Effct Of Conggui Yishen Granules On Serum VEGF And Urinary CTGF In Patients With Early Type 2 Diabetic Nephropathy

Objective: To observe the effects of Conggui Yishen Granules on fasting plasma glucose,postprandial 2h plasma glucose,glycated hemoglobin A1 c,fasting insulin,home ostasis Model evaluation-Insulin resistance,insulin sensitivity index,renal functi on related indexes(cystatin C,homocysteine,serum creatinine,blood urea nitrog en),urinary protein(albumin urine,albumin urine),serum vascular endothelial g rowth factor,urinary connective tissue growth factor and TCM syndrome score and symptoms improvement in type 2 diabetic kidney disease patients with kidn ey deficiency and blood stasis syndrome,to evaluate the clinical efficacy of Con ggui Yishen Granules in the treatment of type 2 diabetic kidney disease.Methods: 60 patients with early type 2 diabetic kidney disease were randomly divided in to two groups.All patients were treated with routine hypoglycemic therapy befo re admission.The control group(30 cases)was treated with irbesartan,and the observation group(30 cases)was treated with Conggui Yishen Granules on the basis of the control group.Four weeks as a course of treatment,a total of thre e courses.The scores of TCM syndromes,improvement of clinical symptoms,b lood glucose related indicators,insulin resistance related indicators,renal functio n related indicators,urinary protein,serum vascular endothelial growth factor an d urinary connective tissue growth factor levels were compared between the two groups before and after treatment.To explore the clinical efficacy of Conggui Yishen Granules in the treatment of type 2 diabetic kidney disease.Results:60 patients with kidney deficiency and blood stasis syndrome of early type 2 di abetic kidney disease were enrolled in the study group,with 30 in the observati on group and 30 in the control group,55 cases(5 cases)were followed up effe ctively,with 27 in the observation group and 28 in the control group.There w as no significant difference in age,sex,weight,course of disease,TCM syndro me score and blood sugar level between the two groups before treatment(?>0.05).(1)TCM syndromes: After treatment,the symptoms and signs of the patients in the observation group were improved,and the total score of TCM syndromes improved significantly compared with the control group(?<0.01).(2)Terms of blood sugar and insulin resistance: After treatment,Fasting plasma glucose(FPG),Fasting insulin(FINS),Homeostasis Model evaluation-Insulin resistance(HOM A-IR)in the observation group were significantly decreased,Insulin sensitivity i ndex(ISI)was significantly increased,compared with before treatment(?<0.05,?<0.01),but there was no significant change in Postprandial 2h plasma glucose(2h PG)and Glycated hemoglobin A1c(Hb A1c);compared with the control group,F PG decreased significantly in the observation group.FINS,HOMA-IR and ISI i mproved significantly(?< 0.01),but there was no significant change in 2h PG a nd Hb A1 c.(3)Relevant indicators of renal function and urinary protein: After tre atment,Cystatin C(cys C),Homocysteine(Hcy,)Albumin urine(ALBU),Urine Al bumin-to-Creatinine Ratio(UACR)in the observation group decreased significantl y compared with those before treatment(?<0.01),while the levels of Serum cre atinine(Scr)and Blood urea nitrogen(BUN)did not change significantly.There was no significant change in Scr and BUN,but significant decrease in ALBU a nd UACR(?<0.01).(4)Serum VEGF and urinary CTGF: After treatment,the leve ls of serum VEGF and urinary CTGF in the observation group were significantl y lower than those before treatment(? < 0.01),while those in the control grou p were significantly lower than those before treatment(? < 0.05),and there we re significant differences between the two groups(?< 0.05).(5)Safety indicators:All subjects routine blood and urine,chest X-ray,liver function and electrocar diogram were in normal range during the follow-up,and no obvious adverse re actions occurred.CONCLUSION: The results of this clinical study show that the curative effect of combination o f Western medicine and Conggui Yishen Granules in treating kidney deficiency and blood stasis syndrome of early type 2 diabetic kidney disease patients is be tter than western medicine alone.It can significantly improve the clinical sympt oms of patients,reduce blood sugar,increase insulin sensitivity index,improve i nsulin resistance and renal function related indicators,reduce urinary protein,an d also improve the serum VEGF and urinary CTGF level of patients with type 2 diabetic kidney disease,has no obvious side effects.This study provides an e ffective basis for the treatment of kidney deficiency and blood stasis syndrome in early type 2 diabetic kidney disease with Conggui Yishen Granules,and lays a foundation for further research.