柴苓归芪汤加蚓激酶对实验性肾病综合征大鼠肾功能的保护作用

目的:探讨柴苓归芪汤加蚓激酶对实验性肾病综合征大鼠肾功能的保护作用.方法:采用尾静脉一次性注射阿霉素5 mg/kg制作肾病大鼠模型,随机分为模型组、辛伐他汀组、柴苓归芪组,并设正常对照组.造模1周后,予以药物干预,共用药5周.采用三氯乙酸法测定大鼠24 h尿蛋白含量;全自动生化分析仪检测血清总蛋白(total protein,TP)、白蛋白(albumin,Alb)、总胆固醇(total cholesterol,TC)、甘油三酯(triglycerides,TG)、高密度脂蛋白(high-density lipoprotein,HDL)、低密度脂蛋白(low-density lipoprotein,LDL)、肌酐(creatinine,Cr)及血尿素氮(blood urea nitrogen,BUN).光镜、电镜下观察肾组织病理形态学变化.结果:模型组与正常对照组比较,24 h尿蛋白定量及血清TC、TG、LDL、Cr、BUN均明显升高(P＜0.05或P＜0.01);血清TP、Alb、HDL则明显降低(P＜0.01).柴苓归芪汤组24 h尿蛋白定量及血清TC、TG、LDL、Cr、BUN均明显低于模型组(P＜0.05或P＜0.01);而血清TP、Alb和HDL则明显高于模型组(P＜0.05或P＜0.01).肾组织病理形态学观察:模型组光镜下部分肾小球呈局灶节段性硬化,近曲小管上皮细胞变性肿胀,部分小管腔内可见蛋白管型,间质可见散在的纤维增生;电镜下肾小球上皮细胞足突广泛融合.柴苓归芪汤组未出现肾小球硬化,肾小管间质病变明显减轻,肾小球上皮细胞足突少量融合.结论:柴苓归芪汤能够降低大鼠尿蛋白,调节脂质代谢紊乱,保护肾脏功能,延缓肾脏疾病进展.

Protective effects of Chailing Guiqi Decoction combined with lumbrukinase on renal function in rats with adriamycin nephropathy

Objective: To study the protective efffects of Chailing Guiqi Decoction (CLGQD) combined with lumbrukinase on renal function in rats with adriamycin nephropathy. Methods: Thirty-six SD rats were randomly divided into four groups: normal control group, untreated group, simvastatin-treated group and CLGQD -treated group. Adriamycin nephropathy was induced by intravenous injection with 5 mg/kg adriamycin. After seven-day treatment, quantitative measurement of 24-h urine protein was determined with trichloroacetic acid, and serum total protein (TP), albumin (Alb), total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), creatinine (Cr) and blood urea nitrogen (BUN) were assessed using automatic biochemistry analyzer. The pathomorphological changes of renal tissues were observed with light and electron microscopes. Results: In the untreated group, the 24-h urine protein excretion, serum TC, TG, LDL, Cr and BUN were significantly higher than those in the normal control group (P<0.05 or P<0.01), while the serum TP, Alb, HDL were significantly lower than those in the normal control group (P<0.01). In the CLGQD-treated group, the 24-h urine protein excretion, serum TC, TG, LDL, Cr and BUN were significantly lower as compared with those in the untreated group (P<0.05 or P<0.01), while the serum TP, Alb and HDL were significantly higher as compared with those in the untreated group (P<0.05 or P<0.01). The pathomorphological findings of the renal tissues under the light microscope in the untreated group showed focal segmental glomerulosclerosis in a few of glomerulus, degenerated and swelled proximal tubular epithelial cells, proteins in cast formation in some renal tubules and scattered fibrosis in interstitial tissues of the kidney, while the electron microscope images showed the fusion of foot processes in glomerular epithelial cells. The pathomorphological changes in the CLGQD-treated group were slighter than those in the untreated group. Conclusion: CLGQD combined with lumbrukinase can reduce proteinuria, regulate lipid metabolism, protect renal function, and delay progressive renal damage in rats.