Investigated The Clinical Efficacy And Effect On Serum FXR Level Of Yishenjiangtang Decoction In Patients With Diabetic Kidney Disease G3A2-3(Qi And Yin Deficiency And Blood Stasis Type) Based On The Gut-Kidney Axis Theory

ObjectiveObservation of the clinical efficacy of Yishenjiangtang Decoction in treating diabetic kidney disease(DKD)G3A2-3 period(Qi and Yin Deficiency and Blood Stasis Type)patients and its influence on serum farnesoid X receptor(FXR),to analyze the correlation between FXR and DKD patients’ renal function,HbA1C,hs-CRP and other related indicators,preliminarily exploring the possible mechanism of intestinal flora disorder of DKD G3A2-3 period(Qi and Yin Deficiency and Blood Stasis Type)patients treated with Yishenjiangtang Decoction,in order to provide a certain idea for clinical treatment of DKD.Methods60 patients with diabetic kidney disease G3A2-3 period(Qi and Yin Deficiency and Blood Stasis Type)who meet the inclusion criteria were randomly divided into control group and experimental group with 30 cases each.The control group was treated with conventional Western medicine,and the experimental group was treated with Yishenjiangtang Decoction on the basis of the control group.The treatment period of the two groups was 8 weeks.The levels of 24-hour urine total protein(24hUTP),urinary albumin-to-creatinine ratio(UACR),serum creatinine(SCr),estimated glomerular filtration rate(eGFR),hypersensitive C-reactive protein(hs-CRP),glycosylated hemoglobin(HbA1C),total Cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),serum FXR and Chinese medicine syndrome accumulation points index before and after treatment were observed and related statistical analysis was carried out.At the same time,10 healthy physical examination personnel were selected as the healthy control group,and the related indicators were compared with those of the DKD group.Results1.There was no statistically significant difference in gender and average age among the three groups(control group,test group,and healthy group)(P>0.05),indicating comparability.There was a significant difference in FXR between the healthy group and the DKD group before treatment(P<0.05).There was no statistically significant difference in disease duration,mean arterial pressure,body mass index,pre-treatment physical and biochemical indicators,and FXR between the control group and the test group(P>0.05),indicating comparability.2.The SCr and eGFR of the control group patients did not show significant progress after treatment(P>0.05),while those of the experimental group patients showed improvement after treatment(P<0.05);both groups of patients showed improvement in hs-CRP,HbA1C,TC,TG,24 hUTP,and UACR after treatment(P<0.05);compared with the control group,the improvement in SCr,eGFR,hs-CRP,HbA1C,24hUTP,and UACR was more significant in the experimental group after treatment(P<0.05),and there was no statistical difference between the two groups in improving TC,TG,and LDL-C(P>0.05).3.The FXR levels in both groups of patients increased after treatment compared to before treatment(P<0.05).Compared to the control group,the experimental group showed a more significant increase in FXR levels(P<0.05).4.The TCM syndrome scores of both groups of patients decreased after treatment compared to before treatment(P<0.05).In terms of reducing the TCM syndrome scores,the experimental group showed a more significant effect(P<0.05).5.The total effective rate of the TCM syndrome in the control group was 62.07%,and the total effective rate of the TCM syndrome in the experimental group was 86.21%.The total effective rate of the TCM syndrome in the experimental group was significantly better than that in the control group(P<0.05).The clinical total effective rate in the control group was 58.62%,and the clinical total effective rate in the experimental group was 82.76%.The clinical total effective rate in the experimental group was significantly better than that in the control group(P<0.05).6.FXR showed a negative correlation with SCr,HbA1C,TC,TG,LDL-C,hs-CRP,24 hUTP,and UACR(P<0.05),and a positive correlation with eGFR(P<0.05).7.No obvious adverse reactions were found in either group of patients during the treatment,and no significant abnormalities were found in the monitoring of related safety indicators.Conclusion1.Yishenjiangtang Decoction combined with conventional Western medicine has a better therapeutic effect on Qi and Yin Deficiency and Blood Stasis Type diabetic kidney disease G3A2-A3 period,compared with conventional Western medicine treatment,it has better effect in improving the TCM syndrome.2.Yishenjiangtang Decoction has a definite therapeutic effect in improving renal function,inhibiting micro-inflammatory state,regulating glucose metabolism,and reducing urinary protein excretion.3.The therapeutic effect of Yishenjiangtang Decoction may be related to the regulation of intestinal microecological environment and the increase of FXR expression level.4.No obvious side effects were found in the Yishenjiangtang Decoction combined with conventional Western medicine treatment during this study,and the safety is high.