Observation On Clinical Effects Of Yi Sheng Jiang Tang Decoction Treating Diabetic Nephropathy(G2A3 Stage)of Qi And Yin Deficiency With Blood Stasis And Effects On NLRP3 And IL-1β

ObjectiveThis study was to observe the clinical symptoms,related clinical indicators,NLRP3 expression of peripheral blood lymphocytes and serum IL-1β in patients with diabetic nephropathy(G2A3 stage)with Qi Yin deficiency and blood stasis syndrome by observing Yishen Jiangtang decoction.To explore the possible mechanism of Yishen Jiangtang Yin in delaying the progression of renal function in patients with diabetic nephropathy(G2A3 stage),so as to provide new ideas for the prevention and treatment of diabetic nephropathy.MethodIn this study,56 patients with diabetes nephropathy(G2A3 stage)and TCM syndrome differentiation of Qi Yin deficiency and blood stasis syndrome were selected from the people’s Hospital of Fujian University of traditional Chinese medicine from February 2021 to December 2021.They were randomly divided into control group and experimental group,with 28 cases in each group.The control group was treated with routine western medicine,and the experimental group was treated with Yishen Jiangtang Decoction on the basis of the control group.The course of treatment of both groups was 8 weeks.The glomerular filtration rate(e GFR),serum creatinine(Scr),morning fasting blood glucose(FBG),glycosylated hemoglobin(Hb A1c),serum albumin(ALB),24 h urinary protein quantification(24h UP),the expression of NLRP3 in peripheral blood lymphocytes and serum IL-1β were observed before and after treatment Level and TCM syndrome score,and make relevant statistical analysis.Result1.Correlation analysis: NLRP3 and IL-1β in peripheral blood lymphocytes It was negatively correlated with e GFR(P<0.01),positively correlated with(Scr,24 h UP,FBG)and Hb A1c(P<0.01),and had no significant correlation with ALB(P>0.05).2.After treatment,Scr and 24 h UP of the two groups were lower than those before treatment(P<0.05),e GFR was higher than those before treatment(P<0.05),and the curative effect of the experimental group was better than that of the control group(P<0.01);After treatment,the ALB of the two groups was higher than that before treatment(P<0.05),and the FBG and Hb A1 c were lower than those before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).3.The expression of NLRP3 in peripheral blood lymphocytes and serum IL-1β in the two groups after treatment that both were lower than those before treatment(P<0.01);The curative effect of the experimental group was lower than that of the control group(P<0.01).4.The TCM syndrome scores of the two groups after treatment were lower than those before treatment(P<0.01),and the curative effect of the experimental group was better than that of the control group(P<0.01);The total effective rate of TCM syndrome curative effect between the two groups was 57.69% in the control group and 88.46% in the experimental group,and the difference was statistically significant(P<0.05).5.The total effective rate of clinical comprehensive curative effect of the two groups was92.32% in the experimental group and 80.77% in the control group.There was significant difference between the two groups(P<0.05).Conclusion1.NLRP3 and IL-1β in patients with diabetic nephropathy were negatively correlated with e GFR,positively correlated with(Scr,24 h UP,FBG,Hb A1c)(P<0.01),but had no significant correlation with ALB(P>0.05).This suggests that the abnormal expression of NLRP3 inflammasome-Caspase-1-IL-1β axis-mediated pyroptosis in the kidney is involved in the progression of DKD.2.Yishen Jiangtang Decoction combined with conventional western medicine treatment is more effective than western medicine alone in improving renal function,reducing urinary protein and reducing micro-inflammatory response.It is considered that it may reduce the downstream pro-inflammatory factors by inhibiting the expression of NLRP3 inflammasome The production of IL-1β,thereby reducing the inflammatory response,reducing the damage to the structure and function of the kidney,and ultimately reducing urinary protein and protecting renal function.3.Yishen Jiangtang Decoction can significantly improve the TCM syndrome scores of diabetic nephropathy(G2A3 stage)patients with Qi-Yin deficiency and blood stasis syndrome,and no obvious adverse reactions occurred during the research process,which to a certain extent shows the efficacy of the prescription It is reliable,safe and has clinical application value.