阿霉素肾病大鼠肾小管间质损害及益气血祛风湿方的干预作用

目的：探讨益气血祛风湿方对阿霉素肾病肾小管间质损伤的有效治疗作用,为临床应用提供实验室理论依据。方法：采用阿霉素一次性尾静脉注射诱导的肾病模型,造模2周后用益气血祛风湿方或黄芪当归水煎剂等干预治疗。实验于第6周末处死大鼠,留取肾脏。采用HE染色观察肾组织病理改变;RT-PCR测定肾组织中TGF-β1基因表达;采用免疫组化技术检测肾小管间质MCP-1、TGF-β1的蛋白表达。结果：肾脏病理结果显示,模型组大鼠肾小管上皮浊肿、严重的空泡变性;肾小管不同程度扩张;可见较多蛋白管型;肾间质出现小灶性～灶性炎细胞浸润和灶性纤维化。各治疗组大鼠肾小管扩张、浊肿及间质炎细胞浸润等病理改变均较模型组减轻,肾间质纤维化程度也显著低于模型组。模型组大鼠肾组织和小管间质TGF-β1表达均显著增多,MCP-1阳性表达也显著增加,各治疗组肾小管间质中的MCP-1、TGF-β1表达较模型组显著降低,益气血祛风湿方组作用显著优于芪归治疗组。结论：益气血祛风湿方可显著改善肾小管间质的炎症损伤和纤维化程度,机制可能与其显著降低肾小管间质炎症因子和促纤维化细胞因子表达的作用有关。

Effects of YiQiXueQuFengShiFang on Renal Interstitial Damage in Adriamycin Nephrosis Rats

Objective：To observe the effects of YiQiXueQuFengShiFang or Astragali and Angelica on renal interstitial damage. Methods：The model of Adriamycin nephrosis in rats was established intravenous injection of adriamycin in dose of 5mg Kg-1 weight. The rats with nephropathy were treated with YiQiXueQuFengShiFang,,or Astragali and Angelica（AA） for 4 weeks. The natural rats were regarded as control group. Renal pathological lesion were quantified on HE and Masson stained tissue sections. Immunohistochemistry combined with semi-quantitive method were used to investigate the protein level of monocyte chemoattractant protein 1（MCP-1） and transfoeming geowth factor-beta1（TGF-β1） in renal tissues. Results：Renal interstitial cell infiltration,tubular atrophy,interstitial fibrosis and the expression level of MCP-1 TGF-β1 in renal interstitium were alleviated significantly by YiQiXueQuFengShiFang or AA treatment compared with those of adriamycin nephrosis rats. The effect of YiQiXueQuFengShiFang on ameliorating interstitial fibrosis and suppressing MCP-1、TGF-β1 expression was better significantly than AA treatment. Conclusion：YiQiXueQuFengShiFang can ameliorate renal pathological lesion,and has more efficiency in preventing tubulointerstitial inflammation,progression of interstitial fibrosis. Suppressing interstitial MCP-1 and TGF-β1 expression is possible one of its mechanisms.