Clinical Research And Mechanism Exploration Of Qidi Xiaoke Shenshuai’an Decoction Combined With Retention Enema In The Treatment Of Diabetic Kidney Failure Based On "One Principle And Eight Methods"

Objective: To evaluate the clinical efficacy of Qidi Xiaoke Shenshuai’an Decoction combined with Retention Enema in the Treatment of Diabetic Kidney Failure(liver-kidney deficiency-dampness,turbid toxin syndrome)based on "One Principle and Eight Methods".To explore its renal protective effect preliminary,riching theoretical connotation of "toxin damages the kidney meridian,evil hides the membrane".The purpose is to provide a newline of thought for clinical treatment of diabetic kidney failure.Methods: 1.A total of 64 cases of diabetic kidney failure(liver-kidney deficiency-dampness,turbid toxin syndrome)were collected in the Endocrinology and Metabolism Department of the Affiliated Hospital of Changchun University of Traditional Chinese Medicine.The patients were divided into two groups by the random number table method with 32 cases in treatment group and 32 in control group.The treatment group was asked to take Qidi Xiaoke Shenshuai’an Decoction orally and was given Paidu Decoction enema combined with "one principle and eight methods" for supervision and control.The control group was given Haikun Shenxi Capsule orally and rectally administered Shenkang Suppository along with lifestyle management Both groups were given basic hypoglycemic,hypotensive and lipid-lowering therapy.A course of treatment is 4 weeks,which can be treated for 3 consecutive courses according to the condition.2.The targets of Qidi Xiaoke Shenshuai’an Decoction and Paidu Decoction in the treatment of diabetic kidney failure were predicted by network pharmacology,and GO and KEGG enrichment analysis was performed.Results: 1.Based on "one principle and eight methods",Qidi Xiaoke Shenshuai’an Decoction combined with retention enema in the treatment of diabetic kidney failure(liver-kidney deficiency-dampness,turbid toxin syndrome),the total effective rate was81.20% in the treatment group and 71.90% in the control group,the treatment group was better than the control group.Both groups of treatment can reduce the patients’ serum creatinine,blood urea nitrogen,blood uric acid,reduce proteinuria,improve clinical symptoms,the treatment group is better than the control group.However,there was no significant difference in the glomerular filtration rate between the two groups after treatment.The blood glucose levels of the two groups were significantly improved after treatment,but there was no significant difference between the treatment group and the control group.After treatment,the expressions of NF-κB,VEGF,ICAM-1,IL-6 and EGFR decreased,and the treatment group was better than the control group.2.Qidi Xiaoke Shenshuai’an Decoction in the treatment of diabetic kidney failure may be through the main active components such as quercetin,β-sitosterol and stigmasterol in the compound,combined with AKT1,IL6,JUN,VEGFA,IL1 B,CASP3,EGFR,HIF1 A,ESR1,MYC and other core targets,through lipid and atherosclerosis,fluid shear stress and atherosclerosis,AGE-RAGE signaling pathway,tumor necrosis factor signaling pathway,HIF-1 signaling pathway.It exerts renal protection in a multi-component,multi-target and multi-path way.3.Paidu decoction in the treatment of diabetic kidney failure may be through the main active components such as quercetin,kaempferol,and luteolin in the compound,combined with core targets such as ALB,IL6,ESR1,CTNNB1,HIF1 A,MYC,PPARG,EGFR,CASP3,VEGFA,etc.point,through lipid and atherosclerosis,fluid shear stress and atherosclerosis,AGE-RAGE signaling pathway,apoptosis,TNF signaling pathway,etc.It exerts renal protection in a multi-component,multi-target and multi-path way.Conclusion: 1.Based on "one principle and eight methods",Qidi Xiaoke Shenshuai’an Decoction combined with retention enema has a exact curative effect in the treatment of diabetic kidney failure(liver-kidney deficiency-dampness,turbid toxin syndrome),which can reduce serum creatinine,blood urea nitrogen,blood uric acid,and reduce proteinuria,improve renal function,improve the clinical symptoms of patients,and have a certain hypoglycemic effect.2.Based on "one principle and eight methods",Qidi Xiaoke Shenshuai’an Decoction combined with retention enema in the treatment of diabetic kidney failure involves the joint action of multiple components,multiple targets and multiple pathways.In this study,it exerted renal protection by inhibiting the inflammatory and fibrotic responses mediated by NF-κB,VEGF,ICAM-1,IL-6,and EGFR.