Abstract:Objective To investigate the changes in urinary α- actinin- 4 and Synaptopodin in patients with diabetic kidney disease (DKD) with deficiency of both Qi and Yin and the intervention effect of Tangshenkang Granule.Methods A total of 70 DKD patients with deficiency of both Qi and Yin who met the inclusion criteria were enrolled and randomly divided into Tangshenkang Granule group and control group,with 35 patients in each group.A total of 64 patients completed the treatment,with 33 in the Tangshenkang Granule group and 31 in the control group.A total of 20 healthy individuals were enrolled as normal group.The patients in the control group were given conventional treatment alone,and those in the Tangshenkang Granule group were given conventional treatment combined with Tangshenkang Granule;the course of treatment was 8 weeks for both groups.Related indices were measured for both groups, including urinary albumin creatinine ratio (UACR),24- hour urinary protein (24hUP), urinary α- actinin- 4,urinary Synaptopodin,serum creatine (SCr),blood urea nitrogen (BUN),fasting plasma glucose (FPG), 2- hour plasma glucose (2hPG), and glycosylated hemoglobin (HbA1c),and the change in traditional Chinese medicine (TCM) syndrome score was evaluated. Results The Tangshenkang Granule group had a significantly better clinical outcome than the control group (P<0.05). Both groups had a significant reduction in TCM syndrome score over the course of treatment (P<0.05), and the Tangshenkang Granule group had a significantly greater reduction than the control group (P<0.05). Both groups had significant reductions in UACR and 24hUP after treatment (P<0.05), and the Tangshenkang Granule group had significantly greater reductions than the control group (P<0.05). There were no significant differences between the two groups in BUN, SCr, glomerular filtration rate, FPG, 2hPG, and HbA1c level before and after treatment (P>0.05). Before treatment, the Tangshenkang Granule group and the control group had significantly higher urinary levels of α- actinin- 4 and Synaptopodin than the normal group (P<0.05); after treatment, the Tangshenkang Granule group had significant reductions in urinary α- actinin- 4 and Synaptopodin (P<0.05), while there were no significant changes in urinary α- actinin- 4 and Synaptopodin in the control group (P>0.05). Conclusion Tangshenkang Granule can significantly improve the clinical symptoms of DKD patients with deficiency of both Qi and Yin and reduce urinary protein, possibly by reducing the urinary levels of α- actinin- 4 and Synaptopodin.