| Objective: Base on the cohesion of micro and macro differentiation,with the treatment of Supplementing Qi and Activating blood stasis,to investigate the clinical efficacy and explore the possible action mechanism of Chinese herbal compound Tangshenbao Granules in treating of the Diabetic Nephropathy(DN).Methods: 94 patients of inpatients and outpatients with DN were enrolled from the Nephrology Departement of Ruikang affiliated hospital of Guangxi University of Chinese Medicine during in Mar,2014 to Dec,2015,whose TCM syndrome type belong to the Qi deficiency and blood stasis type type.They were equally randomly divided into the treated group and the control group.There were no significant differences before treatment in age,sex,diabetes duration,DN staging,complications,etc in two groups(P >0.05).The control group was given to all patients in controlling blood pressure,blood sugar and regulating blood lipid plus irbesartan.The treated group was administered with Tangshenbao Granules twice a day additionally for 12 weeks on the basis of the control group.Changes of symptoms were observed,and laboratory indexes,as fasting plasma glucose(FPG),Glycated hemoglobin(HbA1c),blood pressure,Cystatin C(Cyst c),Serum Creatine(Scr),Urine N-acetyl-β-D-Glucosaminid(NAG),Urinary albumin excretion rate(UAER),24 h urine micro albumin,monocyte chemoattractant protein-1(MCP-1),intercellular adhesion molecule-1(ICAM-1),inter leukin-6(IL-6)and inter leukin-17(IL-17)were detected before and after treatment.Results:(1)FPG and Hb A1 c were no significant differences before and after treatment(P>0.05).(2)The blood pressure has reduced obviously in the two groups after treatment(P<0.01),and while they compared with each other,the blood pressure was no significant differences(P>0.05).(3)Scr was no significant differences before and after treatment(P> 0.05).Cyst c has reduced obviously in the two groups after treatment(P<0.05,P<0.01),but the reduction was more obvious in the treat group than that in the control group(P < 0.05).(4)24h urinary micro albumin and UAER have reduced obviously in the two groups after treatment(P < 0.05,P < 0.01),but the reduction was more obvious in the treat group than that in the control group(P < 0.05,P < 0.01).NAG has reduced obviously in the treat group after treatment(P<0.01),and the reduction was more obvious in the treat group than that in the control group(P < 0.01).While NAG was no significant differences in the control group before and after treatment(P>0.05).(5)The two groups after treatment,MCP-1,ICAM-1,IL-6 and IL-17 were significantly reduced compared with the same group before treatment,the difference was statistically significant(P<0.01),but the reduction was more obvious in the treat group than that in the control group(P<0.05,P<0.01).(6)The symptom integral has reduced obviously in the two groups after treatment(P<0.01),but the reduction was more obvious in the treat group than that in the control group(P < 0.05).(7)The total effective rate in the treatment group reached 80.85%,and the control group was 68.09%.Two groups compared with significant difference(P<0.01).(8)The two groups of patients had no obvious abnormality with no arrhythmia,liver function and blood showed,and compared with the relevant indicators,the difference was not statistically significant(P>0.05),and there was no statistical significance between the two groups(P >0.05).Conclusion:(1)Tangshenbao granules could improve significantly the clinical effect of the DN patients,which is effective,no significant toxic side effects and good safety.(2)Tangshenbao could reduce Cyst c,24 h urine micro albumin,UAER and NAG in DN patients and alleviate the damage of in kidney.(3)Tangshenbao could reduce the levels of serum MCP-1,ICAM-1,IL-6,IL-17 and other inflammatory factors in DN patients.(4)Tangshenbao could protect the kidney of DN patients,and its action mechanism may be related to inhibit inflammatory reaction. |
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