| Objective: To observe the clinical indicators and efficacy of Danzhi Jiangtang Capsule in the treatment of early type 2 diabetic kidney disease(DKD),and the effect on the expression of klotho and FGF2 in diabetic nephropathy rat model.To explore the effect and mechanism of Danzhi Jiangtang Capsule on type 2 diabetic nephropathy,and provide clinical data and theoretical basis.Method: 1 Clinical study Patients with diabetic nephropathy included in the trial were randomly divided into 30 cases in the treatment group and 30 cases in the control group.They were all treated with oral hypoglycemic agents or insulin injections and other conventional hypoglycemic regimens,and routinely took losartan potassium 50 mg once every morning.The treatment group received oral Danzhi Jiangtang Capsule in addition to the above basic treatment,3 capsules 3 times a day.In this study,one course of treatment was 4 weeks,and three consecutive courses were observed.Collect specimens to test and record FPG,2h PG,Hb A1 c,ACR,Scr,BUN,and TCM syndrome scores before and after treatment.2 Animai experiment Ten SD rats were randomly selected from 70 SD rats as the blank group.The rest 60 rats were used as model rats and fed with high-sugar and high-fat diet for 4 weeks.After a single intraperitoneal injection of streptozotocin(STZ),DKD rat models were constructed.9 died and failed during the modeling process.The rats successfully modeled were randomly divided into 11 model groups,10 losartan potassium groups.and 10 high,medium,and low dose groups of Danzhijiangtang capsule.The high,medium and low dose groups were given intragastrically 0.66g/kg·d,0.33g/kg·d,0.17g/kg·d,respectively;the losartan potassium group was given intragastrically losartan potassium 10mg/kg·d;the blank group and the model group were given intragastrically normal saline 5ml/kg·d,and the administration time was 8 weeks.After the test,renal function,blood glucose,and Hb A1 c were measured.Pathological changes were observed by HE staining in kidney tissues,and Klotho and FGF2 protein contents in kidney tissues were detected by Western blot.Result: 1 Clinical trial results 55 included patients completed this trial.After the treatment,the total effective rates of the treatment group and the control group were 78.6% and 51.9%,respectively(P<0.05).Compared with before treatment,the quantitative scores of TCM syndromes of the two groups of patients decreased(P<0.01);the scores of TCM syndromes of the treatment group decreased more significantly than the control group(P<0.05).After treatment,FPG,2h PG,Hb A1 c,SCr,BUN and ACR all decreased(P<0.05).Compared with the control group,the levels of 2h PG,Hb A1 c,Scr,BUN and ACR in the treatment group decreased more significantly(P<0.01),the levels of FPG decreased(P<0.05).2 Animal experiment results After treatment,compared with the blank group,the weight of the rats in the model group and each treatment group decreased(P <0.01).Compared with the model group,the weight of each treatment group increased(P <0.05).Compared with the model group,the FPG in the high,medium,and low dose groups of Danzhijiangtang capsule decreased(P <0.01),and there was no significant difference in the Losartan potassium group(P> 0.05);Compared with the model group,the Scr,BUN in the high,medium of Danzhijiangtang capsule,and Losartan potassium groups were all decreased(P <0.01),low dose groups of Danzhijiangtang capsule decreased lessly(P <0.05).Compared with the model group,the 24 h UP in the traditional Chinese medicine group and the Losartan Potassium group decreased(P <0.01).HE staining showed no obvious abnormalities in the pathological morphology of the kidneys of the rats in the blank group,pathological changes of glomerular and basement membrane were observed in the model group,and the pathological changes were alleviated in the treatment group compared with the model group.Compared with the blank group,the results of Westem blot showed that the expression of klotho decreased and the expression of FGF2 increased in the kidney of the model group(P<0.01).Compared with the model group,the expression of klotho increased in the high dose group of Danzhi Jiangtang capsule and the losartan potassium group(P <0.01),the expression of klotho slightly increased in the medium dose group(P <0.05),and the expression of klotho in the low dose group was not significantly increased(P> 0.05);the expression of FGF2 decreased in the high and medium dose groups of Danzhi Jiangtang capsule and the losartan potassium group(P <0.01),and the expression of FGF2 in the low dose group medicine decreased slightly(P <0.05).Conclusion: Danzhi Jiangtang Capsule can obviously improve the clinical symptoms of qi-yin deficiency in early DKD patients,and alleviate renal damage in DKD rats.The mechanism may be related to increasing klotho expression and reducing FGF2 expression. |
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