肾康2号对肾病综合征大鼠激素治疗撤减时下丘脑-垂体-肾上腺轴的影响

目的探讨补肾健脾中药肾康2号在肾病综合征大鼠激素治疗撤减时对下丘脑-垂体-肾上腺轴(HPA轴)的影响,为其在肾病综合征激素撤减、维持治疗阶段的临床应用提供理论依据。方法以阿霉素建立肾病综合征大鼠模型,予大剂量糖皮质激素治疗造成HPA轴抑制后,激素逐渐撤减,同时予不同剂量肾康2号灌胃,观察2周后肾康2号大、小剂量组及激素对照组、肾病综合征模型组、正常组血促肾上腺皮质激素(ACTH)、皮质醇水平和肾上腺形态学的变化。结果在激素撤减后,肾康2号大、小剂量组及激素对照组大鼠血ACTH、皮质醇水平均逐步回升,虽然2周后均未恢复至正常水平,但大、小剂量组血ACTH、皮质醇水平皆高于激素对照组(P0.05),而大剂量组又高于小剂量组(P0.05);大、小剂量组肾上腺皮质束状带萎缩及细胞排列紊乱情况轻于激素对照组,而大剂量组又轻于小剂量组。结论肾康2号中药有改善糖皮质激素引起的HPA轴抑制的作用,提示我们在临床应用时可适当延长用药疗程及用药剂量。

Effect of Shenkang-Ⅱ on Hypothalamo-pituitary-adrenal Axis in Nephrotic Syndrome Rats during Glucocorticoids Withdrawal

Objective To observe the effect of Shenkang-Ⅱ on hypothalarnus-pituitary-adrenai axis （HPA axis） in nephrotic syndrome rats during high-dose glucocorticoids withdrawal, and provide a theoretical basis for clinical application of Shenkang-Ⅱ during the withdrawing and maintaining stages of glucocorticoids in the treatment of nephrotic syndrome. Methods The models of nephrotic syndrome in rats were established with adriamycin, and treated with high-dose glucocorticoid which can cause HPA axis suppression. After the HPA axis was suppressed, the hormone was reduced gradually. At the same time, the rats were treated by intragastric administration with different doses of Shenkang-Ⅱ. The changes of serum ACTH, cortisol and adrenal morphological in large dose of Shenkang-Ⅱ group, small dose of Shenkang-Ⅱ group, hormone control group, nephrotic syndrome model group and normal group were observed after two weeks. Results In the stage of withdrawing glucocorticoids, there were some amelioration in the changes of serum ACTH, cortisol in every group. After 2 weeks, those changes didn＇t return to normal level. However, compared with the level of hormone control group, there were obvious increases in the levels of serum ACTH and cortisol in the large and small dose of Shenkang-Ⅱ group （P〈0.05）, and levels of serum ACTH and cortisol in the large dose of Shenkang-Ⅱ group ameliorated obviously than that in the small dose of Shenkang-Ⅱ group （P〈0.05）. In the Shenkang-Ⅱ treatment group, there were less atrophy in fascicular zone of adrenal cortex and less cell arrangement disorder in adrenal gland, and the amelioration of morphology was more in the large dose of Shenkang-Ⅱ group than that in the small dose of Shenkang-Ⅱ group. Conclusion Shenkang-Ⅱ can improve the suppressive effect of glucocorticoids on the HPA axis, indicating that we may prolong the course of treatment and increase the dose properly in clinic.