Effective substances and mechanism of Yishen Guluo Mixture in treatment of chronic glomerulonephritis based on metabolomics and serum pharmacochemistry / 中国中药杂志

This study aimed to investigate the effective substances and mechanism of Yishen Guluo Mixture in the treatment of chronic glomerulonephritis(CGN) based on metabolomics and serum pharmacochemistry. The rat model of CGN was induced by cationic bovine serum albumin(C-BSA). After intragastric administration of Yishen Guluo Mixture, the biochemical indexes related to renal function(24-hour urinary protein, serum urea nitrogen, and creatinine) were determined, and the efficacy evaluations such as histopathological observation were carried out. The serum biomarkers of Yishen Guluo Mixture in the treatment of CGN were screened out by ultra-performance liquid chromatography-quadrupole time-of-flight/mass spectrometry(UPLC-Q-TOF-MS) combined with multivariate statistical analysis, and the metabolic pathways were analyzed. According to the mass spectrum ion fragment information and metabolic pathway, the components absorbed into the blood(prototypes and metabolites) from Yishen Guluo Mixture were identified and analyzed by using PeakView 1.2 and MetabolitePilot 2.0.4. By integrating metabolomics and serum pharmacochemistry data, a mathematical model of correlation analysis between serum biomarkers and components absorbed into blood was constructed to screen out the potential effective substances of Yishen Guluo Mixture in the treatment of CGN. Yishen Guluo mixture significantly decreased the levels of 24-hour urinary protein, serum urea nitrogen, and creatinine in rats with CGN, and improved the pathological damage of the kidney tissue. Twenty serum biomarkers of Yishen Guluo Mixture in the treatment of CGN, such as arachidonic acid and lysophosphatidylcholine, were screened out, involving arachidonic acid metabolism, glycerol phosphatide metabolism, and other pathways. Based on the serum pharmacochemistry, 8 prototype components and 20 metabolites in the serum-containing Yishen Guluo Mixture were identified. According to the metabolomics and correlation analysis of serum pharmacochemistry, 12 compounds such as genistein absorbed into the blood from Yishen Guluo Mixture were selected as the potential effective substances for the treatment of CGN. Based on metabolomics and serum pharmacochemistry, the effective substances and mechanism of Yishen Guluo Mixture in the treatment of CGN are analyzed and explained in this study, which provides a new idea for the development of innovative traditional Chinese medicine for the treatment of CGN.

Mechanism of Alisma plantago-aquatica Linn. improving chronic glomerulonephritis based on network pharmacology and experimental verification / 药学学报

This study aims to explore the improvement and the mechanism of the Alisma plantago-aquatica Linn. (ApL) on chronic glomerulonephritis (CGN). All animal experiments were followed the regulation of the Experimental Animal Ethical Committee of Shanghai University of Traditional Chinese Medicine. CGN mouse model was established by a single tail-vein injection of doxorubicin (Dox) (20 mg·kg-1). One week after Dox administration, the mice received water extract of ApL (85 and 255 mg·kg-1) by gavage once a day for 14 days. At the end of experiment, the urine albumin-to-creatinine ratio (ACR), serum albumin (ALB), blood urea nitrogen (BUN) and serum creatinine (SCr) were detected, kidney histopathological H&E staining was analyzed. Active ingredients and action targets of ApL were collected from TCMSP database, and CGN-related targets were obtained from Genecards database. STRING platform was employed to perform protein-protein interaction (PPI), and Metascape platform was used for KEGG pathway and GO enrichment analysis. The results of experiments demonstrated that ApL (85 and 255 mg·kg-1) could reduce the ACR and the content of SCr and BUN, and increase the content of ALB in mice. Network pharmacology results predicted that nuclear factor kappa-B (NF-κB)-related pathway and biological process of oxidoreductase activity regulation may be involved in the ApL-provided amelioration on CGN. The verification results showed that ApL could inhibit the activation of NF-κB and the expression of inflammatory factors in mice, and reduce the activity of renal myeloperoxidase (MPO). Meanwhile, ApL promoted the activation of nuclear factor erythroid 2-related factor 2 (Nrf2) and increased the expression of its downstream gene mRNA, and reduced the level of renal malondialdehyde (MDA) and reactive oxygen species (ROS), and further elevated renal glutathione (GSH) level. Based on network pharmacology combined experiments, this study found that ApL may improve CGN in mice through multiple targets and multiple pathways, in which the inhibition of NF-κB signaling and the activation of Nrf2 signaling may be important mechanisms involved.

A cross-sectional study to evaluate etiopathogenesis, clinical features, complications, and treatment of patients of chronic kidney disease

Background: Chronic kidney disease (CKD) is characterized by a decrease in glomerular filtration rate (GFR) and histological evidence of reduction in nephron population. CKD divided in five stages according to the estimated GFR (eGFR) and lower eGFR suggests more complications. Aims and Objectives: The aim of the study was to study etiology, clinical features, complications, and correlation of complication to stages of CKD. Materials and Methods: This cross-sectional study was carried out among patients who were diagnosed as CKD based on the National Kidney Foundation definition during August, 2019–November 2021. They were evaluated by history taking, clinical examination, and laboratory investigations and data collected and analyzed about etiology, clinical features, and complications of CKD according to the stage. Necessary approval from Institutional Ethics Committee was taken for the study. Results: Chronic glomerulonephritis (CGN) was the most common diagnosis (51, 51%), followed by diabetic nephropathy (22, 22.0%), 73 (73%) had symptoms suggestive of volume overload state such as pedal edema, puffiness of face, and abdominal distension. Oliguria was present in 69 (69%) and 76 (76%) had dyspnea, anemia presents in 90%, cardiovascular disease in 50% in which the most common was left ventricular hypertrophy. Conclusion: CGN is the most common cause of CKD. Severity of anemia and hyperphosphatemia is directly proportional to stage of CKD. Dyspnea and oliguria were the most common manifestations of CKD in the study population. Three-fourth patients of study were treated with some form of renal replacement therapy (hemodialysis and renal transplant).

Analysis of etiological composition and changing trend of chronic kidney disease / 中华健康管理学杂志

Objective:To analyze the etiological composition and changing trends in chronic kidney disease.Methods:CKD patients from our hospital were in cluded in the study from three separate periods, 173 patients from 1990-1991, 956 patients from 2009-2010, and 1440 patients from 2018-2019. The etiology of CKD in patients between the younger and middle-aged group and the elderly group were compared using the χ2 test, and the Bonferroni method was used to correct the pairwise comparisons.Results:The leading cause of CKD in 1990-1991, 2009-2010, and 2018-2019 was chronic glomerulonephritis (52%), chronic glomerulonephritis (35%), and diabetes (36%), respectively. The distribution of the etiologies was different signficantly among the three cohorts (χ2=74.375, P<0.001). Compared with 1990-1991, the percentage of CKD related to diabetes (χ2=14.847, P=0.001) and hypertension (χ2=12.279, P=0.002) significantly increased, while chronic glomerulonephritis showed a downward trend (χ2=19.976, P<0.001). Among the elderly CKD patients, the leading cause of CKD in the three cohorts was chronic glomerulonephritis (34%), diabetes (40%), and diabetes (43%), respectively. Conversely, diabetes and hypertension have become the predominant causes in 2009-2010 and 2018-2019. Although chronic glomerulonephritis remained the leading cause of CKD in the past 30 years, the percentage declined gradually among the younger and middle-aged patients with CKD. The percentage of CKD related to diabetes (χ2=31.345, P<0.001) and hypertension (χ2=15.485, P<0.001) significantly increased. In addition, in the 2018-2019 cohort, there were 494 patients with end-stage renal disease (ESRD), and the percentage of ESRD related to diabetes and hypertension were 48% and 37%, respectively. Conclusion:Diabetes and hypertension have become the predominant causes of CKD in Chinese elderly patients. Although chronic glomerulonephritis was the leading cause among the younger and middle-aged patients with CKD, the percentage declined gradually. Additionally, diabetes and hypertension were also the predominant causes of ESRD.

Clinical Observation of Yishen Tongluo Decoction in Treating Chronic Glomerulonephritis with Spleen and Kidney Qi Deficiency and Blood Stasis Syndrome / 中国实验方剂学杂志

Objective:To observe the clinical efficacy as well as anti-inflammatory and anti-fibrosis mechanism of Yishen Tongluo decoction in the treatment of chronic glomerulonephritis （CGN） with spleen and kidney Qi deficiency and blood stasis syndrome. Method:According to the random number table method， one hundred and twenty patients were divided into control group （60 cases） and observation group （60 cases）. The two groups were given oral valsartan capsules， 160 mg/time， 1 time/day， and dipyridamole tablets orally， 50 mg/time， 3 times/day. Patients in control group additionally took Wubi Shanyao pills orally， 9 g/time， 2 times/day， while patients in observation group additionally took Yishen Tongluo decoction orally， 1 dose/day. Both groups were treated continuously for four months. Before and after treatment， 24 h urine total protein （24 h UTP）， creatinine （SCr）， urea nitrogen （BUN）， serum cystatin C （CysC）， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， interleukin-6 （IL-6）， IL-17， interferon-<italic>γ</italic> （IFN-<italic>γ</italic>）， transforming growth factor-<italic>β</italic>₁ （TGF-<italic>β</italic>₁）， connective tissue growth factor （CTGF）， matrix metalloproteinase-9 （MMP-9）， tissue inhibitor of metalloproteinases （TMP-1） and hypoxia inducible factor-1<italic>α </italic>（HIF-1<italic>α</italic>） levels were detected in both groups. The scores of spleen and kidney Qi deficiency and blood stasis syndrome were graded. Urine protein， and urine red blood cells （urinary RBC） were monitored. Result:The 24 h UTP， SCr， BUN and CysC levels of the observation group were lower than those of the control group （<italic>P</italic><0.01）. The score of spleen and kidney Qi deficiency and blood stasis syndrome in the observation group was lower than that in the control group （<italic>P</italic><0.01）. The levels of TNF-<italic>α</italic>， IL-6， IL-17 and IFN-<italic>γ </italic>in the observation group were lower than those in the control group （<italic>P</italic><0.01）. The levels of TGF-<italic>β</italic>₁， CTGF， TMP-1 and HIF-1<italic>α</italic> in the observation group were lower than those in the control group （<italic>P</italic><0.01）. While MMP-9 level was higher than that in control group （<italic>P</italic><0.01）. The clinical effective rate was 88.33% （53/60） in the observation group， higher than 73.33% （44/60） in the control group （<inline-formula><alternatives><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:msup><mml:mrow><mml:mi>χ</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant="normal">2</mml:mn></mml:mrow></mml:msup></mml:math><graphic specific-use="big" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="alternativeImage/155A9E27-C0C9-44b4-96FF-AF947372054E-M002.jpg"><?fx-imagestate width="3.30200005" height="3.64066648"?></graphic><graphic specific-use="small" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="alternativeImage/155A9E27-C0C9-44b4-96FF-AF947372054E-M002c.jpg"><?fx-imagestate width="3.30200005" height="3.64066648"?></graphic></alternatives></inline-formula>=4.356， <italic>P</italic><0.05）. Conclusion:On the basis of conventional Western medicine treatment， Yishen Tongluo decoction in the treatment of CGN patients with spleen and kidney Qi deficiency and blood stasis syndrome can reduce proteinuria， and improve traditional Chinese medicine （TCM） syndromes， with anti-inflammatory and anti-kidney fibrosis effects. Thereby， it plays a role in protecting renal function and delaying the malignant progression of renal function， with high clinical efficacy and value of clinical use.

miR-324-5p inhibits lipopolysaccharide-induced proliferation of rat glomerular mesangial cells by regulating the Syk/Ras/c-fos pathway / 南方医科大学学报

OBJECTIVE@#To investigate the effect of miR-324-5p on the proliferation of rat glomerular mesangial (HBZY-1) cells and the role of Syk/Ras/c-fos signaling pathway in mediating this effect.@*METHODS@#HBZY-1 cells cultured in vitro were transiently transfected with miR-324-5p mimics or miR-324-5p-mimics-NC followed by treatment with lipopolysaccharide (LPS). MTT assay was used to detect the proliferation activity of HBZY-1 cells, and RT-qPCR was used to detect the expressions of miR-324-5p and the mRNA expressions of Syk, Ras, MEK1/2, ERK1/2 and c-fos mRNA. The protein expressions of p-Syk, Ras, p-MEK1/2, p-ERK1/2 and c-Fos were detected by Western blotting and immunofluorescence assay.@*RESULTS@#MTT assay showed that exposure to LPS significantly enhanced the proliferative activity of HBZY-1 cells. Compared with the cells treated with LPS and LPS + mimics NC, the cells transfected with miR-324-5p mimics prior to LPS exposure exhibited significantly lowered proliferative activity. Transfection with miR-324-5p mimics significantly lowered the mRNA expressions of Syk, Ras, MEK1/2, ERK1/2 and c-fos and the protein expressions of p-Syk, Ras, MEK1/2, ERK1/2 and c-Fos (@*CONCLUSIONS@#miR-324-5p can inhibit the proliferation of rat chronic glomerulonephritis cells induced by LPS by inhibiting Syk/Ras/c-fos signaling pathway and may potentially serve as a diagnostic indicator and a therapeutic target for chronic glomerulonephritis.

Clinical Observation of Yishen Huashi Granules Combined with Losartan Potassium Tablets in the Treat-ment of Chronic Glomerulonephritis / 中国药房

OBJECTIVE:To observe the effects of Yishen huashi granules combined with Losartan potassium tablets on renal function indexes and inflammatory factors of patients with chronic glomerulonephritis. METHODS:A total of 107 patients with chronic glomerulonephritis in our hospital during Jan. 2015-Aug. 2016 were divided into observation group(53 cases)and control group(54 cases)according to therapy plan. Besides basic therapy,control group was given Losartan potassium tablets 50 mg,po, qd;observation group was additionally given Yishen huashi granules 10 g,po,tid,on the basis of control group. Both groups were treated for consecutive 2 mouths. Clinical efficacies,renal function indexes(Scr,BUN,24 h urine protein quantification,urine red blood cell)and inflammatory factors(IL-13,CRP,TNF-α)levels were all observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:Clinical total response rate of observation group(86.79%)was significantly higher than that of control group(66.67%),with statistical significance(P<0.05). Before treatment,there was no statistical significance in renal function in-dexes or inflammatory factors levels between 2 groups(P>0.05).After treatment,renal function indexes and inflammatory factors levels of 2 groups were significantly decreased;and observation group was significantly lower than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Yishen huashi granules com-bined with Losartan potassium tablets in the treatment of chronic glomerulonephritis can improve renal function and reduce inflam-mation factor level with good safety.

Treatment of Chronic Glomerulonephritis from Lung / 中国中医药信息杂志

Chronic glomerulonephritis is with edema, proteinuria, hematuria and high blood pressure as the main clinical manifestations. The pathogenesis is complex, and disease locations are related to the lung, spleen, kidney, heart, and liver. Based on the relationship between lung and chronic glomerulonephritis, this article discussed the feasibility, common treatment and prescription of chronic glomerulonephritis from the lung, which could provide a theoretical basis for the treatment of chronic glomerulonephritis in clinic.

Clinical Observation of Yishen Huashi Granules Combined with Losartan Potassium Tablets in the Treat-ment of Chronic Glomerulonephritis / 中国药房

OBJECTIVE:To observe the effects of Yishen huashi granules combined with Losartan potassium tablets on renal function indexes and inflammatory factors of patients with chronic glomerulonephritis. METHODS:A total of 107 patients with chronic glomerulonephritis in our hospital during Jan. 2015-Aug. 2016 were divided into observation group(53 cases)and control group(54 cases)according to therapy plan. Besides basic therapy,control group was given Losartan potassium tablets 50 mg,po, qd;observation group was additionally given Yishen huashi granules 10 g,po,tid,on the basis of control group. Both groups were treated for consecutive 2 mouths. Clinical efficacies,renal function indexes(Scr,BUN,24 h urine protein quantification,urine red blood cell)and inflammatory factors(IL-13,CRP,TNF-α)levels were all observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:Clinical total response rate of observation group(86.79%)was significantly higher than that of control group(66.67%),with statistical significance(P<0.05). Before treatment,there was no statistical significance in renal function in-dexes or inflammatory factors levels between 2 groups(P>0.05).After treatment,renal function indexes and inflammatory factors levels of 2 groups were significantly decreased;and observation group was significantly lower than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Yishen huashi granules com-bined with Losartan potassium tablets in the treatment of chronic glomerulonephritis can improve renal function and reduce inflam-mation factor level with good safety.

Treatment of Chronic Glomerulonephritis from Lung / 中国中医药信息杂志

Chronic glomerulonephritis is with edema, proteinuria, hematuria and high blood pressure as the main clinical manifestations. The pathogenesis is complex, and disease locations are related to the lung, spleen, kidney, heart, and liver. Based on the relationship between lung and chronic glomerulonephritis, this article discussed the feasibility, common treatment and prescription of chronic glomerulonephritis from the lung, which could provide a theoretical basis for the treatment of chronic glomerulonephritis in clinic.

Clinical Study of Sanqi Granules in Treating Chronic Glomerulonephritis / 广州中医药大学学报

Objective To evaluate the efficacy and safety of Sanqi Granules (SG) for the treatment of chronic glomerulonephritis(CGN).Methods A prospective randomized controlled trial was carried out in 60 CGN patients with qi deficiency and blood stasis syndrome.The included patients were assigned into SG group,losartan group,and SG plus losartan group,20 cases in each group.The course of intervention was 24 weeks.Before and after treatment,24-hour urine protein quantity,serum creatinine (SCr),estimated glomerular filtration rate (eGFR) and the scores of traditional Chinese medical syndromes were observed.The clinical efficacy of Chinese medicine and western medicine,and the safety was evaluated after treatment.Results (1) After treatment for 12 and 24 weeks,the scores of traditional Chinese medical syndromes in the three groups were markedly improved (P ＜ 0.05),and the improvement in SG group and SG plus losartan group was superior to that in losartan group (P ＜ 0.05).(2) After treatment for 24 weeks,24-hour urine protein quantity in losartan group was significantly decreased (P ＜0.05),while SG group and SG plus losartan group only showed a decreasing trend(P ＞ 0.05).(3) After treatment for 24 weeks,renal function indexes of SCr and eGFR in SG group and SG plus losartan group were improved to some degrees,and the difference of eGFR in SG group was significant (P ＜ 0.05 compared with that before treatment),while the renal function injury in losartan group showed a deteriorative trend.SG group and SG plus losartan group had better effect on improving SCr and eGFR than losartan group (P ＜ 0.05).(4) After treatment for 24 weeks,the total effective rate of Chinese medicine in losartan group,SG group,SG plus losartan group was 50.00％,90.00％,84.21％,and the total effective rate of western medicine was 88.89％,75.00％,63.16％,respectively.SG group and SG plus losartan group had better clinical efficacy of Chinese medicine than losartan group (P ＜ 0.05),while the difference of clinical efficacy of western medicine among the three groups was insignificant (P ＞ 0.05).(5) During the follow-up,no severe adverse events were shown in the three groups.Conclusion SG exert certain therapeutic effect on improving the scores of traditional Chinese medical syndromes and protecting renal function,while have no obvious effect on decreasing urine protein.

Analysis of Urinary Metabonomics Pathway in Rats with Chronic Glomerulonephritis Intervened by Tannins from Pericarpium Granati / 中国药师

Objective: To analyze the metabolicomics pathway in the rats with chronic glomerulonephritis intervened by tannins from Pericarpium Granati.Methods: Signal pathway analysis was carried out using the KEGG database and molecular metabolite annotation was performed using HMDB database.The enzyme or transporter and its related properties were analyzed.The metabolite path visualization was carried out by using MetPA network software.Results: The analysis of biological metabolism pathway showed that 12 metabolites involved in 16 metabolic pathways.The pathway of tryptophan metabolism, citrate cycle, phenylalanine metabolism, cysteine and methionine metabolism showed notable changes (P<0.05).Conclusion: The changes of phenylalanine metabolism, citrate cycle, tryptophan metabolism, cysteine and methionine metabolism in the rats with chronic glomerulonephritis intervened by tannins from Pericarpium Granati participate the pathological process.

Effects of Shenfukang Capsule Combined with Sodium Ferulate on Inflammatory Factors and Immune Function of Patients with Chronic Glomerulonephritis / 现代生物医学进展

Objective:To study the effect of shenfukang capsule combined with sodium ferulate on the inflammatory factors and immune function of patients with chronic glomemlonephritis.Methods:78 patients with chronic glomerulonephritis who admitted in our hospital from February 2015 to January 2016 were divided into the observation group and the control group according to the random number method.The control group was treated with sodium ferulate,and the treatment group was treated with Shenfukang capsule combined with sodium ferulate.The clinical curative effect,serum inflammatory factors levels and immune function before and after treatment were compared between two groups.Results:After treatment,the total clinical efficacy of observation group was significantly higher than that of the control group (P ＜0.05).The serum serum levels ofIL-6 observation group,TNF-α and hs-CRP,CD8 in the two groups were significantly higher than those before treatment,which were significantly lower in the observation group than those of the control group (P ＜0.05).After treatment,the levels of CD3,CD4 and CD4 / CD8 in the two groups were significantly higher than those before treatment (P ＜0.05),which were significantly higher in the observation group than those of the control group(P＜0.05).Conclusion:Shenfukang capsule combined with sodium ferulate could effectively relieve the inflammatory response and improve the immune function with good clinical curative effect in the treatment of chronic glomerulonephritis.

Efficacy and safety of traditional Chinese medicine in the treatment of chronic glomerulonephritis / 中国生化药物杂志

ObjectiveTo explore the efficacy and safety of traditional Chinese medicine in the treatment of chronic glomerulonephritis.Methods146 cases of chronic renal glomerulonephritis were randomly divided into two groups.The control group was given oral administration of valsartan 80mg on the basis of routine treatment.On the basis of the control group, Oral, two groups were treated for 12 weeks.The levels of LKN-1, TNF-α, T-PA and renal function were observed before and after treatment.The clinical efficacy and clinical efficacy of the two groups were observed.Adverse reactions.Results The levels of LKN-1 and TNF-α in group two were significantly lower than those before treatment (P<0.05), and the study group was significantly lower than the control group (P<0.05).Compared with the control group, the rats in the study group were significantly higher than those in the control group (P<0.05).After treatment, the levels of SCr, 24h urinary protein, BUN, UCr (P<0.05), and the clinical efficacy of the study group was significantly lower than that of the control group (P<0.05).The clinical curative effect of the study group was higher than that of the control group (P<0.05) There was no significant difference between the control group and the control group.Conclusion TCM treatment of chronic glomerulonephritis can increase the clinical effect, safe and reliable.

Clinical Observation of Mailuoning Injection Combined with Benazepril in the Treatment of Chronic Glo-merulonephritis / 中国药房

OBJECTIVE:To observe clinical efficacy and safety of Mailuoning injection combined with benazepril in the treat-ment of chronic glomerulonephritis. METHODS:130 patients with chronic glomerulonephritis were randomly divided into observa-tion group and control group,with 65 cases in each group. Both groups received rountine treatment as low salt and fat diet. Control group was additionally given Benazepril tablet 10 mg,qd;observation group was additionally given Mailuoning injection 20 ml added into 5% Sodium chloride injection 250 ml,ivgtt,qd,on the basis of control group,20 days of drug withdrawal every 10 days. Both group received 4 months of treatment. Clinical efficacy of 2 groups were observed as well as the levels of BUN,UCr, SCr and 24 h urine protein quantitative (UPE) before and after the treatment. The incidence of ADR was compared between 2 groups. RESULTS:Total effective rate of observation group was 83.1%,which was significantly higher than 67.7% of control group,with statistical significance (P0.05);those indexes of 2 groups decreased significantly after treatment,and the observation group were lower than the control group,with statistical significance(P0.05). CONCLUSIONS:Mailuoning injection combined with benazepril is effective for chronic glo-merulonephritis,and can effectively improve renal function with good safety.

Clinical Research Progress in TCM Treatment for Chronic Glomerulonephritis / 中国中医药信息杂志

Traditional Chinese medicine has advantages in treating chronic glomerulonephritis. According to the articles in recent years, the therapeutic methods of TCM include not only syndrome differentiation, but also symptomatic treatment, modification of the chief prescriptions, Chinese traditional patent medicine, single Chinese herb, and combined internal and external treatment, which all have achieved some remarkable effects. However, the majority of articles were about personal experience and clinical observation which lack experimental study on the therapeutic mechanism. Therefore, the results of relative researches should be under objective evaluation. A large number of experimental researches on the therapeutic mechanism and standardized clinical observation need to be carried out in the future.

Effect of combination of tripterygium glycosides and valsartan on chronic glomerulonephritis complication with hypertension and effect on inflammatory cytokines / 中国生化药物杂志

Objective To explore the clinical curative effect of combination of Tripterygium glycosides and Valsartan on chronic Glomerulonephritis complication with hypertension and the influence on inflammatory cytokines.Methods 90 cases of patients with chronic glomerulonephritis complication with hypertension in our hospital were selected from January 2015 to January 2016,To adopt randomized single blind controlled design methods,were divided into the treatment group Tripterygium glycosides combined with Valsartan,and the control group Tripterygium glycosides,each group were 45 cases,continuous medication for 24 weeks.Before and after treatment respectively observe the changes in blood pressure,24h urinary protein,endogenous creatinine clearance rate(Ccr),blood urea nitrogen(BUN),serum creatinine(Scr),glomerular filtration rate(GFR),inflammatory cytokines such as tumor necrosis factor-α,hypersensitive C-reactive protein,interleukin-6 as reference indicators.Results All the patients were observed for 24 weeks,no adverse effects were found.The effective rate of the treatment group was 95.55%,significantly higher than 75.55%of the control group(P<0.05).After treatment,systolic blood pressure(SBP),diastole blood pressure(DBP),24h urinary protein,SCr and BUN were all decrease,while Ccr and GFR were improved,and inflammatory cytokines such as tumor necrosis factor-α,hypersensitive C-reactive protein,interleukin-6 were reduced in the treatment group and the control group,the difference was statistically significant(P<0.05).Compared with the control group,blood pressure,24h urinary protein,Ccr, Scr,GFR,TNF-α、hs-CRP were improved in the treatment group(P<0.05).Conclusion Tripterygium glycosides combined with Valsartan treatment has good clinical curative effect,It can effectively relieve the symptom of chronic Glomerulonephritis complication with hypertension.

Hypertension in Chronic Glomerulonephritis

Chronic glomerulonephritis (GN), which includes focal segmental glomerulosclerosis and proliferative forms of GN such as IgA nephropathy, increases the risk of hypertension. Hypertension in chronic GN is primarily volume dependent, and this increase in blood volume is not related to the deterioration of renal function. Patients with chronic GN become salt sensitive as renal damage including arteriolosclerosis progresses and the consequent renal ischemia causes the stimulation of the intrarenal renin-angiotensin-aldosterone system(RAAS). Overactivity of the sympathetic nervous system also contributes to hypertension in chronic GN. According to the KDIGO guideline, the available evidence indicates that the target BP should be or =30mg/24 h (i.e., those with both micro-and macroalbuminuria), a lower target of or =30mg/ 24 h. The combination of a RAAS blockade with a calcium channel blocker and a diuretic may be effective in attaining the target BP, and in reducing the amount of urinary protein excretion in patients with chronic GN.

Evaluation of the efficacy and safety of Huoxue Yishen Decoction and Western medicine in treatment of chronic glomerulonephritis / 中国生化药物杂志

Objective To investigate the effect and safety of Huoxue Yishen Decoction and Western medicine in treatment of chronic glomerulonephritis,in order to provide the basis for clinical diagnosis and treatment.Methods 67 cases with chronic glomerulonephritis admitted in People's hospital of Lanxi City from September 2012 to November 2013 were randomly divided into control group (n=32)and treatment group (n=35). The control group were given dipyridamole tablets,fosinopril sodium tablets,anti-infection and other symptomatic treatment and water electrolyte and acid-base balance disorders were corrected.Observation group were added Huoxue Yishen Decoction on the basis of control group treatment.A course of treatment was 4 weeks and all patients were treated for 2 courses. Results After treatment,the symptom score in treatment group (9.34 ±4.27 )was significantly lower than control group(13.35 ±5.64),and the difference was statistically significant (P<0.05).24 h protein,SCr and BUN in treatment group were significantly lower than control group,and the difference was statistically significant (P<0.05 ).The total effective rate of treatment group (91.43%)was significantly higher than control group(28.12%),the difference was statistically significant (P<0.05).Conclusion Huoxue Yishen Decoction combined with Western medicine in treatment of chronic glomerulonephritis can significantly improve renal function,it is effective and safety and has important value in clinical research.

Effects of Yishen Capsule on sEPCR and CD62P in patients with chronic glomerulonephritis / 西安交通大学学报(医学版)

Objective To explore the effects of Yishen Capsule on the soluble endothelium protein C receptor (sEPCR) and P-selectin (CD62P) as well as the serum levels of immunoglobulin (Ig) and complement 3 (C3) in patients with chronic glomerulonephritis (CGN). Methods The changes of sEPCR and CD62P levels in plasma as well as Ig and C3 levels in serum were assessed in 40 normal subjects and 78 patients before and after treatment by double-antibody enzyme-linked immunosorbent assay, flow cytometry and immunoturbidimetry, respectively. Results Compared with those in normal group before treatment, the levels of sEPCR and CD62P in plasma as well as IgA in serum increased obviously (P<0.01), and the levels of IgG and IgM as well as C3 in serum decreased significantly in CGN patients (P<0.01). After three months' treatment with Yishen Capsule, the levels of sEPCR and CD62P in plasma and IgA in serum decreased significantly (P<0.05 or P<0.01), and the levels of IgG and IgM in plasma as well as C3 in serum increased obviously (P<0.05 or P<0.01). Conclusion The mechanism of Yishen Capsule's effect in treating patients with CGN may be correlated with decreasing sEPCR and CD62P levels in plasma as well as regulating the levels of Ig in serum and C3.