Objective:To investigate the clinical efficacy of Tangshen prescription combined with Guanchang enema for patients with type 2 Ⅳ-stage diabetic kidney disease (DKD) and observe its effect on clinical indices and inflammatory factors. Method:The 120 eligible patients with type 2 Ⅳ-stage DKD were randomly divided into three groups:western medicine group

Tangshen prescription (TS) group and Tangshen prescription combined with Guanchang enema (TG) group. A parallel control study was conducted according to certain medication methods. The clinical effective rate and Serum creatinine(SCr)

urinary albumin excretion rate(UAER)

2 h-postprandial plasma glucos(2 h-PPG)

24 h urinary protein quantitation (24 h UPr)

transforming growth factor-β1(TGF-β1)

and plasminogen activator inhibitor-1(PAI-1) levels in each group were observed both before and after treatment. Result:After treatment

the total effective rate in TG group was higher than that in western medicine group (P<0.05). As compared with those before treatment

all the indexes except SCr and 2 h PPG were significantly reduced after treatment in all groups (P<0.05

P<0.01).After treatment

as compared with western medicine group

levels of UAER

24 h UPr

TGF-β1

PAI-1 were decreased in TS group(P<0.05

P<0.01)

and levels of SCr

UAER

2 h PPG

24 h UPr

TGF-β1

and PAI-1 were significantly decreased in TG group (P<0.05

P<0.01). After treatment

as compared with TS group

levels of SCr

UAER

24 h UPr

TGF-β1

and PAI-1 were decreased in TG group (P<0.05

P<0.01). Conclusion:The combination of Tangshen prescription and Guanchang enema in treatment of DKD can improve total clinical effective rate

reduce urinary protein excretion and protect renal function

and effect in reducing SCr

UAER and 24 h UPr is more obvious than Tangshen prescription alone. The efficacy of Tangshen prescription combined with Guanchang enema for kidney function may be associated with regulation of TGF-β1 and PAI-1 expression in serum.