Clinical Efficacy of Tangshen Dihuang Decoction in Treating Diabetic Kidney Disease with Liver-kidney Yin Deficiency and Blood Stasis Syndrome and Its Impact on Gut Microbiota
10.13422/j.cnki.syfjx.20251124
- VernacularTitle:糖肾地黄汤治疗肝肾阴虚兼血瘀型糖尿病肾病的临床疗效观察及对肠道菌群的影响
- Author:
Chaomao YANG
1
;
Shunxiao ZHANG
1
;
Zhixin YANG
1
;
Jiandong GAO
2
Author Information
1. Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine，Shanghai 201999，China
2. Shuguang Hospital Affiliated to Shanghai University of TCM，Shanghai 201203，China
- Publication Type:Journal Article
- Keywords:
diabetic kidney disease;
liver-kidney Yin deficiency and blood stasis;
Tangshen Dihuang decoction;
angiotensin Ⅱ;
gut microbiota
- From:
Chinese Journal of Experimental Traditional Medical Formulae
2026;32(6):171-178
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo observe the clinical efficacy of Tangshen Dihuang decoction in treating diabetic kidney disease （DKD） with liver-kidney Yin deficiency and blood stasis syndrome and its impact on gut microbiota. MethodsA randomized controlled clinical trial was conducted， in which 102 DKD patients with liver-kidney Yin deficiency and blood stasis syndrome were randomly assigned to the Tangshen Dihuang decoction group and the control group. Each group consisted of 51 cases， and the treatment period was 3 months. The primary efficacy indicators included urinary albumin-to-creatinine ratio （UACR）， fasting blood glucose （FBG）， 2-hour postprandial blood glucose （2 hPBG）， glycated hemoglobin （HbA1C）， serum creatinine （SCr）， blood urea nitrogen （BUN）， angiotensinⅡ （AngⅡ）， serum cystatin C （Cys-C）， urinary N-acetyl-β-D-glucosaminidase （NAG）， urinary β2-microglobulin （Uβ2-MB）， traditional Chinese medicine （TCM） symptom scores， and gut microbiota. ResultsAfter treatment， the total response rate in the Tangshen Dihuang decoction was 87.23% （41/47）， which was higher than that （69.57%， 32/46） in the control group （Z=4.30， P<0.05）. After treatment， the TCM symptom scores decreased in both groups （P<0.01） and were lower in the Tangshen Dihuang decoction group than in the control group （P<0.01）. After treatment， the control group showed decreases in UACR， Uβ2-MG， AngⅡ， and FBG （P<0.05） as well as 2 hPBG and HbA1C （P<0.01）， and no significant differences in BUN， Cys-C， eGFR， SCr， and NAG. The Tangshen Dihuang decoction group showed increased eGFR （P<0.05）， declined levels of UACR， BUN， Cys-C， Uβ2-MB， AngⅡ， FBG， 2 hPBG， NAG， and HbA1C （P<0.01）， and no significant difference in SCr. The Tangshen Dihuang decoction group had lower BUN （P<0.05）， Cys-C （P<0.05）， AngⅡ （P<0.05）， 2 hPBG （P<0.05）， Uβ2-MG （P<0.01）， and NAG （P<0.01） and higher eGFR level （P<0.05） than the control group. After treatment， the control group showed declines in Shannon， Observed_species， and Chao1 indices （P<0.05）. The samples from both groups showed statistically significant differences in the principal coordinates analysis （PCoA） plot based on Anosim analysis （P<0.05）. After treatment， the Tangshen Dihuang decoction group showed decreased relative abundance of Actinobacteria （P<0.05）. Moreover， the relative abundance of Actinobacteria was significantly lower in the Tangshen Dihuang decoction group than in the control group （P<0.05）. At the genus level， the control group showed decreased relative abundance of Bifidobacterium （P<0.05）， and the Tangshen Dihuang decoction group presented increased relative abundance of Bifidobacterium and Blautia_A （P<0.05）. After treatment， the Tangshen Dihuang decoction group had higher relative abundance of Bifidobacterium than the control group （P<0.01）. ConclusionTangshen Dihuang decoction has a significant therapeutic effect on DKD patients with liver-kidney Yin deficiency and blood stasis syndrome. It can markedly relieve clinical symptoms and reduce proteinuria and postprandial blood glucose by antagonizing the local renin-angiotensin system （RAS） and alleviating gut microbiota dysbiosis.
