延肾胶囊延缓残肾损伤的实验研究

目的探讨延肾胶囊延缓残进行性损伤的量效关系.方法Wistar大鼠120只,随机分为6组,A组为假手术对照组;B组为5/6肾切除;C,D和E分别为5/6肾切除 低、中、高剂量延肾胶囊;F组为5/6肾切除 肾衰宁.术后A和B两组给予等容积生理盐水灌胃.定量喂养,自由饮水.于术后15,90天测定血尿素氮(BUN)、血肝酐(SCr)、血红素(Hb),肾组织光镜及其形态计量、电镜,每组每时相点观察10只大鼠.结果术后B组BUN和SCr显著高于A组,Hb显著低于A组;C,D和E组BUN和SCr也有所升高,但显著低于B组,随着延肾胶囊剂量增加,BUN和SCr逐渐降低;F组的BUN和SCr低于B组,高于E组.术后B组,光镜下可见肾小球系膜细胞增生,肾小球系膜区增宽,肾小球硬化和肾间质纤维化,术后时间越长病变越重,形态计量示硬化肾小球比率和病变肾小管肾间质比率显著高于A组,C,D和E组硬化肾小球比率和病变肾小管肾间质比率逐渐降低;F组硬化肾小球比率和病变肾上管间质比率低于B组,但高于D和F两组.电镜观察,B组术后肾小球系膜细胞增生,未见明显系膜细胞凋亡,C,D和E组可见增生的系膜细胞凋亡,A组无明显异常发现.结论延肾胶囊能显著降低血BUN,SCr,抵制残肾纤维化,延缓慢性肾衰的进程,呈剂量依赖性,其效果优于肾衰宁;延肾胶囊促进增生的系膜细胞凋亡可能是其抑制残肾纤维化、保护残肾功能的重要机制之一.

Experimental study of Yan-shen capsule retarding remnant kidney damage

Objective: To clarify the dosage-effect relation of Yan-shen capsule to retard remnant kidney progressive damage and compared the curative effect of Yan-shen capsule with Shen-Shuai-Ning capsule. Methods:120 adult Wistar rats were randomly divided into 6 groups, 20 rats in each group. Rats of group A were shin-operattrol drug Shen-Shuai-Ning capsule. Group A and B were given the same volume of saline. The rats were feeded with standard big granule feed for 15 g/100 g bw/d. the rats were permitted to drink water freely. On day 15 and 90 after operation, serum urea (BUN) and creatinine (SCr), hemoglobin (Hb), renal histology under optical microscope and trans-electron microscope, and morphometry were observed. There were 10 rats for each group and each time point.Results: It was found that, on 90 day after operation, concentrations of BUN and SCr in group B were obviously higher and concentration of Hb was lower and concentration of Hb was higher than that in group B (P ＜0.05). the higher the dosage of Yan-Shen capsule was, the lower the concentrations of BUN and SCr. The concentrations of BUN and SCr iin group F were lower than that in group B but higher than that in group E. under optical microscope,the remnant kidney of group B showed glomerular mesangial cell proliferating, glomerular mesangial matrix dilation,glomerular sclerosis and interstitial fibrosis. The longer the time was after operation, the serious the renal histological damage. The morphometry showed that group B had higher ratio of sclerosis glomeruli and damaged tubules and interstitial than group A (P ＜0.05). group C, D and E had lower ratio of sclerosis glomeruli and damaged tubules and interstitial than group B (P ＜0.05). the higher the dosage of Yan-Shen capsule was, the lower the ratio of sclerosis glomeruli and damaged tubules and interstitial. This ratio of group F was lower than group B but higher than group D and F. under trans-electron imcroscope, the glomerular mesangial cell proliferating was outstanding in group B with less proliferative mesangial cells. In group F, it showed mesangial cell proliferating without obvious cell apoptosis in mesangium. In group A, there were not obvious apoptosis nor proliferating in mesangium. Conclusions: YanShen capsule could reduce BUN and SCr, inhibit the fibrosis of remnant kidney, an retard the progress of chronic renal failure in dosage dependent manner. Yan-Shen capsule had better protective effects on the remnant kidney than Shen-Shuai-Ning capsule. Promoting apoptosis of proliferative mesangial cells might be one of the mechanisms that Yan-Shen capsule inhibit fibrosis and protect function of remnant kidney.