to detect the expressions of autophagy related proteins p62,Beclin-1,LC3-?,autophagy signaling pathway protein AMPK?p-AMPK,and cytokine TGF?-1.The formation of autophagosome was observed under transmission electron microscope.To explore the effect of YiQiZiShenQuFeng method on proliferation and autophagy of mesangial cells.Results1.Mesangial cell proliferation was best at 48h.The method of YiQiZiShenQuFeng could inhibit the proliferation of mesangial cells induced by hyperglycemia,and the difference was statistically significant compared with the hyperglycemia group(P<0.01).2.ELISA results showed:The expressions of FN and LN extracellular matrix proteins in the high-glucose group were up-regulated,and the differences were statistically significant compared with the normal control group(P<0.05).The expressions of FN and LN were down-regulated in the YiQiZiShenQuFeng method group,and the difference was statistically significant compared with the high-sugar group(P<0.01).3.High glucose decreased the expressions of LC3? and Beclin-1,increased the expressions of p62,compared with the normal control group,the difference was statistically significant(P<0.01).Meanwhile,high glucose decreased the expression of AMPK and p-AMPK proteins in the autophagy signaling pathway,compared with the normal control group,the difference was statistically significant(P<0.05).The YiQiZiShenQuFeng method and telmisartan group increased the expressions of LC3? and Beclin-1,decreased the expressions of p62,and increased the expression of AMPK?p-AMPK,compared with the high glucosegroup,the difference was statistically significant(P<0.01).The expression of TGF-?1 protein in mesangial cells cultured in high glucose was increased,and the difference was statistically significant compared with the normal control group(P<0.05).The YiQiZiShenQuFeng method and telmisartan group decreased the expression of TGF-?1 protein,compared with high glucose group,the difference is statistically significant(P<0.01).4.The results of TEM showed that the structure of the mesangial cell was intact,the nuclear membrane and nucleolus were clear,the structure of cell organelle was normal,the autophagosomes were fewer in the control group.In the high glucose group,the number of autophagosomes were decreased.Cell organelles can be contained in the autophagosomes.After the intervention of YiQiZiShenQuFeng and telesartan containing serum,the number of autophagosomes in mesangial cells was increased,and organelles were wrapped in the autophagy body.Conclusions1.The method of YiQiZiShenQuFeng can inhibit the proliferation of mesangial cells and the expression of TGF-?1 protein induced by high glucose,thereby reducing the accumulation of extracellular matrix protein and delaying glomerular sclerosis.2.The method of YiQiZiShenQuFeng can improves the level of autophagy in mesangial cell,which may delay the progression of diabetic nephropathy and glomerulosclerosis. |
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