| 1.Objective and significanceThe purpose of this study is the clinical effect of uremic Ling observed in strict accordance with the diagnostic criteria for inclusion criteria to select patients with drug use,and observe the points syndromes,biochemical indicators such as changes in;At the same time,the role of Hope for the uremic mechanisms to TGF/smad pathway targets for research,experimental study of exploratory;aimed at finding new treatments for DN on the experience of veteran experts who carried out the role of the clinical efficacy and mechanism at the same time,in order to prepare for the development of new drugs.2.MethodInpatient and outpatient diabetes were selected in line with the diagnostic criteria of DN patients,in line with the diagnostic criteria,serum creatinine 178≤(Cr)≤442ummol/l,to exclude other causes of renal dysfunction observed in patients with 30 cases observed for three months observed in patients with symptoms of drug use before and after integration, biochemical,blood lipids,liver function,blood changes,and the final effect.SPF level 48 male Wister rats,weighing 180-220g,adaptive feeding week. Were randomly divided into normal control group 12,36 for the remainder of model.Selected as the model way to STZ(streptozotocin) + adenine ig:STZ used to buffer(2.1g of citric acid dissolved in 100ml double distilled water pair A liquid,2.44g sodium citrate dissolved in 100ml double distilled water for the B solution,A,B buffer solution is mixed) configuration,36 rats were fasted for 12 hours,STZ with a dose of 60mg/kg body weight,intraperitoneal injection of one-time,three days Random post-test blood glucose,blood glucose is greater than 16.1mmol/l of the rat,model successful,To reduce the mortality,rate of blood glucose greater than 25mmol/l in rat subcutaneous insulin ordinary 1-2iu,inadequate blood glucose 16.1mmol/l in rats, complement injection STZ 20mg/kg;all into a mold,the 2 percent to adenine, 300mg/kg administered every 7 days until the check into one orbital venous mode..Model the process five rats dead,after the mold into the remaining 31 rats,high to low according to serum creatinine levels,divided into model group,Niaoduling group,Niaoduqing group;model group,2-4ml orally given normal saline,NiaoduLing group to 0.432g/kg,Niaoduqing Niaoduqing group to 0.27g/kg;administration two months after the orbital venous plexus biochemical blood test,so take some kidney immunohistochemistry,kidneys do some RT-PCR.3.ResultExperimental study components:treatment group compared with the model group,serum creatinine uremic spiritual group,blood urea nitrogen were statistically significant decline;Ling uremic group compared with the model group of cholesterol,triglyceride,low-density lipoprotein cholesterol were no significant differences,no statistical significance;TGF-β1,Smad3, Smad4,PhI-1 expression in model group than those in blank control group significantly increased,with statistical significance,P＜0.05,Ling uremic group than those in the above-mentioned protein expression in model group decreased significantly;RT-PCR detection of rat renal tissue TGF-β1mRNA, Smad3 mRNA,Smad4 mRNA,fluorescence quantitative PCR detection of various targets in the kidney tissue,the model group and blank group were significantly different,P＜0.05,Ling-uremic group Niaoduqing group compared with the model group significantly different,P＜0.05,statistically significant after administration.Clinical Observation Part:Effect of uremic Ling:5 cases markedly,accounting for 16.67%;21 cases effective,accounting for 70%;nulland void four cases,accounting for 13.33%; the total effective rate 86.67%.Control before and after medication,the patient symptom score was statistically significant decrease(P＜0.01).Before and after contrast administration,patients with blood urea nitrogen,serum creatinine was statistically significant decrease(P＜0.05); patients with CHOL,TG and LDL-L reduction in the level of statistical significance(P＜0.05);the safety of drug use indicators of liver function no statistical significance before and after,blood leukocytes,no significant changes in red blood cells,hemoglobin increased.4.ConclusionExperimental studies by the following conclusion:a good soul uremic serum creatinine clearance,blood urea nitrogen,such as the role of toxins.Uremic Ling has a good reduction of transforming growth factor(TGF-β),plasminogen activator inhibitor(PAI-1) in the kidney of small ball,interstitial,tubular expression of TGF-β1 inhibition of mRNA synthesis.Therefore,it can be concluded that uremic TGF-β/Smad Ling can inhibit transduction pathway.Ling uremic TGF-β/Smad may be through inhibiting the transduction pathway,to achieve the inhibition of glomerular,renal interstitial fibrosis,tubular fibrosis,and thus play a role in renal protection.Through clinical research,to observe the targets and safety indicators before and after contrast.A very good effect can be gained,renal failure symptoms in patients with uremic diabetic nephropathy was improved,removal of small and medium-sized molecules of blood toxins,to increase the role of hemoglobin;not found a clear role in lowering serum uric acid;not found any adverse reactions in patients,and adverse events the occurrence of unknown side effects.
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