Clinical Observation Of Sinomenine In The Treatment Of Early Diabetic Kidney Disease And Its Effect On Inflammatory Cytokines

Research objective: to study the observation of sinomenine in early diabetic kidney disease in patients with urinary protein excretion,renal function,serum inflammatory cytokines and other biochemical indicators and clinical symptoms of traditional Chinese medicine,to evaluate the clinical effect of sinomenine,and discuss the treatment and its possible mechanism of diabetic kidney disease.Screening methods: from April 2018 to September 2019 in hubei province traditional Chinese garden mountain CGMH between the inpatient and outpatient service,phoenix mountain clinic diagnosis and treatment of early DKD patients,western medicine diagnosis accord with the original diabetic kidney disease clinical diagnosis,conforms to the collateral kidney disease diagnosis of traditional Chinese medicine,a total of 68 cases,randomly divided into control group and test group,each group(n = 34).The control group received basic treatment,including lifestyle intervention,control of blood sugar,control of blood pressure,control of blood lipids,reduction of urinary albumin and other symptomatic support treatment.In the experimental group,zhengqing fengtongning sustained release tablets(120mg bid Po)were added to the basic treatment.The total observation course was 12 weeks.Observe clinical comprehensive curative effect of two groups of patients before and after treatment,improvement of syndromes,and urine trace albumin/creatinine(UACR)before and after the treatment,24 h urine protein quantitative,renal function,related indicators,inflammatory cell factor,the change of blood glucose,blood lipid,to assess the curative effect,and the results are related to statistical analysis.Results: 1.In terms of the total clinical efficacy,the total effective rate of the sinomenine test group was 81.25%,which was higher than 68.75% in the control group(P < 0.05).In terms of the therapeutic effect of TCM symptoms,the effective rate of sinomenine test group was 81.25%,significantly better than that of control group(56.25%),P < 0.01,the difference was significant and statistically significant.2.Improvement of urinary protein and renal function indicators: after treatment,UACR and 24 h UP decreased significantly in the two groups compared with before treatment,indicating that both treatment regimentation could effectively control urinary protein level(P < 0.01).The decrease rate of UACR and 24 h UP in the experimental group was significantly greater than that in the experimental group(P<0.01).3.The renal function indexes Scr,Cys C and e GFR in the two groups after treatment were slightly improved compared with those before treatment(P < 0.05).After treatment,there was no significant difference in Scr and e GFR between the two groups(P > 0.05),and the C value of Cys in the experimental group decreased more significantly than that in the control group(P<0.05).4.After treatment,the inflammatory factors hs-crp,TNF-level and il-6 in both groups decreased compared with those before treatment(P <0.05).The improvement of inflammatory factors in sinomenine test group was much larger than that in the test group(P<0.01).5.After treatment,blood glucose and blood lipid-related indexes FPG,2h PG,Hb A1 c,TC,TG and ldl-c in the two groups were significantly lower than before treatment(P < 0.01).After treatment,there was no significant difference in blood glucose and blood lipid between the two groups(P > 0.05).Conclusion: 1.Sinomycin combined with basal therapy has a good effect on early DKD,which is better than the basic therapy alone.It can effectively reduce urinary protein excretion,protect renal function and delay the progress of the disease in the early application of DKD.2.Compared with the simple basic treatment of western medicine,sinomenine can better improve the clinical symptoms and signs of traditional Chinese medicine and improve the quality of life of patients.3.Compared with simple western medicine basic therapy,sinopsinine combined with basic therapy can better reduce the serum inflammatory cytokines TNF-,il-6 and hs-crp of DKD patients,improve the chronic inflammatory state of DKD patients and delay the disease progression.4.Sinomenine treatment of DKD improves urinary protein excretion and protects renal function in patients,and its mechanism may be related to reducing the level of inflammatory cytokines to inhibit the low inflammatory response in patients with DKD.