Abstract:【Objective】To investigate the clinical efficacy and mechanism of sequential treatment of diabetic nephropathy with Shenkang injection and Shenkang suppository. 【Methods】A total of 180 patients with diabetic nephropathy from October 2017 to January 2018 were divided into the observation group and the control group by random number table method, with 90 case in each group. Patients in the control group received routine treatment for diabetic nephropathy, while patients in the observation group received Chinese medicine (Shenkang Injection sequentialy combined with Shenkang suppository treatment) for 8 weeks. Before and after treatment, serum interleukin-17 (IL-17) and tumor cell necrosis factor-a (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA); And serum hypersensitive C-reactive protein (hs-CRP) was detected by immunoturbidimetry. The levels of plasma resistin, nitric oxide (NO) and matrix metalloproteinase-9 (MMP-9) were measured by Elisa method. The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) of renal artery were measured by Doppler ultrasound. Serum homocysteine (Hcy), cystatin-C (Cys-c), β2-microglobulin (β2-MG), twenty-four hours urinary microalbumin (24UAE), serum uric acid and insulin resistance index (HOMA-IR) were compared between the two groups. 【Results】After treatment, the serum Hcy, Cys-C, β 2-MG, 24UAE, UA, HOMA-IR of the two groups were significantly improved compared to those before treatment. The improvement range of the observation group was better than that of the control group; The difference was statistically significant (P<0.05). Compared to before treatment, the levels of IL-17, TNF-α, hs-CRP, resistin, MMP-9 and NO in the two groups decreased; And the changes in the observation group were more significant (P<0.05). After treatment, the PSV speed and RI in the observation group decreased significantly compared to before treatment and the control group (P<0.05). The incidence of adverse reactions in the observation group was 6.67%, which was slightly higher than that in the control group (4.44%), but there was no statistical difference (P>0.05). 【Conclusion】Shenkang injection with sequential Shenkang suppository treatment can significantly reduce the urinary protein content in patients with diabetic nephropathy, improve renal tissue blood perfusion, reduce renal function damage, and improve the clinical efficacy of patients with diabetic nephropathy. Its mechanism is related to the down-regulation of inflammatory response and the improvement of vascular endothelial cell function in patients treated with sequential Chinese medicine.
李改仙, 刘萍, 王皓, 贺晖英, 张虹, 车秀英, 伍华英. 肾康注射液并序贯肾康栓治疗对糖尿病肾病患者的炎性因子及肾功能的影响[J]. 医学临床研究, 2019, 36(12): 2313-2316.
LI Gai-xian, LIU Ping, WANG Hao, et al. Clinical Efficacy and Mechanism of Sequential Treatment of Diabetic Nephropathy with Shenkang Injection and Shenkang Suppository. JOURNAL OF CLINICAL RESEARCH, 2019, 36(12): 2313-2316.