Treatment of diabetic kidney disease by Huoxue Yishen Recipe plus sodium-glucose co-transporter 2 inhibitors

Objective To explore the efficacy of Huoxue Yishen Recipe plus sodium glucose cotransporter 2 (SGLT2) inhibitors in the treatment of diabetic kidney disease (DKD). Methods From January 2020 to January 2021, 200 hospitalized DKD patients were randomized into two groups. Control group (n=100) received conventional measures plus empagliflozin while study group (n=100) had Huoxue Yishen Recipe on the basis of control group. Total effective rate of two groups was evaluated. And urinary albumin (Alb), urinary β2 microglobulin (β2-MG), urinary microalbumin/creatinine (A/C), blood 8-iso-prostaglandin-F2α (8-iso-PGF2α), cystatin C (CysC), inflammatory factors, fibrotic indices and improvement of main symptoms were compared between two groups before and after treatment. Results Total effective rate was higher in study group than in control group 90.0% vs 77.0%, χ²=6.133, P=0.013). After treatment, the levels of urinary Alb, urinary β2-MG, urinary A/C, blood 8-iso-PGF2α and blood Cys-C control group:(17.18±5.69) mg/L, (5.11±1.07) mg/L, (292.85±45.42) mg/g, (15.05±2.21) ng/mL, (0.63±0.09) mg/L; study group:(8.35±2.76) mg/L, (3.73±1.01) mg/L, (264.38±38.63) mg/g, (9.16±1.27) ng/mL, (0.58±0.04) mg/L were lower than before treatment control group:(52.54±13.72) mg/L, (7.49±1.43) mg/L, (328.57±49.72) mg/g, (22.12±3.38) ng/mL, (1.07±0.12) mg/L; study group: (51.86±12.23) mg/L, (7.55±1.38) mg/L, (323.66±47.84) mg/g, (21.86±3.35) ng/mL, (0.95±0.14) mg/L (P<0.05), the levels of urinary Alb, urinary β2-MG, urinary A/C, blood 8-iso-PGF2α and blood CysC (8.35±2.76) mg/L, (3.73±1.01) mg/L, (264.38±38.63) mg/g, (9.16±1.27) ng/mL, (0.58±0.04) mg/L were lower in study group than those in control group (17.18±5.69) mg/L, (5.11±1.07) mg/L, (292.85±45.42) mg/g, (15.05±2.21) ng/mL, (0.63±0.09) mg/L (P<0.05). After treatment, the scores of main symptoms of two groups control group:(1.67±0.54) points, (1.56±0.49) points, (1.26±0.39) points, (1.13±0.36) points, (1.23±0.39) points, (1.34±0.43) points; study group:(0.95±0.31) points, (0.84±0.27) points, (0.65±0.19) points, (0.59±0.18) points, (0.72±0.23) points, (0.79±0.25) points were lower than those before treatment control group:(2.74±0.89) points, (2.85±0.94) points, (2.27±0.74) points, (2.06±0.67) points, (2.17±0.72) points, (2.32±0.76) points; study group:(2.79±0.92) points, (2.78±0.91) points, (2.34±0.77) points, (2.11±0.69) points, (2.24±0.73) points, (2.27±0.74) points (P<0.05) and the points of main symptoms of study group (0.95±0.31) points, (0.84±0.27) points, (0.65±0.19) points, (0.59±0.18) points, (0.72±0.23) points, (0.79±0.25) points were lower than those of control group (1.67±0.54) points, (1.56±0.49) points, (1.26±0.39) points, (1.13±0.36) points, (1.23±0.39) points, (1.34±0.43) points (P<0.05). After treatment, the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and Creactive protein (CRP) control group:(57.95±12.23) ng/L, (18.67±4.11) ng/L, (7.79±2.54) ng/L; study group:(44.32±11.02) ng/L, (14.85±2.2) ng/L, (5.12±1.68) ng/L were lower than before treatment control group:(67.62±10.14) ng/L, (22.24±3.72) ng/L, (10.23±3.38) ng/L; study group:(66.49±11.82) ng/L, (21.73±4.58) ng/L, (9.58±3.09) ng/L (P<0.05) and the levels of TNF-α, IL-6, and CRP (44.32±11.02) ng/L, (14.85±2.2) ng/L, (5.12±1.68) ng/L were lower in study group than those in control group (57.95±12.23) ng/L, (18.67±4.11) ng/L, (7.79±2.54) ng/L (P<0.05). After treatment, laminin (LN), type Ⅲ procollagen (PC Ⅲ), type Ⅳ collagen (C-Ⅳ) and hyaluronic acid (HA) control group:(101.63±13.04) μg/L, (87.04±16.53) μg/L, (92.89±22.63) μg/L, (137.07±45.63) ng/L; study group:(76.81±9.38) μg/L, (57.85±14.07) μg/L, (61.52±13.64) μg/L, (121.05±40.34) ng/L were lower than before treatment control group:(128.42±16.18) μg/L, (135.17±18.59) μg/L, (130.93±31.52) μg/L, (175.11±52.24) ng/L; study group:(129.69±18.42) μg/L, (133.83±20.62) μg/L, (128.72±28.11) μg/L, (178.29±51.86) ng/L (P<0.05) and LN, PCⅢ, C-Ⅳ and HA (76.81±9.38) μg/L, (57.85±14.07) μg/L, (61.52±13.64) μg/L, (121.05±40.34) ng/L were lower in study group than those in control group (101.63±13.04) μg/L, (87.04±16.53) μg/L, (92.89±22.63) μg/L, (137.07±45.63) ng/L (P< 0.05). Conclusion Huoxue Yishen Recipe plus empagliflozin in the treatment of DKD may regulate urinary Alb, urinary β2-MG, urinary A/C, blood 8-iso-PGF2α, blood CysC levels and inflammatory factor levels and improve fibrotic indices and main symptoms and enhance total effective rates.