Clinical And Experimental Study On The Effect Of Tangshenkang Granules On Diabetic Kidney Diseases Notch1 And Hes1

Objective: To observe through clinical controlled trials that patients with diabetic kidney disease(DKD)with deficiency of both qi and yin and blood stasis,after taking Tangshenkang granules,affect the Notch1,the transmembrane proteins of blood mononuclear cells(Transmembrane proteins Notch1)and hair split-related enhancer 1(Hairy enhancer of splitl 1,Hes1)and the influence of DKD related indicators and TCM syndrome integrals to explore the clinical efficacy and mechanism of Tangshenkang Granules in the treatment of patients with DKD Qi and Yin deficiency and blood stasis syndrome,and provide an objective for TCM to prevent and treat DKD in accordance with.Methods: The research plan adopted for this subject was approved by the Ethics Committee of Anhui Provincial Hospital of Traditional Chinese Medicine.A total of 75 eligible patients with DKD syndrome of deficiency of both qi and yin and blood stasis who were admitted to the Department of Nephrology and Endocrinology in our hospital from January 2020 to October 2020 were selected.A total of 75 eligible cases were enrolled.According to the random number table method,they were divided into 38 cases in the control group and 37 cases in the treatment group.Both groups received lifestyle intervention and basic western medicine treatment.The treatment group was treated with Tangshenkang granules(3 times/day,1 bag/time),and the course of treatment was 8 weeks.In addition,20 healthy patients were included in the normal group,all from the health examination center of our hospital at the same time.Detect Notch1 and Hes1 proteins in blood mononuclear cells,renal function,blood sugar,urine albumin to creatinine ratio(UACR)and 24 hour urine protein(24h Upro)before and after treatment in the two groups of patients,and observe TCM syndrome scores Changes;the normal group only detected blood Notch1 and Hes1 proteins in blood mononuclear cells,and used statistical methods to compare and analyze.Results:1.A total of 75 patients with DKD Qi and Yin Insufficiency and Blood Stasis Syndrome were collected,70 of them completed the clinical observation of the whole process,3cases in the control group,2 cases in the treatment group,and the rate of loss was 6.70%.The following results are completed The situation of 70 patients.2.Disease curative effect:the total efficacy rate of the treatment group was 82.86% and that of the control group was 51.43%.Compared with the two groups,the curative effect was significantly different(P<0.05);the total effective rate of the treatment group and the control group was 85.71% and 57.14% respectively.there was a significant difference between the two groups in curative effect(P<0.05).3.Comparison of TCM syndrome scores:there was no difference between the two groups before treatment(P>0.05);after treatment,the treatment group and the control group were significantly lower than before treatment(P<0.01);while the treatment group’s score decreased compared with the control group Group is more significant(P<0.01).4.UACR and 24 h Upro:There was no difference between the two groups before treatment(P>0.05);after treatment,the control group and the treatment group were significantly lower than before the treatment(P<0.01);while the decline of treatment group was significantly higher than the control group(P<0.01).5.Scr,e GFR,FBG,2h PBG:Before treatment,there was no significant difference between the two groups(P>0.05);after treatment,there was no significant change in the indicators of the above two groups compared with before treatment(P>0.05).6.Notch1 and Hes1 proteins in blood mononuclear cells:Before treatment,the levels of Notch1 and Hes1 proteins in blood mononuclear cells in the two groups were significantly higher than these in the normal group(P<0.01);while there was no significant difference between the control group and the treatment group(P>0.05).After treatment,the levels of protein levels of Notch1 and Hes1 in blood mononuclear cells in the two groups were significantly down-regulated(P<0.01),and the improvement in the treatment group was distinctly better than that in the control group(P<0.05).7.Safety indicators:There were no abnormalities in blood routine,alanine aminotransferase,stool routine + occult blood(OB),and electrocardiogram in the treatment group.Conclusion:1.Tangshenkang granules can improve the clinical symptoms of patients with DK D Qi and Yin deficiency and blood stasis syndrome,and have the effect of reducing urine protein.2.The expression levels of Notch1 and Hes1 in DKD patients with Qi and Yin deficiency and blood stasis syndrome were significantly higher than those in healthy people.3.Tangshenkang Granules can down-regulate the expression levels of Notch1 and Hes1 proteins in blood mononuclear cells in patients with DKD Qi and Yin insufficiency and Blood Stasis Syndrome.This may be one of the mechanisms of Tangshenkang Granules in the treatment of DKD.4.The safety indicators of Tangshenkang Granules have not changed significantly during the treatment process,and there are no adverse reactions,indicating that the drug has good safety.Objective: To observe the effects of Tangshenkang Granules on Notch1(Transmembrane receptor proteins Notch1)and Hes1(Hairy enhancer of splitl 1)proteins in the kidney tissue of diabetic kidney disease(DKD)rats,and to explore the effects of Tangshenkang Granules on DKD rats The mechanism of efficacy.Methods: Forty male SD rats were selected and randomly divided into 2 groups by a simple random sampling method,including 10 normal groups and 30 models in total.All the models used the triple method to prepare DKD animal models.The rats after successful modeling were randomly divided into a model group,a Tangshenkang group and a valsartan group,with 10 rats in each group.After successful modeling,the normal group and the model group were given the same amount of tap water by gavage,and the Tangshenkang group was gavage after dissolving the Tangshenkang granules in warm water.The valsartan group was given valsartan suspension by intragastric administration,and the course of administration was 8 weeks.After the experiment,the rat blood Scr,BUN,ACR,24 h Upro were detected.Western blot was used to detect the changes of Notch1 and Hes1 proteins in the rat kidney tissue;the pathological changes of the kidney were observed by HE and Masson+PASM staining.Results:1.Comparison of UACR and 24 h Upro: The model group has a significant increase compared with the normal group,and the difference is statistically significant(P<0.01).Compared with the model group,the Tangshenkang group and the valsartan group were significantly lower,and the difference was statistically significant(P<0.01).There was no significant change between the Tangshenkang group and the valsartan group,and the difference was not statistically significant(P>0.05).2.Comparison of renal function(Scr BUN): There was no statistically significant difference between Scr and BUN in each group(P>0.05).3.Comparison of the relative expression levels of Notch1 and Hes1 proteins in kidney tissue: Compared with the normal group,the relative expression levels of Notch1 and Hes1 proteins in the model group were significantly increased(P<0.01).Compared with the model group,both the Tangshenkang group and the valsartan group were significantly reduced(P<0.01).There was no significant difference between Tangshenkang group and valsartan group(P>0.05).4.Observation of pathological morphology of kidney tissue:(1)The size and shape of the left kidney of the rats in the normal group were normal,and the color was dark red;the volume of the left kidney of the model group was significantly increased;the volume of the left kidney of the rats in the Tangshenkang group and the valsartan group was larger than that in the normal group,But they are all smaller than the model group.(2)(HE,PASM-Masson staining): The size and morphology of the glomerulus of rats in the normal group were normal,and the structure was clear.The glomeruli of rats in the model group are obviously hypertrophy,the space between the renal capsules is narrowed,the basement membrane is obviously thickened,the mesangial area and the mesangial extracellular matrix proliferate,which shows the basic pathological changes of DKD;compared with the model group,glucose The renal glomerular lesions of rats in the Shenkang group and the valsartan group were alleviated.Conclusion:1.Tangshenkang granules can improve the quality of life of DKD rats and reduce the urine protein of DKD rats.2.The levels of Notch1 and Hes1 in the kidney tissue of DKD rats increased significantly,suggesting that Notch1 and Hes1 may be involved in the pathogenesis of DKD.3.Tangshenkang granules can significantly down-regulate the expression of the above indicators.4.Tangshenkang granules can improve the renal pathological manifestations of DKD rats.