OBJECTIVE  To explore the effect of Shenmai Dihuang Decoction combined with valsartan on oxidative stress, vascular endothelial function and serum miR-133b, miR-135b in patients with diabetic nephropathy.

  METHODS  A total of 90 patients with diabetic nephropathy who were treated in the outpatient department of Jiangyin Hospital of Traditional Chinese Medicine from January 2017 to October 2020 were selected as the research objects, and they were divided into the control group and the observation group, with 45 cases in each group according to the random number table method. The control group was treated with valsartan dispersible tablets orally, and the observation group was additionally given Shenmai Dihuang Decoction on the basis of the treatment of the control group. The course of treatment for both groups was 3 months. Before and after treatment, TCM syndrome scores were evaluated; fasting blood glucose (FPG), serum creatinine (SCr), blood urea nitrogen (BUN), urine albumin/creatinine ratio (UACR), the changes of oxidative stress indexes superoxide dismutase (SOD) and malondialdehyde (MDA), vascular endothelial function indicators soluble intercellular adhesion molecule-1 (sICAM-1) and endothelin-1 (ET-1) and miR-133b, miR-135b were assessed.

  RESULTS  After treatment, the TCM syndrome scores, FPG, SCr, BUN, UACR, and the expression levels of MDA, sICAM-1, ET-1, miR-133b, and miR-135b were significantly decreased, and the SOD activity was significantly increased in the two groups (P<0.01). The observation group showed better therapeutic efficacy than the control group (P<0.01), with the total effective rate higher than the control group (P<0.01).

  CONCLUSION  Shenmai Dihuang Decoction combined with valsartan can effectively improve the clinical symptoms of diabetic nephropathy, which may be related to the regulation of oxidative stress, vascular endothelial function, and serum miR-133b and miR-135b levels.