Developing The Relationships Between Urine KIM-1,urineβ₂-MG Content Change Of Early Stage Of Diabetic Nephropathy And Damp-heat Related Symptoms

Objective:Diabetic nephropathy(DN) is one common capillaries complication of Diabetes mellitus(DM). The western physicians believe the pathology in early stage DN should be glomerular sclerosis, yet researchers found that the tubular damage occurred in the early DN stage. By checked the previous literatures, kidney injury molecule-1(KIM-1)and urineβ2-MG are identified to be marker for specifically diagnosing renal tubular injury. The traditional chinese physicians hold the view of which the real pathogeny of DN is widely believed to be asthenia in origin and asthenia in superficiality. Most of the related researches lie in Hauptbeweis, which is to treat both symptoms and root causes.Background check tells us that patients mainly show damp-heat or related symptoms in the stage of DN. Therefore, we are aiming at developing the relationships between markers urine KIM-1, urineβ2-MG of the early DN stage and damp-heat related symptoms, which may provide new methods and directions for early diagnosing and treating DN in the ways of west-Chinese combination.Methods:Grouped 60 patients all came from the diabetics of departments of traditional Chinese medicine and endocrinology of Airforce General Hospital during 2014.5 and 2015.1, in which contains 30 DM patients(DM group) and 30 DN(Ⅲ) patients(DN group). For the controlled group(NC group), we selected 30 healthy people which came to our Health Examination Center during the same period. The DN group was further sortedinto damp-heat group and non-damp-heat group after finished designed Chinese medical questionnaire and inquiry. Clean middle urine of DM and DN patients after morning rise was collected and the KIM-1 and urineβ2-MG were analyzed using enzyme-linked immuno sorbent assay method. Those data will be further analyzed using SPSS 17.0Results:1. Middle aged men and beyond occupied most early DN stage patients, both their morbidity and mean age are higher than women’s. Most of the DN patients are office clerk and retired light labor, farmers ranked third. All patients didn’t have a regular daily schedule, love fatty, salty, or strong tasty food, they probably had history of smoking or drinking, and showed signs of DN in about 10-20 years.2. To analyze from the dialectical point of Chinese medicine view, DN patients showed mainly the symptoms of Yin scorching, taking 68.3%, which is in the sequence of Yin scorching, Qi-and-Yin deficiency, vital energy deficiency of spleen and kidney,and Yin-and Yang deficiency. Standard symptoms of damp-heat takes 35% and non-damp-heat and phlegm stagnation counts 30%.3. Relative to the early stage of DN group patients, density of urine KIM-1 and urineβ2-MG will low in DM and NC groups(p<0.05). The average density of those two markers showed higher in DM than NC group.4. Creatinine clearance rate(CCR) in DN and DM groups exhibited evidently degradation compared to the NC group(p<0.05),but the early stage of DN group showed a little advanced CCR.The CCR in DM and DN groupshas no statistical significance(P>0.05).5. In the DN group, compared to the non-damp-heat group, damp-heat group showed higher concentration urine KIM-1.6. In the DN group, compared to the non-damp-heat group, damp-heat group showed lower urine β2-MG concentration.This data showed statistical significance(p<0.05).7. Relative to NC group,CCR in DN of damp-heat group showed lower than non-damp-heat group,but non-damp-heat group showed statistical significance(p<0.05).Conclusions:1. The influence factors of DM in the occurrence and development ofthe early stage of DN is closely related with course of disease, age, sex, occupation, living habits, etc..2. The early stage of DN in traditional Chinese medicine by dryness heat due to deficiency of Yin Syndrome in TCM, comply with the rules of DM.The early stage of DN standard card is the damp heat syndrome and stagnation of phlegm and blood stasis together accounted for the majority, prompting the pathogenesis evolution is deficiency, which provides a theoretical basis for the treatment of traditional Chinese medicine.3. The early stage of DN group patients presence ofrenal tubular injury and the urine KIM-1, urineβ2-MG contentincreased.4. More severe in the early stage of DN group patients with damp heat syndrome of renal tubular damage compared with non damp heat syndrome.