Effect Of Traditional Chinese Medicine Shenkangling On Serum IL-17,TGF-β1 And NF-κB In Children With Primary Nephrotic Syndrome (Simple Type)

Objective Application of Traditional Chinese Medicine Shenkangling in children with Primary nephrotic Syndrome(PNS),observing the changes of serum IL-17,TGF-β1,NF-κB,in order to explore the pathogenesis of PNS in children,clarify the mechanism and drug targets of Traditional Chinese Medicine Shenkangling in the treatment of children with PNS(simple type),so as to improve the clinical efficacy.Methods30 children from the People’s hospital and the second affiliated People’s hospital outpatient and hospitalization affiliated to fujian university of traditional Chinese medicine,who met the diagnostic criteria of PNS(simple type)and the diagnostic points of TCM syndrome of kidney deficiency and blood stasis type were selected as the treatment group(Group A).At the same time,30 healthy children aged 2-14 were selected from the Physical Examination Center of the People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine as the healthy control group(group B).The treatment group was treated with the combination of traditional Chinese and Western medicine(Traditional Chinese Medicine Shenkangling combined with Glucocorticoid and/or Immunosuppressants).The differences in the expression levels of serum IL-17,TGF-β1,NF-κB,and the 24-hour urine protein quantification,serum albumin,cholesterol,and triglyceride between the healthy control group and the treatment group were observed before and after treatment.SPSS 26.0 statistical software was used for statistical analysis of the data.Results1.A total of 30 children with PNS(simple type)were included in this study according to the inclusion and exclusion criteria,mainly boys,and most of them were school-age children aged 7-14.Among them,1 case dropped out due to inability to cooperate with clinical observation and follow-up,and 2 cases dropped out due to not taking prescribed medication.2.Before treatment: there was no significant difference in gender and age between groups A and B(all P>0.05),and the levels of serum IL-17,TGF-β1 and NF-κB in group A were significantly higher than those in group B(all P<0.01).3.After 4 weeks of treatment: Compared with before treatment,the levels of serum IL-17 and TGF-β1 in group A were significantly decreased(all P < 0.01),and there was no significant difference in the levels of serum NF-κB(P>0.05).The levels of 24-hour urine protein quantification,serum total cholesterol and triglyceride were significantly decreased(P<0.05),the levels of serum albumin were significantly increased(P<0.01).Compared with group B,the levels of serum IL-17,TGF-β1 and NF-κB in group A were significantly increased(all P<0.01).4.After 12 weeks of treatment: compared with before treatment,the levels of serum IL-17,TGF-β1 and NF-κB in group A were significantly decreased(all P < 0.01),the levels of24-hour urine protein quantitative,serum total cholesterol,triglyceride was significantly decreased(all P < 0.01)serum albumin,the level of serum albumin was significantly increased(P < 0.01).Compared with after 4 weeks of treatment,there was no significant difference in the level of serum IL-17 and TGF-β1 in group A(all P>0.05),but the level of NF-κB levels were significantly decreased(P< 0.01),The levels of 24-hour urine protein quantitative,serum cholesterol was significantly decreased(all P<0.01),the levels of serum albumin was significantly increased(P<0.01),and there was no significant difference in the levels of serum triglyceride(P > 0.05).Compared with group B,there was no significant difference in the levels of serum IL-17 in group A(P>0.05),but the levels of serum TGF-β1and NF-κB were significantly increased(all P<0.05).5.After 12 weeks of treatment,17 children with PNS had complete remission,and 10 had partial remission.No adverse reactions occurred during the clinical efficacy observation period.Conclusions1.The serum levels of IL-17,TGF-β1,and NF-κB in children with PNS were significantly increased,suggesting that they act as cytokines to mediate immune damage and may directly or indirectly participate in the occurrence and development of children with PNS.2.The treatment of children with PNS(simple type)with integratived traditional Chinese and western medicine can significantly reduce serum IL-17,TGF-β1,NF-κB,suggesting that it may inhibit the overexpression of IL-17 and TGF-β1 and block NF-κB signaling pathway to play a therapeutic role.3.Integrative Chinese and Western medicine treatment can significantly increase serum albumin,reduce abnormally elevated urinary protein,correct lipid metabolism disorders and hypercoagulability,thereby relieving the condition of children and improving clinical efficacy.