Clinical study on modified self-made Jishen prescription for treatment of type 2 diabetic nephropathy (phase Ⅲ) with deficiency of both Qi and Yin and blood stasis / 国际中医中药杂志

ABSTRACT

Objective:This paper is to evaluate the curative effect of Self-made Jishen prescription combined with conventional western medicine in the treatment of type 2 diabetic kidney disease (DKD) with both deficiency of both qi and yin and blood stasis.Methods:A total of 80 patients from February 2019 to July 2020 with the syndrome of deficiency of both Qi and Yin with blood stasis in the DKD Ⅲ stage of Ruzhou Jiren Diabetes Hospital were selected. Those patients who met the diagnostic criteria were randomly divided into 2 groups, the control group and the treatment group, according to registration orders, with 40 in each group. The control group was treated with conventional western medicine therapy, and the treatment group was treated with modified self-made Jishen prescription on the basis of the control group. The treatment of both groups lasted for 3 months. Traditional Chinese Medicine (TCM) symptoms were scored before and after the treatment; hexokinase method was used to detect FPG, sarcosine oxidase method was used to detect SCr and eGFR were calculated, latex enhanced turbidimetric inhibition immuno assay method was used to detect hypersensitive C-reactive protein (hs-CRP), the sandwich ELISA was used to detect transforming growth factor-β1 (TGF-β1), and HbA1c was detected by high performance liquid chromatography; 24 h urine was collected, and 24 hUTP was detected by pyrogallol red-molybdenum method; and the clinical efficacy was evaluated.Results:The total effective rate was 87.5% (35/40) in the treatment group and 67.5% (27/40) in the control group. The difference between the two groups was statistically significant ( Z=-2.72, P=0.006). After treatment, hs-CRP [(2.52±1.02) mg/L vs. (3.21±1.22) mg/L, t=2.74], TGF-β1 [(32.2±6.52) mg/L vs. (38.3±6.8) mg/L, t=-4.97], 24 hUTP [(120.91±38.84) mg vs. (144.84 ±49.69) mg, t=-5.94] in the treatment group were significantly lower than those in the control group ( P<0.05); eGFR [(66.23±4.91)ml?min -1?1.73m -2vs. (59.69 ±4.51) ml?min -1?1.73m -2, t=6.61] in the treatment group was significantly higher than that of the control group ( P<0.05). The TCM Symptom Score after treatment in the treatment group was significantly lower than that of the control group ( P<0.01). Conclusion:For the patients with T2DM kidney disease of Phase Ⅲ with Deficiency of both Qi and Yin and Blood Stasis, the treatment of self-made Jishen prescription combined with conventional western medicine can inhibit the inflammatory reaction and renal interstitial fibrosis, improve the glomerular filtration rate, and reduce the excretion of urine protein.