| Objective: prospective, randomized and controlled trial to investigate the correlationbetween the urinary and serum transforming growth factor-β1 (TGF-β1) and differentpathological types, different pathological features, the changes of serum creatinine level(Scr), glomerulus and renal tubule marked protein. Meanwhile, to study the significance ofthe level of the serum and urinary TGF-β1 in chronic glomerulonephritis treated withBuqiyangying qushitongluo decoction.Methods: 45 patients with chronic glomerulonephritis were enrolled, all of them wereconfirmed by kidney biopsy. Serum and urinary TGF-β1, urinary ALB, urinary IgG,,urinary TRF, urinaryα1-MG, urinary RBP, urinaryβ2-MG were measured using asandwich enzyme-linked immunosorbant assay(ELISA) kit before being biopsied. The38 patients after being biopsied were divided into two groups by random, one group of 19cases were routinely treated with prednisolone, the other group were added withBuqiyangying qushitongluo decoction. All of them were treated for two months. We testedSerum and urinary TGF-β1 after treatment.Results: (1) The levels of serum and urinary TGF-β1 were significantly higher in 45patients with chronic glomerulonephritis than in healthy controls, The level of serum andurinary TGF-β1 in mesangial proliferative glomerulonephritis(MPG), membranousglomemlonephritis (MG), sclerosing glomerulonephritis(SG), focal and segmentalproliferative glomemlonephritis (FSPG) were significantly higher than in healthycontrols(P＜0.01), the difference had remarkable significance. (2) There were 4 cases ofspleen-kidney qi insufficiency, 3 cases of lung-kidney qi insufficiency, 5. cases ofspleen-kindey yang insufficiency, 6 cases of liver-kidney ying insufficiency, 27 cases of qi and ying insufficiency in 45 patients with chronic glomerulonephritis, so most of themwere qi and ying insufficiency. (3) The levels of serum and urinary TGF-β1 weresignificantly correlated with the degree of glomerular mesangial cellular proliferation,mesangial base proliferation and interstitial inflammatory cell infiltration, were notcorrelated with the degree of glomerulosclerosis, renal tubule atrophy, interstitial fibrosis,renal arteriole lesion.. (4) The levels of serum and urinary TGF-β1 were significantlycorrelated with urinary ALB, urinary IgG,, urinary TRF, urinaryα1-MG, urinary RBP andurinaryβ2-MG(P＜0.01). The levels of urinary TGF-β1 were also significantly correlatedwith serum creatinine level (Scr)(P＜0.01), the levels of serum TGF-β1 were no correlatedwith serum creatinine level (Scr)(P＞0.05). (5)The total effective rate in one group treatedwith prednisolone was 68.42%, the total effective rate in another group treated withprednisolone and Buqiyangying qushitongluo decoction was 94.74%(P＜0.01). (6)Thelevels of urinary TGF-β1 were significantly decreased after prednisolone andBuqiyangying qushitongluo decoction therapy in chronic glomerulonephritis(p＜0.01), thedifference had remarkable significance.Conclusions: (1) The levels of serum and urinary TGF-β1 were significantly higherin 45 patients with chronic glomerulonephritis than in healthy controls and the mechanismwas probably associated with stimulating mesangial cellular proliferation and resulting inextracellular matrix. This experiment suggested the express of TGF-β1 in acute tissuedamage higher than in chronic tissue damage. (2) The serum and urinary TGF-β1 couldreflect the degree of proteinuria, especially urinary TGF-β1 reflected renal production itself,it was connected with the progressive of chronic glomerulonephritis. (3)Buqiyangyingqushitongluo decoction could restrain the secretion and expression of TGF-β1, it sloweddown the scleroses of glomerulus and interstitial fibrosis. This might be one of mechanismof treating chronie glomerulonephritis.
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