To explore the mechanism for Ershiwei Chenxiang pills to regulate the composition of intestinal microflora probiotics in diabetic nephropathy rats.

Fifty specific pathogen free male SD rats aged from 8 to 10 weeks were selected, of which ten were included in a control group, and the rest 40 were used to induce diabetic nephropathy. Then, the 40 diabetic nephropathy rats were randomly divided into a model group, and low-, medium-, and high-dose Ershiwei Chenxiang pills groups, with 10 rats in each group. The control group and model group were given 3 ml of normal saline, and low-, medium-, and high-dose groups were given 0.5, 1, and 2 g/kg Ershiwei Chenxiang pills, respectively. Liver function indexes, the levels of inflammatory factors, the diversity and richness of intestinal flora, and the expression of P38 mitogen-activated protein kinase (p38MAPK) pathway proteins in each group were detected.

Compared to the control group, aspartate aminotransferase (AST), alanine aminotransferase (ALT), hypersensitive C-reactive protein (HS-CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1 β (IL)-1β), p38MAPK, phosphorylated cAMP response element binding protein (P-CREB), and fibronectin (FN) increased significantly, while AST/ALT ratio, operational taxonomic unit (OTU) number, Chaol index, Shannon index, and Simpson index decreased significantly in all the other groups (P＜0.05). Compared with the model group, the levels of AST, ALT, Hs-CRP, TNF-α, IL-6, IL-1β, p38MAPK, P-CREB, and FN in the three Ershiwei Chenxiang pills decreased significantly, and AST/ALT ratio, OTU number, Chaol index, Shannon index and Simpson index increased significantly (P＜0.05). Compared with the low-dose group, the levels of AST, ALT, Hs-CRP, TNF-α, IL-6, IL-1β, p38MAPK, P-CREB, and FN in the medium- and high-dose groups decreased significantly, and AST/ALT ratio, OTU number, Chaol index, Shannon index, and Simpson index increased significantly (P＜0.05). Compared with the medium-dose group, the levels of AST, ALT, Hs-CRP, TNF-α, IL-6, IL-1β, p38MAPK, P-CREB, and FN in the high-dose group decreased significantly, and AST/ALT ratio, OTU number, Chaol index, Shannon index, and Simpson index increased significantly (P＜0.05).

High-dose Shiwei Chenxiang pills can improve liver function, alleviate inflammatory reaction, and maintain the stability of intestinal flora and probiotics.