Effect Of Traditional Chinese Medicine Shenkangling On Serum TGF-β1,TNF-α And IL-1β In Children With Primary Nephrotic Syndrome (Simple Type)

ObjectivePrimary nephrotic syndrome(PNS)in children was treated with Traditional Chinese Medicine Shenkangling in serum levels of transforming growth factor-β1(TGF-β1),tumour necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)were observed before and after treatment.The aim was to improve the pathogenesis of paediatric primary nephrotic syndrome,to elucidate the mechanism of action of the renal blood activation method in the treatment of paediatric PNS and to improve its clinical efficacy.Methods30 children from the People’s hospital affiliated to fujian university of traditional Chinese medicineand the second affiliated People’s hospital outpatient and hospitalization,who met the diagnostic criteria of PNS(simple type)and the diagnostic points of TCM syndrome of kidney deficiency and blood stasis type were selected as the treatment group(Group A).At the same time,30 healthy children aged 2-14 were selected from the Physical Examination Center of the People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine as the healthy control group(group B).The treatment group was treated with the combination of traditional Chinese and Western medicine(Glucocorticoid and/or Immunosuppressants combined with traditional Chinese medicine Shenkangling).The differences in the expression levels of serum TGF-β1、TNF-α、IL-1β,and the 24-hour urine protein quantification,serum albumin,cholesterol,triglyceride and low densith lipoprotein between the healthy control group and the treatment group were observed before and after treatment.SPSS 26.0 statistical software was used for statistical analysis of the data.Result1.A total of 30 children with PNS(simple type)were included in this study according to the inclusion and exclusion criteria,mainly boys,and most of them were school-age children aged 7-14.Among them,1 case dropped out due to inability to cooperate with clinical observation and follow-up,and 2 cases dropped out due to not taking prescribed medication.2.Before treatment: there was no significant difference in gender and age between groups Treatment and Healthy control group(all P>0.05),and the levels of serum TGF-β1、TNF-αand IL-1β in group Treatment were significantly higher than those in group Healthy control group(all P<0.05).3.After 4 weeks of treatment: Compared with before treatment,the levels of serum TGF-β1、TNF-α and IL-1β in group Treatment were significantly decreased(all P<0.01).Compared with healthy controls,serum TGF-β1 、 TNF-α and IL-1β levels increased significantly in the treated group(all P<0.01).The 24-hour urine protein,total cholesterol and serum triglyceride levels were significantly lower than before treatment(all P<0.05),serum albumin levels were significantly higher(P<0.01)and low densith lipoprotein levels were not significantly different(P>0.05).4.After 12 weeks of treatment: serum TGF-β1 、 TNF-α and IL-1β levels were significantly lower in the treatment group(P < 0.01),TGF-β1 、 TNF-α and IL-1β in the treatment group(P > 0.05).24 h urine protein determination,serum total cholesterol triglyceride and low densith lipoprotein levels were significantly lower than before treatment(P<0.01)and serum albumin levels increased significantly(P<0.01).After 24 hours,urine concentrations were significantly lower in the treatment group,and serum total cholesterol and triglyceride levels were significantly higher than before treatment(P<0.01).Compared with 4 weeks after treatment,serum TGF-β1 、 TNF-α and IL-1β levels were significantly lower(P<0.01),24-hour urine protein,serum cholesterol and low densith lipoprotein levels(P<0.01),triglycerides were not different(P>0.05).5.After 12 weeks of treatment,17 children with PNS had complete remission,and 10 had partial remission.No adverse reactions occurred during the clinical efficacy observation period.Conclusions1.Serum levels of TGF-β1、TNF-α and IL-1β were significantly elevated in children with PNS(simple type),suggesting that as mediators of inflammation they may be involved in the etiology of PNS in children.2.The use of combined Chinese and Western medicine for paediatric(simple type)PNS can significantly reduce serum levels of TGF-β1、TNF-α and IL-1β.This suggests that the use of integrated Chinese and Western medicine to treat paediatric PNS(simple type)can improve the inflammatory response and reduce serum levels of TGF-β1、TNF-α and IL-1β to achieve therapeutic goals.3.Combined treatment with Chinese and Western medicine has a significant impact on reducing abnormally high urine protein,blood lipids and high blood albumin,and renal circulatory techniques can improve lipid metabolism disorders and hypercoagulability in children,relieving their condition and improving their clinical efficacy.There were 17 patients in complete clinical remission and 10 in partial remission.