Clinical And Experimental Study On Diabetic Nephropathy With The Method Of Tonify Qi And Yin And Activate Blood And Remove Stasis

Objective: To observe the clinical effect of Qizhi jiangtang capsule on the treatmentof Diabetic Nephropathy (DN)3rd stage. And, to investigate the renoprotective effect andits possible mechanism of Qizhi jiangtang capsule on the right kidney removal with celiacstreptozcin(STZ) preparation methods DN rats.Methods:1, Ninety-six appropriate DN patients3rd stage were accord to the digital meter methodrandomly divided into two groups: the experiment group(n=48), control group(n=48). The experimentgroup patients were treated by Qizhi jiangtang capsule (2.5g, tid), while Valsarttan capsule(80-160mg,qd) was given to control group patients. After3months’ treatment, urinary albumin excretionrate(UAE), blood pressure(BP), renal function, endotheiln(ET), nitric oxide(NO), were examined.2,Forth-eight male Wistar rats were randomly divided into normal control group (n=8), model group(n=10), Valsarttan capsule groups (n=10), low dose Qizhi jiangtang capsule group (n=10), high doseQizhi jiangtang capsule group (n=10).The rats diabetic nephropathy was established by right kidneyremoval with celiac STZ. Medicine was given to each group according to the designed concentrationand dosage. Respectively on4,8and12weeks observation DN rats BP,24TP, retinol bindingprotein(RBP), utral alpha glucosidase(NAG), urine prophase renal function, blood sugar(BS), renalfunction, β2-MG were measured. After12weeks, puted to death all the animals, kidney tissues wereperformed with HE and PAS staining, light-miScroscopy tissue lesions, measured renal parenchymasmall artery intima/medium film thickness ratio, and semi-quantitative analysis calculation ballhardening index (GSI) and interstitial fibrosis index (IF); Immunohistochemical detection renal tissuesMCP-1protein and CD31; In situ hybridization method to detect MCP-1mRNA in renal tissue ofexpression; Immunofluorescence test renal arterioles alpha SMA expression.Results:1, In clinic, the UAE in the experiment group was significantly lower than controlgroup(P<0.05), the renal function was ameliorated obviously in test group(P<0.05), ET wassignificantly lower than control group(P<0.05), NO was significantly higher than controlgroup(P<0.05). Indicated that Qizhi jiangtang capsule by reducing urine protein, BS and BP in order toprotect renal function, adjust ET and NO improve vascular contraction function expansion, patients withqi and yin deficiency, blood stasis blocking collaterals of improvement in symptoms and signs of traditional Chinese medicine, play the role of the treatment of DN3rd stage.2, In experiment, Qizhijiangtang capsule improved the renal function of DN rats markedly(P<0.01), HE staining, PAS stainingand electron microscopy results showed there treatment groups improved renal tissue lesions, GSI andIF indirect improved significantly in the model group showed renal tissue lesions, down-regulated therenal expression of monocyte chemoattractant protein-1(MCP-1)(P<0.05-P<0.01), CD31(P<0.05-P<0.01), MCP-1mRNA(P<0.05-P<0.01), α-SMA(P<0.05-P<0.01). Reflect the renal parenchymasmall artery intima/medium film thickness ratio and inflammatory factor expression were positivelycorrelated, reduce the urine protein, improve the glomerular basement membrane thickening mesangialproliferation and extracellular matrix increase, obviously postponed DN.Conclusion:1, Qizhi jiangtang capsule can help to reduce urine protein, BS and BP,reduce ET and increase NO in order to protect the vascular morphology features,postponed DN course.2, Qizhi jiangtang capsule owns the renoprotective effect in DN ratsand can reduce urinary protein excretion, the effect may lie in down-regulation of MCP-1,CD31, MCP-1mRNA and α-SMA, the mechanism of which may be through theinhibition of inflammatory factors on renal vascular injury and play the role of DNintervention.