| Background: Chronic kidney disease(chronic kidney disease, CKD) become a common chronic diseases, the incidence rate is rising year by year,which has attracted much attention in the global scope. Primary glomerular disease is a common chronic kidney disease, with chronic glomerulonephritis(chronic glomerulonephritis, CGN)incidence rate occupies the first place, lingering illness, repeated seizures, kidney tissue damage gradually, the development of chronic renal failure, data confirmed.CGN is the main renal failure of primary disease, significantly reduce the quality of life of the patients.CGN is an immune mediated, slow development of glomerular disease, its clinical and pathological processes varied, showing different degrees of proteinuria, hematuria, edema,hypertension and renal function impairment. Western Medicine on the pathogenesis of this disease has been relatively clear, but no better treatment, and the side effect is big, cost is higher. Traditional Chinese medicine has obvious curative effect and no obvious side effect on the clinical disease, but the micro mechanism is not clear. This study to test the new index as the means, reveals the mechanism of traditional Chinese medicine in the treatment of CGN, combined with modern medical detection method, preliminary clarify Chinese medicine therapeutic target.Objective: To observe the effect of New Yishen Decoction on the TGF-β1,and MMP-9 in patients with chronic nephritisto,and to investigate the effect and mechanism of New Yishen Decoction from the perspective of molecular biology.Methods: 90 cases of CGN patients as the object of study, all cases were from Shanxi Province Hospital of traditional Chinese and Western medicine kidney Department of internal medicine inpatient and outpatient patients. The patients numbered according to the random number table,were randomly divided into Lotensin group, Yishen Decoction group and the new kidney Tonga Lotensin group, 30 cases in each group. 15 cases of health also set up the same period in this hospital is normal control group. Before treatment, detection and comparison of normal group and 90 patients with 24 hour urinary protein quantitative(UTP), urine beta 2 microglobulin(β2-MG), serum cystatin C(Cysc), serum creatinine(SCr), and by enzyme linked immunosorbent assay(ELISA) method for detection levels of serum TGF-β1, MMP-9. 12 weeks of treatment, during treatment, every 2 weeks records the levels of UTP, Cysc, SCr,β2-MG. The levels of TGF- β1, MMP-9 were measured every 4 weeks.Results:1) Before treatment, The levels of TGF- β1 of 90 cases patients were(14.5±2.5) ng/ml, which increased compared with(8.2±2.8) ng/ml in the normal group;The levels of MMP-9were(82.4 ±10.4) ng/ml, which decreased compared with(102.3 ± 9.6)ng/m in lthe normal group, P <0.05;2) In terms of disease curative effect, total effectiveness in Lotensin group and New Yishen Decoction group respectively was 76.7%(23/30) and 80%(24/30), the differencewas not statistically significant(P > 0.05);the total efficiency of new Kidney Decoction Lotensin groupwas 93.3%(28/30), better than the other two groups,( P <0.05);3) In terms of traditional Chinese medicine curative effect, total effectiveness in Lotensin group and New Yishen Decoction group respectively was 76.7%(23/30) and 73.3%(22/30), the difference was not statistically significant(P > 0.05); the total efficiency of New Kidney Decoction Lotensin group was 90%(27/30), better than the other two groups(P <0.05);4) Before treatment, the difference of laboratory index levels was not statistically significant among three groups(P > 0.05); after the treatment, the levels of each index in every group were decreased, there were statistical significance compared with those before treatment(P <0.05);the difference of laboratory index levels was not statistically significant between Lotensin group and New Yishen Decoction groups, there were no significant differences between the groups(P > 0.05);the level of UTP in new kidney Tonga Lotensin group significantly decreased, there were statistical significance compared with those before treatment(P <0.05), and the other two groups after treatment;β2-MG,SCr, Cysc decreased, but compared with the other two groups of indexes had no statistical difference(P > 0.05);5) Before treatment, the level of TGF- β1 MMP-9were no significant difference(P > 0.05);after the treatment, the level of TGF- β1 MMP-9 in Lotensin group and New Yishen Decoction group changed significantly, there were statistical significance compared with those before treatment(P <0.05),but there were no significant differences between the groups(P > 0.05)after the treatment; the level of TGF- β1, MMP-9 in New kidney Tonga Lotensin group were(8.7±2.2) ng/ml and(102.6±7.4) ng/ml, significantly improved compared with the levels before treatment, and better than the other two groups(P < 0.05);6) All of grades adverse reactions were not found in all patients, no statistically significant between group differences in safety coefficient(P > 0.05).Conclusion: 1) Compared with healthy subjects, the level of TGF- β1 in CGN patients increased obviously, while the level of MMP-9 level decreased, which may be related to glomerular fibrosis in patients with CGN;2) New Yishen Decoction can effectively improve the clinical symptoms of the patients with CGN, reduce the urinary protein quantitative, secretion and regulation of CGN in patients with TGF- β1, MMP-9, the down-regulation of TGF- β1 levels and increase the level of MMP-9, protect renal function, and delay renal fibrosis, may be one of the mechanism of New Yishen Decoction Treatment of CGN, provide new ideas and basis for traditional Chinese medicine therapeutic target. |
PDF Full Text Request