| ObjectiveThis study aimed to validate the excellence of TCM treatment for the patients of DN(diabetic nephropathy) with CHD (coronary heart disease) using the decoction modify Si Ni San and Zhen Wu Tang. To discuss the pathogen and pathogenesis of TCM and the law of differentiation on the DM (diabetes mellitus) with the pattern of both disease of the heart and kidney from the theory.method, formula and herb of Shao Yin disease. To reveal the mechanism of fight back the inflammationMethods62 patients measure up to the standard of diagnose of DN(diabetic nephropathy) with CHD (coronary heart disease) were in a randomized, controlled study and divided into treatment group and control group. Based on the conventional therapy, nothing were added to the control group while modified Si Ni San and Zhen Wu Tang were supplied to the treatment group. Treating were constant for both of the groups. Comprehensive effect and clinical symptoms on patients of two groups were evaluated from the change of serum soluble cluster of differentiation 14(sCD14) tested by ELISA. In addition, some important indicators, such as CRP(C-reactive protein), FIB(fibrinogen), ApoA(apolipoprotein A),MA(microalbuminuria), BUN (blood urea nitrogen), Scr(serum creatinine),HbAlc (glucosylated hemoglonbin), TG(Triglyceride),TC(Total cholesterol), LDL(Low-density lipoprotein), HDL(High-densitylipoprotein), ECG(electrocardiogram), BRT(Blood Routine Test), the function of liver and so on were contrasted between two groups as well as in the own control.Results(1)The clinical comprehensive curative rates in the treatment group was 78.1% while the control group was 60.0%, there were no statistical significant difference between the two groups (P>0.05); (2) Compared with pre-treatment, the total scores of symptoms in two groups were significantly decreased after treatment(P<0.05), and the treatment group decreased significantly (P<0.05); The clinical efficacy on symptoms of TCM was 90.6% in the treatment group and 60.6% in the control group, there were statistical significant difference between the two groups (P<0.05); Compared with the control group, each symptom score in the treatment group improved inordinately after treatment;(3)The level of sCD14 decreased significantly in both groups(P<0.05),and there were statistical significant difference between two groups; Compared with patients with early stage diabetic nephropath level of sCD14 with diabetic nephropathy and overt proteinuri is higher in pre-treatment; The levels of sCD14 decreased significantly in patients both early stage diabetic nephropathy and diabetic nephropathy and overt proteinuri after treatment(P<0.01), and the levels of early stage diabetic nephropathy in the treatment group decreased significantly(P<0.05) compared with the control group; (4) The levels of CRP and FIB decreased significantly in both groups (P<0.05), and there were statistical significant difference on FIB between the two groups (P<0.05); (5) There were no statistical significant difference between two groups on the changes of ECG(P>0.05); (6)The levels of MA decreased significantly in both groups after treatment(P<0.05), and there were statistical significant difference between two groups(P<0.05); The levels of BUN were not decreased significantly in both groups after the treatment (P>0.05) The level of SCr decreased significantly in both groups(P<0.05), and there were statistical significant difference between two groups; (7)The levels of TC and TG decreased significantly in both groups (P<0.05), but there were no statistical significant difference between the two groups (P>0.05). The levels of LDL were not decreased significantly in both groups after the treatment (P>0.05); The levels of HDL were increased significantly in both groups (P<0.01); The levels of ApoA were increased significantly in both groups (P<0.05); and there were statistical significant difference between two groups(P<0.05); (8)Indicators of safety,such as BRT and liver function unchanged in both groups during the test(P>0.05);and there were no obvious side-effect in the treatment group.Conclusion(1)Heart-kidney-yang deficiency and disfunction of Shao Yin is the major pathogenesis on the DM(diabetes mellitus) with the pattern of both disease of the heart and kidney. Treating methods such as warming the kidney to assist yang, regulate the qi activity, relieve the blood stasis and eliminate the fluid were supplied based on the pathogenesis. (2)Modified Si Ni San and Zhen Wu Tang has the function of reducing vascular inflammation and protecting the heart and kidney by reducing the levels of CD14 and MA for the pationts of DM with the pattern of both disease of the heart and kidney. (3) Microcirculation was improved and the occurrence of thrombotic diseases was prevented by modified Si Ni San and Zhen Wu Tang.Because the decoction can significantly decrease the level of plasma FIB, reduce the concretion, sticky and concentrate of the blood. (4) Modified Si Ni San and Zhen Wu Tang has a role in regulating blood lipids, can significantly increase the level of ApoA. The decoction is safe to use on the clinic. (5) Modified Si Ni San and Zhen Wu Tang can improve clinical symptoms in persons with DM with the pattern of both disease of the heart and kidney. |
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