OBJECTIVETo observe the effects of Tangshen Recipe (TR) on the homocysteine (Hcy) metabolism of patients with diabetic nephropathy.

METHODS64 patients with diabetic nephropathy were randomly assigned to two groups, 32 in each. Those in the Western medicine treatment group (Group A) received insulin and orally took anti-diabetic drugs, while those in the TR group (Group B) received insulin and orally took TR (consisting of astragalus, raw rehmannia root, sanchi root, euonymus branchlet, rhubarb, bitter orange, and dogwood fruit, etc. 4 g/package). Six months was taken as one therapeutic course. Another 48 healthy volunteers were recruited as the control group. Eight intermediate metabolites of the homocysteine metabolism in plasma were quantitated before treatment, three months and six months after treatment. The in vivo changes of each metabolite after treatment were analyzed.

RESULTSCompared with the healthy control group, contents of cysteine (Cys), Hcy, s-adenosylmethionine (SAM), and SAH significantly increased in Group A and B before treatment. Contents of methionine (Met), glutathione (GSH), and Cys-gly decreased significantly, showing statistical difference (P<0.05). Patients' in vivo contents of Cys, Hcy, SAM, and SAH significantly decreased, while contents of Met, GSH, and Cys-gly significantly increased after three and six months of treatment when compared with before treatment in the same group (all P<0.05). No statistical difference existed in contents of SAH, SAM, and GSH of Group A and B after six months of treatment when compared with the healthy control group (P>0.05). No adverse reaction occurred in Group A and B.

CONCLUSIONSTreatment of insulin and TR showed similar favorable effect to Western medicine in treatment of diabetic nephropathy. It could improve in vivo hypomethylation and oxidative stress.