| Objective:By observed the effect of Yishen Huashi Granules on the gut microecology of diabetic kidney disease patients with spleen deficiency and dampness,explore the possibility of intervening diabetic kidney disease through gut microecology.To provide ideas for effectively intervening in the progress of diabetic kidney disease,and to provide a theoretical basis for further clarifying its pathogenic mechanism.Methods:A randomized controlled clinical trial study was conducted on diabetic kidney disease patients with spleen deficiency and dampness excess syndrome.After 2 weeks of drug elution,they were randomly divided into the experimental group(hereinafter referred to as the YSHS group)and the control group(hereinafter referred to as the PFK group)by using the random number table method.In addition to the basic western medicine treatment,the PFK group was given Bifidobacterium triple viable bacteria capsules(PFK),and the YSHS group was given Yishen Huashi Granules.After8 weeks of treatment,the urinary microalbumin/urine creatinine ratio(UACR),serum creatinine,blood urea nitrogen,e GFR and other laboratory indicators,as well as the changes of TCM syndrome scores and intestinal flora were observed.Result:1.During the 8-week study,a total of 64 patients completed clinical observation,including 31 in the YSHS group and 33 in the PFK group.Before the start of the study,the basic information,laboratory indicators and TCM syndrome scores of the two groups of patients were all comparable(p>0.05).2.After 8-week study,the diversity and richness of gut flora in the YSHS group and the PFK group were significantly improved(p<0.01),and there was no significant difference between the two(p>0.05).Compared the two groups,the proportion of Firmicutes,and Actinobacteria increased,and the proportion of Proteobacteria and Bacteroidetes decreased at the phylum level(p<0.05).The YSHS group increased the proportion of Bacteroides,Prevotella＿9,Lachnospira and Bifidobacterium at the genus level(p<0.05).And down-regulated the abundance of Eecherichia-Shigella(p<0.05).3.After 8-week study,compared between the two groups before and after treatment,the UACR of the two groups was significantly decreased(p<0.05).The levels of Scr and BUN in the YSHS group were significantly lower than before(p<0.05),while the levels of Scr,BUN and e GFR in the PFK group had no significant changes(p>0.05).After treatment,compared between the two groups,the test group was significantly better than the PFK group in reducing UACR(p<0.01).After treatment,the BUN level in the YSHS group was lower than that in the PFK group(p<0.05).And there was no significant difference in Scr and e GFR levels between the two groups(p>0.05).4.After 8-week study,the total effective rate of TCM syndromes in the YSHS group was 81.5%,and that in the PFK group was 51.5%.The effect of improving TCM symptoms in the YSHS group was significantly stronger than that in the PFK group(p<0.01).At the level of specific symptoms,the main symptoms of the YSHS group were improved compared with the previous ones after treatment(p<0.01),and all were better than those of the PFK group after treatment(p < 0.05).After treatment,the test group had different degrees of improvement in each syndrome(p<0.05),and was better than the PFK group in the improvement of symptoms such as head and body sleepiness,soreness and weakness of waist and knees,and stickiness in the mouth(p<0.05).And the improvement of each sub-symptom was better than that of the PFK group(p<0.05).Conclusion:Yishen Huashi Granules combined with the basic treatment of western medicine,adjusted the gut microecology of patients with diabetic kidney disease due to deficiency of spleen and dampness,and increased the relative abundance of probiotics and reduce the abundance of pathogenic bacteria;Moreover,it can significantly improve the TCM symptoms of patients,reduce urinary protein excretion,stabilize renal function,and delay the progression of the disease.Its clinical use is safe and reliable. |
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