Network Meta-analysis of Qi-supplementing and Yin-nourishing Chinese patent medicines in treatment of early diabetic nephropathy / 中国中药杂志

This study aimed to evaluate the efficacy of Qi-supplementing and Yin-nourishing Chinese patent medicine in the treatment of early diabetic nephropathy(DN) by network Meta-analysis to explore the Chinese patent medicine with optimal efficacy and provide references for preventing renal deterioration and delaying the progression of early DN. Eight databases, including CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, and Web of Science, were searched for clinical randomized controlled trial(RCT) of Qi-supplementing and Yin-nourishing Chinese patent medicines in the treatment of early DN. After the literature mee-ting the inclusion criteria was screened, the quality of the literature was evaluated using the Cochrane risk-of-bias tool, and network Meta-analysis was performed using the BUGSnet package in R 4.2.1. Seventy-two research articles with a sample size of 6 344 cases were included, involving eight Chinese patent medicines and seven outcome indicators. The results of the network Meta-analysis showed that(1)in terms of improving urinary albumin excretion rate(UAER), Chinese patent medicines combined with conventional treatment were superior to conventional treatment, and Qiyao Xiaoke Capsules + conventional treatment was optimal.(2)In terms of reducing serum crea-tinine(Scr), Bailing Capsules + conventional treatment had superior efficacy.(3)In terms of reducing 24-hour urine total protein(24hUTP), Shenyan Kangfu Tablets + conventional treatment and Jinshuibao Capsules + conventional treatment had equivalent efficacy, and Shenyan Kangfu Tablets + conventional treatment was superior.(4)In terms of improving fasting blood glucose(FBG), Shenyan Kangfu Tablets + conventional treatment had superior efficacy.(5)In terms of improving total cholesterol(TC), Qiyao Xiaoke Capsules +conventional treatment had superior efficacy.(6)In terms of reducing triglyceride(TG), Bailing Capsules + conventional treatment had superior efficacy.(7)In terms of safety, the occurrence of adverse reactions was reported in seven interventions, but due to the large clinical heterogeneity, the quantitative analysis could not be performed. Overall, Qi-supplementing and Yin-nourishing Chinese patent medicines combined with conventional treatment were superior to conventional treatment alone in the treatment of early DN. The results showed that Qi-supplementing and Yin-nourishing Chinese patent medicines combined with conventional treatment had good clinical efficacy, and they could significantly reduce renal function indicators such as UAER, Scr, and 24hUTP, and reduce blood sugar and blood lipid, which can provide evidence-based support for the treatment of early DN. However, due to the differences in the quantity and quality of the included research articles, large-sample, multi-center, high-quality studies are still needed for further verification.

Comparative diagnostic utility of different urinary biomarkers during pre-albuminuric stages of non-hypertensive type 2 diabetic nephropathy

Background & objectives: Activation of renin-angiotensin system and tubulointerstitial damage might be seen in pre-albuminuria stage of diabetic nephropathy (DN). Here, diagnostic utility of four urinary biomarkers [Angiotensinogen (Angio), Interleukin (IL)-18, Neutrophil Gelatinase-Associated Lipocalin (NGAL) and Cystatin] during pre-albuminuria stages of non-hypertensive type 2 diabetes patients was studied. Methods: A total of 952 type 2 diabetes mellitus (T2DM) patients were screened for nephropathy [estimated glomerular filtration rate (eGFR) ?120 ml/min and albumin–creatinine ratio (ACR) ?30], and 120 patients were followed up for one year. At one year, they were classified into hyperfiltration (43), normoalbuminuria (29) and microalbuminuria (48) groups. Another 63 T2DM patients without nephropathy were included as controls. Hypertension, patients on angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, eGFR <60 ml/min/1.73 m2 and all proteinuric conditions were excluded. All were subjected to testing for urine protein, ACR, HbA1C, eGFR, along with urinary biomarkers (IL-18, cystatin-C, NGAL and AGT). Comparative analysis of all the diagnostic tests among different subgroups, correlation and logistic regression was done. Results: Urinary IL-18/Cr, cystatin/creatinine (Cr) and AGT/Cr levels were higher in groups of hyperfiltration (13.47, 12.11 and 8.43 mg/g), normoalbuminuria (9.24, 11.74 and 9.15 mg/g) and microalbuminuria (11.59, 14.48 and 10.24 mg/g) than controls (7.38, 8.39 and 1.26 mg/g), but NGAL/Cr was comparable. The area under receiver operating characteristic curve (AUC) and sensitivity of AGT to detect early CKD were higher than ACR and eGFR (0.91 and 90.4%, 0.6 and 40% and 0.6 and 37%, respectively). AUC values of other biomarkers, namely IL-18/Cr, cystatin/Cr and NGAL/Cr, were 0.65, 0.64 and 0.51, respectively. Angio/Cr and IL-18/ Cr showed correlation with log albuminuria (r=0.3, P=0.00, and r=0.28, P=0.00, respectively). NGAL showed correlation with log eGFR (r=0.28 P=0.00). Multivariate logistic analysis showed that odds ratio of developing nephropathy was 7.5 times with higher values of log Angio/Cr. Interpretation & conclusions: Urinary AGT showed a higher diagnostic value than ACR and eGFR followed by IL-18 and cystatin to diagnose DN during pre-albuminuric stages.

Clinical Efficacy of Modified Buyang Huanwu Tang Combined with Sanrentang in Treatment of Spleen and Kidney Deficiency and Damp-heat and Blood Stasis Syndrome in Early Diabetic Nephropathy / 中国实验方剂学杂志

Objective::To observe the clinical efficacy of modified Buyang Huanwu Tang combined with Sanrentang in treating early diabetic nephropathy(DN)with deficiency of spleen and kidney, damp-heat and blood stasis syndrome and its effect on glucose and lipid metabolism, oxidative stress and inflammatory factors, in order to explore its mechanism. Method::A total of 72 early DN atients were randomly divided into control group and treatment group, with 36 cases in each group. The control group was orally treated with losartan potassium tablets(50 mg every time, once/day), while the treatment group was treated with modified Buyang Huanwu Tang combined with Sanrentang orally in addition to the therapy of the control group(1 dose/day). Both groups were treated for 3 months. The changes in clinical efficacy and safety indicators were observed for both groups. The 24 h urine albumin excretion rate(UAER), serum creatinine(SCr), serum cystatin C(Cys C), urea nitrogen (BUN), fasting blood glucose (FBG), 2 h postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), malondialdehyde(MDA), superoxide dismutase(SOD), glutathione Peroxidase(GSH-Px), interleukin-2(IL-2), interleukin-4(IL-4), interleukin-8(IL-8), interleukin-10(IL-10), tumor necrosis factor-α(TNF-α)of patients in two groups were observed before and after treatment. Result::The total clinical effective rate was 88.9%in therapy group, which was higher than 61.1%in control group(P<0.05). After treatment, levels of UAER, SCr, Cys C and BUN were lower in both groups(P<0.05), and the levels in treatment group were all lower than those in control group(P<0.05). Levels of FBG, 2 hPG and HbA1c were lower in both groups(P<0.05). There was no significant difference in FBG, 2 hPG and HbA1c levels between two groups after treatment. The levels of HDL-C were higher in both groups(P<0.05), and the levels in treatment group were higher than that in control group(P<0.05). The levels of TC, TG and LDL-C were lower in both groups(P<0.05), and the levels in treatment group were all lower than those in control group(P<0.05). The level of MDA was lower in both groups(P<0.05), and the level in the treatment group was lower than that in control group(P<0.05). The levels of SOD and GSH-Px were higher in both groups(P<0.05), and the levels in the treatment group were all higher than those in the control group(P<0.05). Serum levels of IL-2, IL-8 and TNF-α were lower in both groups(P<0.05), and the levels in the treatment group were lower than those in control group(P<0.05). Serum levels of IL-4 and IL-10 were higher in both groups(P<0.05), and the levels in the treatment group was higher than those in control group(P<0.05). Conclusion::Modified Buyang Huanwu Tang combined with Sanrentang is effective and safe in the treatment of early DN with spleen and kidney deficiency, damp-heat and blood stasis syndrome. They can further improve renal function and lipid metabolism, inhibit oxidative stress reaction and regulate the secretion balance of inflammatory factors in early DN patients.

Effect of Shenqi Dihuang decoction on inflammatory factor, renal function and microcirculation in patients with early diabetic nephropathy / 中国中药杂志

To study the effect of Shenqi Dihuang decoction on inflammatory factor, renal function and microcirculation in patients with early diabetic nephropathy. A total of 205 cases of patient with early diabetic nephropathy treated in our hospital from March 2014 to April 2016 were selected and divided into two groups according to the admitted order, with 103 cases in clinical group and 102 in control group. Patients in control group were treated with melbine and captopril, which may be adjusted according to the clinical symptom. The clinical group was given Shenqi Dihuang decoction. Then the clinical efficady, inflammatory factors, renal function, endothelial function and hemorheology index were compared. Compared with 77.45% in the control group, the total effective rate of the clinical group was 92.23%. There was a significant increase (<0.05). The comparison of the values of IL-6, IL-8, TNF-α and CRP between the two groups before and after treatment showed significant differences. The values of inflammatory factors in treatment group were lower than in control group (<0.05). The comparison of the values of β2-MG, Cys-C and urine m-ALB between the two groups before and after treatment showed significant differences. The values of renal function in treatment group were lower than those in control group (<0.05). Compared with before treatment, ET-1 of the two groups after treatment decreased, while NO increased (<0.05). Compared with the control group, the value of ET-1 in patients of the experimental group was lower after treatment, while NO was higher (<0.05). The comparison of the values of whole blood viscosity, plasma viscosity, whole blood reduction viscosity, platelet aggregation rate and fibrinogen between the two groups before and after treatment showed significant differences. The value of hemorheology index in treatment group was lower than that in control group (<0.05). Shenqi Dihuang decoction has a better effect on patients with early diabetic nephropathy. It can significantly intervene with inflammatory response, reduce proteinuria, protect the renal function of patients, and improve the patient's vascular endothelial function and blood rheology, so as to make microcirculation to recover to the normal level.

Therapeutic Effect of Shenluo'an Decoction for Obese Patients with Early Diabetic Nephropathy and Its Anti-inflammation Mechanism / 广州中医药大学学报

Objective To observe the therapeutic effect of Shenluo'an Decoction(SD) for the treatment of obese patients with early diabetic nephropathy and to explore the possible mechanism.Methods A total of 68 obese patients with early diabetic nephropathy were randomly assigned into control group and treatment group,34 cases in each group.Both groups were given conventional western medicine treatment including lifestyle regulation,dietary control,and medicine for lowering blood pressure,blood glucose and blood lipids.Additionally,the control group was given oral use of Irbesartan,and the treatment group was given oral use of SD combined with Irbesartan.Before and after treatment,we observed the traditional Chinese medical syndrome scores,body mass index(BMI),blood levels of cystatin C (Cys C),β2-microglobumin(β2-MG),homocysteine (Hcy) and fasting blood glucose (FBG),and urine parameters of urinary monocyte chemoattractant protein-1 / urinary creatinine (UMCP-1/UCR),urinary factor of regulated on activation in normal T cell expressed and secreted / urinary creatinine (URANTES/UCR),urinary albumin-to-creatinine ratio (UACR) and urinary albumin excretion ratio (UAER) before treatment and after treatment for 16 weeks.After treatment,the clinical efficacy and safety were also evaluated.Results (1) During the treatment,5 cases were dropped out,and a total of 63 cases (32 from the treatment group and 31 from the control group) completed the experiment.(2) The total effective rate of the treatment group(90.6％) was significantly higher than that of the control group(67.7％),the difference being significant(P ＜ 0.05).(3)BMI of the two groups after treatment was significantly lower than that before treatment (P ＜ 0.05).(4) After treatment,the traditional Chinese medical syndrome scores,blood parameters (Cys C,β2-MG,Hcy,FBG) and urine parameters (UMCP-1/UCR,URANTES/UCR,UACR,UAER) in the treatment group were decreased as compared with those before treatment and those in the control group after treatment(P ＜0.05).(5) A positive correlation was present among the parameters of UMCP-1/UCR,URANTES/UCR,UACR and UAER.(6) No abnormal changes took place in the blood and stool routine examination,hepatic function,or electrocardiography of the 63 cases.Conclusion SD combined with western medicine exerts certain therapeutic effect for obese patients with early diabetic nephropathy,and is effective on relieving clinical symptoms anddecreasing BMI,Cys C,β2-MG,UACR,UAER,UMCP-1 and URANTES.Its mechanism is probably related with the inhibition of chronic renal inflammation.

Curative effects of alfacalcidol combined with losartan potassium tablets in the treatment of early diabetic ;nephropathy / 中国基层医药

Objective To discuss the curative effects of alfacalcidol combined with losartan potassium tablets in the treatment of early diabetic nephropathy (EDN).Methods 90 EDN patients in our hospital were chosen and randomly divided into the observation group and control group (45 cases in each group).The control group was given losartan potassium tablets treatment,while the observation group was given alfacalcidol combiend with telmisartan treatment.All the two groups were treated for 3 months.Before and after treatment,the fasting blood glucose (FBG), 24h urine trace albumin quantitative (UAER),24h urine protein (24h pro),serum creatinine (SCr),25 -hydroxyl vitamin D [2 5 (OH )D ],blood calcium (Ca2+),potassium (K+),glycosylated hemoglobin (HbA 1 C )and serum inflammatory factors[C-reactive protein (CRP),tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6 )] were observed,and the correlation between 25 (OH)D and UAER,24h pro was analyzed.At the same time,the clinical curative effects and adverse reactions during treatment were evaluated.Results In the observation group,the total effective rate was 93.3%,which was significantly higher than 71.1% in the control group (χ2 =7.601,P0.05).After treatment,Scr,24h pro and UAER in the two groups were all significantly reduced compared with before treatment (P0.331).After treatment,25(OH)D in the observation group decreased significantly compared with before treatment (t=12.000,P0.436).Pearson correlation analysis showed that 25 (OH)D level was negatively correlated with 24h pro and UAER (r=0.483,0.778,all P0.151 ).Conclusion Alfacalcidol combined with losartan potassium tablets can significantly reduce the proteinuria levels of EDN patients and inflammation,which has better clinical curative effects and higher safety.

Clinical efficacy of Jiawei Dihuang decoction combined with valsartan in treatment of early diabetic nephropathy / 中华全科医师杂志

One hundred patients with early diabetic nephropathy were randomly divided into control group and study group with 50 cases in each group.All patients received conventional antidiabetic therapy with valsartan tablets 80mg, q.d;patients in study group were given additional TCM Jiawen Dihuang decoction.TCM syndrome scores, relevant biochemical testing and renal function changes were evaluated before and after treatment in two groups.After 8 weeks of treatment, the results showed than the TCM scores in both groups were significantly reduced (study group: 18.9±1.6 vs.7.2±5.1, control group 18.8±1.5 vs.10.3±6.2.both P<0.05);the improvement rate of TCM syndrome in study group was significantly higher than that of control group (90% vs.68%, x2=5.3,P<0.05);and the improvement of relevant biochemical index and renal function in study group was more marked than that in control group.The study indicates that the integrated TCM and Western medicine can enhance the efficacy in treatment of early diabetic hephropathy.

The relationship between cystatin C and homocysteine in patients with early diabetic nephropathy / 中国生化药物杂志

Objective To analyze the relationship between cystatin C(Cys C) and homocysteine(Hcy) in patients with early diabetic nephropathy.Methods48 cases of T2DM patients from June 2013 to December 2015 in our hospital for treatment were chosen as the observation group, including 30 patients with early diabetic nephropathy patients as the observation group 1, 18 cases of T2DM patients as the observation group 2, were selected in our hospital physical examination of 28 healthy persons as control group,serum Cys C and Hcy levels were measured at the same time, urinary albumin / creatinine ratio (Ualb/cr) was measured in the observation group, test results of three groups were analyzed and compared.ResultsThe serum Cys C and Hcy in the observation group were significantly higher than the control group, and Cys C and Hcy levels in observed 1 group were significantly higher than that observed in the 2 group, the difference was statistically significant in the observation group, serum Cys C and Hcy level was positively correlated with Ualb/cr.ConclusionThe relationship between Cys C and Hcy levels and early diabetic nephropathy has very important significance in the early diagnosis of diabetic nephropathy, can effectively improve the rate of diagnosis of early diabetic nephropathy patients.

Effect of sanqi decoction on early diabetic nephropathy and its effect on lipid metabolism and renal function / 中国生化药物杂志

Objective To investigate the clinical efficacy of Sanqi Decoction in the treatment of early diabetic nephropathy (Diabetic, Nephropathy, DN) and its influence on the metabolism of lipid and glucose and renal function. Methods 96 patients with DN in our hospital were randomly divided into two groups. 48 cases in control group were treated with Enalapril, and 48 cases in observation group were treated with Sanqi decoction. Results The total effective rate of the observation group was 95.65%, which was significantly higher than that of the control group (81.25%) (P<0.05). Lipid, glucose metabolism and renal function improvement were better than those in the control group (P<0.05). Conclusion Sanqi Decoction is effective in the treatment of early DN, it can effectively improve the metabolism of lipid and sugar, reduce the excretion rate of urinary albumin, and have the effect of renal protection.

Evaluation on the effetc of comprehensiv e management of patients with early diabetic nephropathy in a Community / 上海预防医学

Objective To evaluate the effect of comprehensive management of patients with early diabetic nephropathy in community . Methods A randomized controlled trial was adopted and 201 patients with early diabetic nephropathy in a community were randomized into two groups:intervention group(n=101) and control group(n=100).The intervention group received comprehensive intervention and standardized management , while the control group received routine medical services of diabetes mellitus.The changes of related indicators were compared between the patients in two groups before and after twelve months of intervention . Results After twelve months of intervention , the patients in the intervention group showed greater improvement in cognition , attitude and self-management behavior for the disease compared with the patients in the control group .The values of disease-related knowledge and attitude in the intervention group increased by 1 .20 points and 0 .52 points significantly more than those in the control group .Medication compliance , weekly exercise time , communication between doctors and patients in the intervention group increased by 0.19 points, 0.74 times/week and 0.44 points significantly more than those in the control group ( all P <0 .05 ) .Two-hour postprandial blood glucose , glycosylated hemoglobin decreased by 1.13 mmol/L and 0.42%respectively , significantly more than those in the control group.Urinary albumin/urine creatinine, systolic blood pressure decreased by 26.81 mg/g and 3 mmHg respectively, significantly more than those in the control group (all P<0.05). Conclusion Compared with the routine medical services of diabetic nephropathy, the comprehensive intervention and standardized management of early diabetic nephropathy in community is more effective on the improvement in disease-related cognition, attitude and self-management behavior , as well as the biological indexes such as urine albumin/urine creatinine , postprandial blood glucose and blood pressure .

Relationship between neutrophil-to-lymphocyte ratio and early-stage diabetic nephropathy in patients with ;newly diagnosed type 2 diabetes / 中国糖尿病杂志

Objective To explore the relationship between neutrophil‐to‐lymphocyte ratio (NLR) and early‐stage diabetic nephropathy in patients with newly diagnosed type 2 diabetes(T2DM ). Methods A total of 160 patients with newly diagnosed T2DM were enrolled in this study and divided into two groups:early‐stage diabetic nephropathy (EDN ) group and non‐DN group (T2DM group). The clinical and biochemical data were collected. Results NLR ,neutrophia cell count ,2 hPG ,HbA1 c ,age were significantly higher in EDN group than in T2DM group[NLR (2.27 ± 0.92)vs(1.81 ± 0.56) ,neutrophia cellcount(4.35±1.47)vs(3.78±1.08)109/L,2hPG(21.98±4.30)vs(20.37±4.40)mmol/L,HbA1c (11.06±2.02)% vs (10.22 ± 1.89)% ,age(49.22 ± 12.71) vs (44.41 ± 10.81)years] (P< 0.05).Logistic regression analysis showed that NLR (OR= 6.529 ,95% CI:1.946 ~ 21.873 ,P= 0.002)and 2 hPG(OR = 1.213 ,95% CI:1.002 ~ 1.467 ,P= 0.047 ) were independent risk factors for EDN.Conclusion Increased NLR is significantly associated with EDN. High NLR level may be a reliable predictive marker for EDN.

The efficacy of atorvastatin and irbesartan in the treatment of early diabetic nephropathy and its influence on serum cystatin C and adiponectin / 中国基层医药

Objective To observe the efficacy of atorvastatin and irbesartan in the treatment of early diabetic nephropathy and the influence on serum cystatin C and adiponectin,thus to improve clinical outcomes.Methods 80 patients with early diabetic nephropathy met the inclusion criteria were randomly divided into observation group (40 cases)and control group(40 cases).All patients were given conventional diabetes comprehensive intervention, the control group then was given irbesartan 150mg/d,qd,the observation group was given atorvastatin on the basis of control group,20mg/d,qd,both two groups were treated for 12 weeks.The FBG,HbA1c,renal function indication (Scr,BUN,UAER),lipid parameters indication(TC,TG),cystatin C,adiponectin were detected.DBP,SBP were detected by 24h ambulatory blood pressure.Results The DBP,SBP,Scr,BUN,UAER,TC,TG,cystatin C,adiponec-tin of the observation group after treatment were lower than before treatment(P 0.05).The DBP,SBP,Scr,BUN, UAER,TC,TG,cystatin C,adiponectin of the observation group after treatment were lower than the control group (P <0.05 or P <0.01).Conclusion Atorvastatin combined with irbesartan can effectively control blood pressure, has overall improvement in glucose and lipid metabolism,effectively reduce adiponectin,inhibit glomerular dysfunc-tion,improve kidney function,it is a good method for prevention and treatment of early diabetic nephropathy.

Influence of Wuling Capsules Combined with Calcitriol on Urine Marker Proteins in Early Diabetic Ne-phropathy / 中国药师

Objective:To observe the effect of Wuling capsules combined with calcitriol on urine marker proteins in early diabetic nephropathy ( DN) . Methods: Totally 64 patients with early DN were randomly divided into the control group and the observation group with 32 cases in each. The two groups were with appropriate diet and exercise, relatively stable protein intake and optimal hypo-glycemic program. The observation group was additionally treated with Wuling capsules (0. 9 g, po tid) and calcitriol 0. 25 μg,po qd, with the treatment course of eight weeks. The levels of FBG and 2hBG, HbA1c, hs-CRP, urinary protein, ALB, β2-MG and RBP were observed in the two groups before and after the treatment. Results:After the treatment, FBG, 2hBG, HbA1c, hs-CRP, total pro-tein, Alb and RBP in the two groups were improved when compared with those before the treatment, and the difference had statistical significance(P<0. 05). The total protein, ALB,β2-MG, RBP and hs-CRP in the observation group were better than those in the con-trol group after the treatment, and the difference was statistically significance (P<0. 05). Conclusion: Wuling capsules combined with calcitriol can effectively reduce glomerular and renal tubular damage in early DN patients.

Clinical observation of Shenluoan Decoction for treating obese patients with early diabetic nephropathy / 中草药

Objective: To observe the therapeutic effects and possible mechanism of Shenluoan Decoction on the obese patients with early diabetic nephropathy. Methods: Obese patients with early diabetic nephropathy (106 cases) were randomly assigned into control group (n = 53, treated by Irbesartan) and treatment group (n = 53, treated by Shenluoan Decoction combined with Irbesartan), and the conventional Western therapy was given to all the patients in both groups. The changes of therapeutic efficacy, Chinese medicine syndrome, such as waistline, serum creatinine (SCr), blood urea nitrogen (BUN), total cholesterol (TC), triglyeride (TG), fasting blood glucose (FBG), urinary podocalyxin (PCX), urinary nephrin, urinary albumin, and urine creatinine were detected before and after 6 months treatment. Results: The experiment was completed with 102 cases. The total effective rate in the treatment group (90.00%) was significantly higher than that of control group (67.31%) (P 0.05). After the treatment, the levels of SCr, TC, and TG were reduced significantly in the treatment group (P < 0.05), and showed significant difference compared with those in the control group (P < 0.05). The levels of UPCX/UCR, UNephrin/UCR, and UACR were decreased with significant differences compared with those before treatment and in the control group, respectively (P < 0.05). UPCX/UCR, UNephrin/UCR, and UACR showed positive correlation. Conclusion: The combination of Shenluoan Decoction and Irbesartan has a better effect than the single use of Irbesartan on the obese patients with early diabetic nephropathy. Its mechanism may be related to providing some renal protection and reducing the PCX and nephrin excretion.

Effect of Tangshenning on Renal Function and LOX-1 mRNA Expression in Early DN Rats Model / 中国药师

Objective:To observe the effect of Tangshenning on renal function and LOX-1 mRNA expression in the kidney of early diabetic nephropathy rats model. Methods:Early diabetic nephropathy rats model was made with high fat diet, STZ and unilateral ne-phregtomy. After the 12-week drug intervention, the rats were sacrificed, the kidneys were removed and the mRNA expressions of LOX-1 in the kidney were observed by the method of RT-PCR. Results:Early diabetic nephropathy rats model was successfully made by the triple-modeling method. The mRNA expression of LOX-1 in the kidney was significantly increased, and Tangshenning could low-er the expression of LOX-1 in the kidney in a dose-dependent manner. Conclusion:The abnormal expression of LOX-1 could be one of the mechanisms for diabetic nephropathy. Tangshening has good kidney protective effect through decreasing LOX-1 abnormal expression in the kidneys, which deserves further research.

Influence on Establishment and Implementation of Individual Healthy Diets on Patients with Early Diabetic Nephropathy / 世界科学技术-中医药现代化

This study was aimed to explore the efficacy of establishing and implementing individual healthy di-ets on patients with early diabetic nephropathy ( DN ) . A total of 120 patients with early DN of our hospital were randomly divided into two groups , which were the experimental group and the control group . There were 60 cases in each group . All patients received routine treatment . The fasting blood glucose and 24-hour uri-nary protein were measured pre-treatment , 2-week , 2-month , and 6-month after treatment . Patients in the experimental group were required to receive individual healthy diet therapy as well as routine treatment . The fasting blood glucose of both groups was compared in each stage . The fasting blood glucose of the experimental group was lower than that of the control group after 2-week treatment . After 6-month treatment , the fasting blood glucose of the experimental group was lower than that of pre-treatment . However , there was no obvious difference in the control group compared to that of pre-treatment . There were significant differences on the number of cases with fasting blood glucose below the level of 7.0 mmol/L in different stages of both groups. The 24-hour urinary protein of both groups was also compared in each stage . After 2-week treatment , there was no distinct difference on the 24-hour urinary protein in each stage of both groups . However , after 6-month treatment , the urinary protein of the experimental group , compared to pre-treatment , indicated striking difference , while the control group did not show any difference . It was concluded that individual healthy diet has a significant efficacy in the treatment of early DN , especially in reducing and controlling fasting blood glucose. After carrying out the treatment for 6 months, healthy diet also takes on distinct effects in cutting down 24-hour urinary protein and keeping the glycosylated hemoglobin below 6 . 5%.

Effect of Danzhi Jiangtang Capsule on NF-κB and Urinary Albumin Excretion Rate in Early Diabetic Nephropathy Patients / 世界科学技术-中医药现代化

This study was aimed to observe the effect of Danzhi Jiangtang Capsule ( DJC ) on NF-κB in the peripheral blood mononuclear cell , and inflammation indices such as serum MCP-1 , TGF-β1 and urinary albu-min excretion rate ( UAER ) in early diabetic nephropathy ( EDN ) , in order to discuss the possible mechanism of DJC on anti-inflammatory and renal protection effect of EDN. A total of 72 EDN patients which met the in-clusion criteria after the start-up stage were taken as research objects . They were randomly divided into the control group and the treatment group. The western comprehensive treatment plan was given to both groups. In the treatment group, DJC was added. And the treatment course was 8 weeks. Changes of MCP-1, NF-κB, TGF-β1 and UAER were observed before and after the treatment . The results showed that MCP-1 , NF-κB and TGF-β1 had significant positive correlation with UAER ( P ment , the levels of MCP-1 , NF-κB , TGF-β1 and UAER in the control group and treatment group after treat-ment were significantly declined ( P < 0 . 05 ) . Compared with the control group , after treatment , the levels of MCP-1 , NF-κB , TGF-β1 and UAER of the treatment group were obviously reduced ( P < 0 . 05 , or P <0 . 01 ) . It was concluded that DJC can reduce the UAER , delay the renal injury , and downregulate levels of MCP-1, NF-κB and TGF-β1, block the expression of inflammatory mediators, inhibit inflammatory reaction and improve microinflammatory state of EDN. This may be one of the important mechanisms in the protection of renal function .

Protection of valsartan combined with simvastatin on the kidney in early diabetic nephropathy rats / 中国综合临床

Objective To explore the protection of valsartan combined with simvastatin on kidney in early diabetic nephropathy rats. Methods Diabetic nephropathy rats model were induced by streptozocin (STZ) ,the experimental rats were randomly divided into 5 groups: control (group C), diabetic nephropathy (group D) ,diabetes treated with valsartan (group X) ,diabetes treated with simvastatin (group Z) ,and diabetes treated with combined valsartan and simvastatin ( group L). Blood glucose (BG), HbA1c, blood cholesterol ( TC), trigalloylglycerol ( TG ), blood ureanitrogen ( BUN ), serum creatinine (SCr) , urinary albumin excretion rate (UAER) were measured, and the podocyte ultrastructure was observed by transmission electronic microscopy. Results The levels of BG, HbA1c,TC,TG and UAER in group D increased significantly compared togroup C(BG:[20.3 ±3.2]mmol/L vs [6.1 -±0. 4]mmol/L;HbA1c:[7.18 ±0.47]% vs [3.37 ±0. 15]% ;TC: [2. 69 ±0. 35] mmol/L vs [1.28 ±0. 24] mmol/L;TG: [3.09 ±0. 37] mmol/L vs [1.18 ±0. 25]mmol/L) (P ＜ 0. 05 ). Creatinine clearance rates (Ccr) in group D ( [0. 89 ± 0. 19] ml/min ) decreased significantly compared to group C( [1.27 ±0. 33] ml/min) ,as well as group X,Z and L( Ps ＜ 0. 05 ). UAER in group D was significantly higher than that in group C ( [19. 87 ±3. 85] μg/24 h vs [3. 67 ± 1.01] μg/24 h) (P ＜ 0. 05 ), as well as group X, Z and L ( P ＜ 0. 05 ), and the improvement in group L was particularly significant ( P ＜ 0. 05 ). The projections of podocyte in group D severely syncretized, there were slightly improvement in group X, Z and L compared to group D, and the improvement in group L was remarkable. Conclusion The treatment with valsartan, simvastatin and their combination will effectively protect the kidney in early diabetic nephropathy rats,and the effect of using the combination therapy is much better.

Effect of Ginkgo Biloba Extract Injection on Urinary Microalbumin Excretion in Patients with Early Diabetic Nephropathy / 中国药房

OBJECTIVE:To observe the effect of Ginkgo biloba extract injection on the urinary microalbumin excretion rate in patients with early diabetic nephropathy(DN).METHODS:A total of 84 patients with early DN were randomly divided into two groups:the control group was treated with routine therapy while the treatment group was treated with routine therapy plus Ginkgo biloba extract injection(at a dose of 10mL)q.d for 3 consecutive weeks.The urinary microalbumin excretion rate and the related clinical and biochemical indicators were compared between the two groups before and after treatment.RESULTS:As compared with the control group,urinary microalbumin excretion rate was significantly lowered in the treatment group(P

Study on Early Diabetic Nephropathy Treated with Tangshenling / 中国中医药信息杂志

Objective To observe the effect of Chinese medicine Tangshenling, which can increase function of spleen and kidney and, remove blood stasis, on early Diabetic Nephropathy, and explore the mechanism. Methods 70 cases of early diabetic nephropathy were observed for comparation with 2 months as a course of treatment. The observing indexes were clinical symptoms, blood fat, blood sugar, HbA1C, UAER, Urine ?2-MG. Results Tangshenling could evidently not only improve the symptoms of early DN patients but also decrease blood fat, blood sugar, UAER, HbA1C and Urine ?2-MG. Conclusion Tangshenling could improve the high blood sugar, high blood fat of the early DN patients, decrease UAER, protect kidney function, which proves Tangshenling has definite curative effect on early DN.