Clinical Study On Effects Of Sinomenine On Renal Tubular Proteinuria And Serum TNF-? In Early DKD

Objective:By observing the effects of sinomenine on urinary?2-microglobulin,urinary NAG enzyme,urine microprotein and serum tumor necrosis factor-? in patients with early diabetic nephropathy,the effects of sinomenine on renal tubulointerstitium in patients with diabetic kidney disease can be studied.Methods:Fifty patients with early diabetic kidney disease from Hubei provincial hospital of traditional Chinese medicine who met the criteria included in this study were randomly divided into control group(n=25)and test group(n=25).The control group was treated with basic treatment such as hypoglycemia,hypotension,lipid-lowering and so on.The test group was treated with sinomenine 120 mg Bid on the basis of control group.And then the study measured two group's urine ?2-microglobulin,urinary NAG enzyme,urine microprotein,glycosylated hemoglobin,serum creatinine and serum tumor necrosis factor-? levels before and 8 weeks after treatment.Results:1.Comparison of total curative effect between the two groups: the total effective rate of disease in control group was 48% and that in sinomenine test group was 76%.There was a statistically significant difference after the rank sum test(P<0.05).2.Comparison of urinary ?2-microglobulin,urinary NAG enzyme and urinary microprotein in two groups before and after treatment: There was no significant difference between before and after treatment in control group(P>0.05).While urine ?2-microglobulin,urine NAG enzyme and urine microprotein all decreased after treatment in the test group(P<0.05).And the study showed the levels of ?2-microglobulin,NAG enzyme and trace protein in urine of the test group were lower than those of the control group(P<0.05)after the comparison among two groups.3.Comparison of serum TNF-? levelsin two groups before and after treatment:There was no significant difference between before and after treatment in control group(P>0.05),but TNF-? significantly decreased after treatment in the tset group(P<0.05).Also,the study showed the TNF-? levels of test group were lower than the control group after treatment,and the difference was statistically significant(P<0.05).4.Comparison of glycosylated hemoglobin and serum creatinine in two groups before and after treatment:There was no significant difference between before and after treatment in both two groups(P>0.05).And between the two groups,there was no significant difference in the levels of hemoglobin and serum creatinine after treatment(P>0.05).5.Comparison of safety indexes between the two groups: There was no significant difference in liver function,electrocardiogram and blood routine before and after treatment between the two groups(P>0.05).No obvious side effects were found in the two groups during the observation period.Conclusion:1.Sinomenine can reduce the level of urinary ?2-microglobulin,urinary NAGase and urinary microprotein in patients with early DKD,improve the clinical symptoms of patients,effectively protect the renal tubular function in them,and delay the progression of DKD.2.Sinomenine can reduce the level of serum tumor necrosis factor-? in patients with diabetic kidney disease,improve the situation of inflammation and stress in patients with early diabetic kidney disease.What's more,the study implied that sinomenine may be one of the mechanisms of renal tubular protection in patients with diabetic kidney disease and it deserve the further study.