Clinical Study Of Compound "Lingzhi Jianshen Decoction" In The Treatment Of Diabetic Nephropathy

Objective:To observe the clinical effect of compound "Lingzhi Jianshen Decoction" in the treatment of early diabetic nephropathy (DN) patients and the influence on expression of angiotensinogen (AGT)、insulin-like growth factor 1 (IGF-1) in serum and urine,and to explore the possible mechanism of compound"Lingzhi Jianshen Decoction" in treating DN.Methods:60 cases of early-stage diabetic nephropathy treated in the Department of Renal medicine and Endocrinology of the first people’s Hospital of Jining City From June 2014 to June 2015 were selected, and divided into the observation group and the control group according to the principle of random.Patients in the two groups were treated with diabetes education, proper exercise, reasonable diet guidance, and strict control of blood glucose treatment.The two groups were treated with valsartan 0.08g/days. The observation group was treated with compound "Lingzhi Jianshen Decoction" on the basis of the above treatment, Water decoction prescription 200ml,1 dose/day (morning and evening service).The treatment course was 12 weeks. The changes of clinical symptoms and blood glucose, blood lipid, urinary albumin excretion rate and other indicators were measured before and after treatment.AGT and IGF-1 in Serum and urine were measured by enzyme-linked immunosorbent assay (ELISA).Results:(1) The observation group in improving the clinical symptoms of DN were significantly better than the control group (P<0.05), The total efficiency of the observation group (87.50%) was significantly higher than the total efficiency of the control group(68.18%), the difference was statistically significant (p<0.01);(2) TG、LDL-C、HDL-C in patients of the two groups were significantly improved (P< 0.05), the improvement of blood lipids in the observation group was better than that in the control group (P<0.05); (3) UAER in the observation group decreased significantly after treatment, there were significant differences compared with before treatment (P<0.01), There were also obvious differences between the two groups (P< 0.05); (4) Serum and urine AGT in observation group were decreased after treatment,there was significant difference compared with before treatment (P <0.01), in the groups a more significant decrease was observed (P<0.05); (5) Serum IGF-1 within and between the groups were no significant difference (P>0.05), Urine IGF-1 in the observation group were significantly lower than those before treatment, there were also significant differences compared with the control group(P<0.05); (6) Correlation analysis showed that urinary AGT was positively correlated with UAER (r=0.359, P< 0.05), urine IGF-1 was positively correlated with UAER (r=0.455, P<0.05).Conclusions:Compound "Lingzhi Jianshen Decoction" can obviously improve the clinical symptoms of patients with early DN, significantly reduce urinary albumin, and improve the lipid metabolism disorders to a certain degree.It has ideal renal protective effect,the mechanism may be related to decreased urinary IGF-1 levels, and inhibited the activity of RAS in a certain extent. Renal protective effect does not rely on the hypoglycemic effect,.It has exact curative effect,and it is worthy of clinical application.