International Journal of Chinese Medicine

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Qizhi Decoction may Protect Diabetic Nephropathy Through Decrease Lipid and Inflammation

Received: Aug. 17, 2018    Accepted: Sep. 12, 2018    Published: Sep. 29, 2018
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Abstract

Diabetic nephropathy (DN) affects approximately one-third of individuals with diabetes mellitus. Many patients develop kidney damage despite modern pharmacologic therapies available for DN treatment. Chinese medicine is a good choice for patients with DN. The aim of this study is to study the effect and safety of Qizhi decoction on patients with diabetic nephropathy. Approximately 255 men and women aged ≥18 to ≤80 years with DN were enrolled and randomized to two groups. The experimental intervention accepted Qizhi decoction in addition to their usual Novolin 50R penfill regimen. The control intervention accepted only Novolin 50R penfill. All participants receive their regimen for 12 weeks. Estimated glomerular filtration rate (eGFR), serum free fatty acid (FFA) level, the urine protein/creatinine ratio (U/C), plasma cystatin C (Cyst), Plasma C-reactive protein (CRP), hemoglobin A1c, serum uric acid, dyslipidemia were tested before entering the group. At the end of this study the index above and safety were measured again. Urine albumin levels, U/C, Cyst, CRP, FFA, TNF-α and MCP-1 levels decreased in both groups after 12 weeks of treatment. The eGFR, Cyst improved after12 weeks of treatment. Compared to the control, urine albumin levels, U/C, Cyst, CRP, FFA, TNF-α and MCP-1 levels decreased obviously in treatment group after 12 weeks of treatment. The kidney function, as measured by the eGFR, Cyst, significantly improved after12 weeks of treatment. The results indicate that combined Chinese and western medicine should be the better choice of patients with DN. QZD may protect Diabetic nephropathy through decrease lipid and inflammation.

DOI 10.11648/j.ijcm.20180202.11
Published in International Journal of Chinese Medicine ( Volume 2, Issue 2, June 2018 )
Page(s) 6-13
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Diabetic Nephropathy, Albumin, Lipid, Inflammation, Kidney Function, Chinese Herbs

References
[1] Martínez-Castelao A, Navarro-González JF, Górriz JL, de Alvaro F. The Concept and the Epidemiology of Diabetic Nephropathy Have Changed in Recent Years. J Clin Med. 2015; 4 (6):1207-1216.
[2] Farag YM, Gaballa MR. Diabesity: an overview of a rising epidemic. Nephrol Dial Transplant. 2011; (1):28-35.
[3] Gaballa M, Farag MK. Predictors of Diabetic Nephropathy. Eur J Med. 2013; 8:287–296.
[4] Ziamajidi N, Nasiri A, Abbasalipourkabir R, Sadeghi Moheb S. Effects of garlic extract on TNF-α expression and oxidative stress status in the kidneys of rats with STZ + nicotinamide-induced diabetes. Pharm Biol. 2017, 55 (1):526-531.
[5] Katsoulieris EN, Drossopoulou GI, Kotsopoulou ES, Vlahakos DV, Lianos EA, Tsilibary EC. High Glucose Impairs Insulin Signaling in the Glomerulus: An In Vitro and Ex Vivo Approach. PLoS One. 2016 Jul 19; 11 (7):e0158873.
[6] Jo HA, Kim JY, Yang SH, Han SS, Joo KW, Kim YS, Kim DK. The role of local IL6/JAK2/STAT3 signaling in high glucose-induced podocyte hypertrophy. Kidney Res Clin Pract. 2016, 35 (4):212-218.
[7] Zhang Y, Xiao HQ, Zeng XT, Zuo HX, Xu YC. Associations between endothelial nitric oxide synthase polymorphisms and risk of diabetic nephropathy: an updated meta-analysis. Ren Fail. 2015, 37 (10):312-326.
[8] Hanning You; Ting Gao; Timothy K. Cooper; W. Brian Reeves; Alaa S. Awad. Macrophages directly mediate diabetic renal injury. American Journal of Physiology Renal Physiology, 2013, 305, (12):, F1719-F1727
[9] Mir M, Rostami A, Hormozi M. Comparison of serum levels of IL-18 in peripheral blood of patients with type II diabetes with nephropathyclinical protests and patients with type II diabetes without nephropathy clinical protests. Diabetes Metab Syndr. 2016; 31 (16):30171-30180.
[10] Harshini Mudaliar; Carol Pollock; Muralikrishna Gangadharan Komala; Steven Chadban; Huiling Wu; Usha Panchapakesan. The role of Toll-like receptor proteins (TLR) 2 and 4 in mediating inflammation in proximal tubules. American Journal of Physiology Renal Physiology. 2013, 305, (12):F143-F154
[11] Molinario R, Pocino K, Daloiso PD, Giannace A, Spirito G, Zuppi C, Antenucci M. Urinary Albumin Detection: Comparison of Two Different Methods. J Clin Lab Anal. 2016; 30 (6):888-891.
[12] Said SM1, Nasr SH2. Silent diabetic nephropathy. Kidney Int. 2016; 90 (1):24-26.
[13] Pan Y, Jiang S, Qiu D, Shi J, Zhou M, An Y, Ge Y, Xie H, Liu Z. Comparing the GFR estimation equations using both creatinine and cystatin c to predict the long-term renal outcome in type 2 diabetic nephropathy patients. J Diabetes Complications. 2016, S1056-8727 (16):30292-6.
[14] Xuan L, Zheng F, Lin X, Zhu W, Yin X, Li H. Correlation between serum free fatty acid level and estimated glomerular filtration rate in type 2 diabeticpatients. Zhonghua Yi Xue Za Zhi. 2016; 96 (17):1320-1324.
[15] Brenneman J, Hill J, Pullen S. Emerging therapeutics for the treatment of diabetic nephropathy. Bioorg Med Chem Lett. 2016, 15; 26 (18):4394-402.
[16] Chamberlain JJ, Rhinehart AS, Shaefer CF Jr, Neuman A. Diagnosis and Management of Diabetes: Synopsis of the 2016 American Diabetes AssociationStandards of Medical Care in Diabetes. Ann Intern Med. 2016; 164 (8):542-552.
[17] Zheng YY: Guidelines for Clinical Research of Chinese Medicine (New Drug). Beijing: Chinese Medicine and Science Publication House; 2002.
[18] Pofi R, Di Mario F, Gigante A, Rosato E, Isidori AM, Amoroso A, Cianci R, Barbano B. Diabetic Nephropathy: Focus on Current and Future Therapeutic Strategies. Curr Drug Metab. 2016; 17 (5):497-502.
[19] Papademetriou V, Lovato L, Tsioufis C, Cushman W, Applegate WB, Mottle A, Punthakee Z, Nylen E, Doumas M; ACCORD Study Group. Effects of High Density Lipoprotein Raising Therapies on Cardiovascular Outcomes in Patients with Type 2 Diabetes Mellitus, with or without Renal Impairment: The Action to ControlCardiovascular Risk in Diabetes Study. Am J Nephrol. 2016; 45 (2):136-145.
[20] Bonora E, Bryzinski B, Hirshberg B, Cook W. A post hoc analysis of saxagliptin efficacy and safety in patients with type 2 diabetes stratified byUKPDS 10-year cardiovascular risk score. Nutr Metab Cardiovasc Dis. 2016; 26 (5):374-379
[21] Mohammedi K, Woodward M, Hirakawa Y, Zoungas S, Williams B, Lisheng L, Rodgers A, Mancia G, Neal B, Harrap S, Marre M, Chalmers J; ADVANCE Collaborative Group. Microvascular and Macrovascular Disease and Risk for Major Peripheral Arterial Disease in Patients With Type 2 Diabetes. Diabetes Care. 2016; 39 (10):1796-1803.
[22] Helou N, Talhouedec D, Shaha M, Zanchi A. The impact of a multidisciplinary self-care management program on quality of life, self-care, adherence to anti-hypertensive therapy, glycemic control, and renal function in diabetic kidney disease: A Cross-over Study Protocol. BMC Nephrol. 2016; 17 (1):88.
[23] Górriz JL, Nieto J, Navarro-González JF, Molina P, Martínez-Castelao A, Pallardó LM. Nephroprotection by Hypoglycemic Agents: Do We Have Supporting Data?J Clin Med. 2015;4 (10):1866-1889.
[24] Persson F, Theilade S, Eugen-Olsen J, Rossing P, Parving HH. Renin angiotensin system blockade reduces urinary levels of soluble urokinaseplasminogen activator receptor (suPAR) in patients with type 2 diabetes. J Diabetes Complications. 2016; S1056-8727 (16) 30282-3.
[25] Grolla E, Bonanni L, Cutolo A, Presotto F, Dalla Vestra M. Disputes in the Treatment of Diabetic Nephropathy: The Dual Blockade of Renin-Angiotensin System. Exp Clin Endocrinol Diabetes. 2016; 124 (6):361-6.
[26] Adler AI, Stratton IM, Neil HA, et al.: Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ. 2000; 321 (7258): 412–419.
[27] Czupryniak L, Joshi SR, Gogtay JA, Lopez M. Effect of micronized fenofibrate on microvascular complications of type 2 diabetes: a systematic review. Expert Opin Pharmacother. 2016 Aug; 17 (11):1463-1473.
[28] Bhattacharjee N, Barma S, Konwar N, Dewanjee S, Manna P. Mechanistic insight of diabetic nephropathy and its pharmacotherapeutic targets: An update. Eur J Pharmacol. 2016; 25;791:8-24.
[29] Khatami PG, Soleimani A, Sharifi N, Aghadavod E, Asemi Z. The effects of high-dose vitamin E supplementation on biomarkers of kidney injury, inflammation, and oxidative stress in patients with diabetic nephropathy: A randomized, double-blind, placebo-controlled trial. J Clin Lipidol. 2016;10 (4):922-929.
[30] Andersen H, Hansen PB, Bistrup C, Nielsen F, Henriksen JE, Jensen BL. Significant natriuretic and antihypertensive action of the epithelial sodium channel blocker amiloride indiabetic patients with and without nephropathy. J Hypertens. 2016;34 (8):1621-1629.
[31] Boels MG, Avramut MC, Koudijs A, Dane MJ, Lee DH, van der Vlag J, Koster AJ, van Zonneveld AJ, van Faassen E, Gröne HJ, van den Berg BM, Rabelink TJ. Atrasentan Reduces Albuminuria by Restoring the Glomerular Endothelial Glycocalyx Barrier in Diabetic Nephropathy. Diabetes. 2016; 65 (8):2429-2439.
[32] Chen J, Hou XF, Wang G, Zhong QX, Liu Y, Qiu HH, Yang N, Gu JF, Wang CF, Zhang L, Song J, Huang LQ, Jia XB, Zhang MH, Feng L. Terpene glycoside component from Moutan Cortex ameliorates diabetic nephropathy by regulating endoplasmic reticulum stress-related inflammatory responses. J Ethnopharmacol. 2016; S0378-8741 (16) 30933-3.
[33] Borges CM, Papadimitriou A, Duarte DA, Lopes de Faria JM, Lopes de Faria JB. The use of green tea polyphenols for treating residual albuminuria in diabetic nephropathy: A double-blind randomised clinical trial. Sci Rep. 2016; 20;6:28282.
[34] Cui F, Gao Y, Zhao W, Zou D, Zhu Z, Wu X, Tian N, Wang X, Liu J, Tong Y. Effect of Tongxinluo on Podocyte Apoptosis via Inhibition of Oxidative Stress and P38 Pathway in DiabeticRats. Evid Based Complement Alternat Med. 2016; 2016:5957423.
Cite This Article
  • APA Style

    Cunyun Min, Tingting Fu, Xuhui Huang, Yu Du, Changjun Wang. (2018). Qizhi Decoction may Protect Diabetic Nephropathy Through Decrease Lipid and Inflammation. International Journal of Chinese Medicine, 2(2), 6-13. https://doi.org/10.11648/j.ijcm.20180202.11

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    ACS Style

    Cunyun Min; Tingting Fu; Xuhui Huang; Yu Du; Changjun Wang. Qizhi Decoction may Protect Diabetic Nephropathy Through Decrease Lipid and Inflammation. Int. J. Chin. Med. 2018, 2(2), 6-13. doi: 10.11648/j.ijcm.20180202.11

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    AMA Style

    Cunyun Min, Tingting Fu, Xuhui Huang, Yu Du, Changjun Wang. Qizhi Decoction may Protect Diabetic Nephropathy Through Decrease Lipid and Inflammation. Int J Chin Med. 2018;2(2):6-13. doi: 10.11648/j.ijcm.20180202.11

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  • @article{10.11648/j.ijcm.20180202.11,
      author = {Cunyun Min and Tingting Fu and Xuhui Huang and Yu Du and Changjun Wang},
      title = {Qizhi Decoction may Protect Diabetic Nephropathy Through Decrease Lipid and Inflammation},
      journal = {International Journal of Chinese Medicine},
      volume = {2},
      number = {2},
      pages = {6-13},
      doi = {10.11648/j.ijcm.20180202.11},
      url = {https://doi.org/10.11648/j.ijcm.20180202.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijcm.20180202.11},
      abstract = {Diabetic nephropathy (DN) affects approximately one-third of individuals with diabetes mellitus. Many patients develop kidney damage despite modern pharmacologic therapies available for DN treatment. Chinese medicine is a good choice for patients with DN. The aim of this study is to study the effect and safety of Qizhi decoction on patients with diabetic nephropathy. Approximately 255 men and women aged ≥18 to ≤80 years with DN were enrolled and randomized to two groups. The experimental intervention accepted Qizhi decoction in addition to their usual Novolin 50R penfill regimen. The control intervention accepted only Novolin 50R penfill. All participants receive their regimen for 12 weeks. Estimated glomerular filtration rate (eGFR), serum free fatty acid (FFA) level, the urine protein/creatinine ratio (U/C), plasma cystatin C (Cyst), Plasma C-reactive protein (CRP), hemoglobin A1c, serum uric acid, dyslipidemia were tested before entering the group. At the end of this study the index above and safety were measured again. Urine albumin levels, U/C, Cyst, CRP, FFA, TNF-α and MCP-1 levels decreased in both groups after 12 weeks of treatment. The eGFR, Cyst improved after12 weeks of treatment. Compared to the control, urine albumin levels, U/C, Cyst, CRP, FFA, TNF-α and MCP-1 levels decreased obviously in treatment group after 12 weeks of treatment. The kidney function, as measured by the eGFR, Cyst, significantly improved after12 weeks of treatment. The results indicate that combined Chinese and western medicine should be the better choice of patients with DN. QZD may protect Diabetic nephropathy through decrease lipid and inflammation.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Qizhi Decoction may Protect Diabetic Nephropathy Through Decrease Lipid and Inflammation
    AU  - Cunyun Min
    AU  - Tingting Fu
    AU  - Xuhui Huang
    AU  - Yu Du
    AU  - Changjun Wang
    Y1  - 2018/09/29
    PY  - 2018
    N1  - https://doi.org/10.11648/j.ijcm.20180202.11
    DO  - 10.11648/j.ijcm.20180202.11
    T2  - International Journal of Chinese Medicine
    JF  - International Journal of Chinese Medicine
    JO  - International Journal of Chinese Medicine
    SP  - 6
    EP  - 13
    PB  - Science Publishing Group
    SN  - 2578-9473
    UR  - https://doi.org/10.11648/j.ijcm.20180202.11
    AB  - Diabetic nephropathy (DN) affects approximately one-third of individuals with diabetes mellitus. Many patients develop kidney damage despite modern pharmacologic therapies available for DN treatment. Chinese medicine is a good choice for patients with DN. The aim of this study is to study the effect and safety of Qizhi decoction on patients with diabetic nephropathy. Approximately 255 men and women aged ≥18 to ≤80 years with DN were enrolled and randomized to two groups. The experimental intervention accepted Qizhi decoction in addition to their usual Novolin 50R penfill regimen. The control intervention accepted only Novolin 50R penfill. All participants receive their regimen for 12 weeks. Estimated glomerular filtration rate (eGFR), serum free fatty acid (FFA) level, the urine protein/creatinine ratio (U/C), plasma cystatin C (Cyst), Plasma C-reactive protein (CRP), hemoglobin A1c, serum uric acid, dyslipidemia were tested before entering the group. At the end of this study the index above and safety were measured again. Urine albumin levels, U/C, Cyst, CRP, FFA, TNF-α and MCP-1 levels decreased in both groups after 12 weeks of treatment. The eGFR, Cyst improved after12 weeks of treatment. Compared to the control, urine albumin levels, U/C, Cyst, CRP, FFA, TNF-α and MCP-1 levels decreased obviously in treatment group after 12 weeks of treatment. The kidney function, as measured by the eGFR, Cyst, significantly improved after12 weeks of treatment. The results indicate that combined Chinese and western medicine should be the better choice of patients with DN. QZD may protect Diabetic nephropathy through decrease lipid and inflammation.
    VL  - 2
    IS  - 2
    ER  - 

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Author Information
  • The Integrated Division of Chinese and Western Medicine, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangdong Academy of Geriatrics, Guangzhou, China

  • The Integrated Division of Chinese and Western Medicine, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangdong Academy of Geriatrics, Guangzhou, China

  • The Integrated Division of Chinese and Western Medicine, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangdong Academy of Geriatrics, Guangzhou, China

  • The Integrated Division of Chinese and Western Medicine, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangdong Academy of Geriatrics, Guangzhou, China

  • The Integrated Division of Chinese and Western Medicine, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangdong Academy of Geriatrics, Guangzhou, China

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