RESUMEN
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.
RESUMEN
Alzheimer' s disease (AD) is a neurodegenerative disease with insidious onset and complex etiology and pathogenesis. The main pathological changes are the damage of cholinergic neurons and the loss of synapses. Because of advantages of multi-pathway and multi-target intervention, traditional Chinese medicine(TCM) compound prescriptions have a significant effect in the prevention and treatment of AD. Buyang Huanwu Tang, which is the representative prescription for benefiting Qi and activating blood circulation, has been widely used in cerebrovascular diseases, with significant effects in protecting neurons, repairing blood-brain barrier, reducing permeability, resisting cerebral edema and vascular endothelial cell injury and promoting new angiogenesis and maturation. Due to its powerful therapeutic effect the brain, a large number of scholars have found that Buyang Huanwu Tang has a significant effect in improving cognitive impairment, and different components can improve the therapeutic effect of cognitive impairment through different mechanisms. However, different studies focus on a relatively single mechanism of action, which is not conducive to a comprehensive understanding of its mechanisms of action and intervention targets. This article summarizes relevant literatures in recent years for the effect of Buyang Huanwu Tang and its component in reducing beta amyloid precursor protein (APP) expression and beta amyloid protein deposition, inhibiting the central nervous system inflammatory signaling pathways in reducing inflammatory cytokines release factor expression protect neurons, repair, neuron apoptosis blood brain barrier, preventing harmful substances from the central nervous system, improving the low-density lipoprotein receptor (LRP)-1 content, lowering ages receptor (RAGE) beta amyloid protein expression, and increasing peripheral clearance of β amyloid protein, and elaborated the mechanisms in protecting neurons and alleviating learning and cognitive dysfunction, in order to provide strong literature support for the treatment of Alzheimer's disease with Buyang Huanwu Tang.