二种不同治法对甲减肾损害大鼠血管内皮生长因子表达及肾功能形态的影响

目的:主要观察扶正软坚和温肾助阳二种不同治法对甲减肾损害大鼠血管内皮生长因子(VEGF)表达及肾功能形态的影响。方法:将大鼠随机分为正常组及实验组,实验组随机分为模型组、补中益气汤组、芪贝复元饮组,实验组建立碘缺乏致甲减肾损害模型,21d成模时及用药56d后观察甲功(TT3、TT4、TSH)和血清尿素氮(BUN)、肌酐(Scr)水平和肾脏形态及VEGF表达的变化。结果:用药56d后:(1)补中益气汤组血清BUN及Scr与正常组相比差异无统计学意义(4.87±0.27)mmol/L对(5.00±0.24)mmol/L,(23.81±2.83)μmol/L对(22.5±2.07)μmol/L,P>0.05]。芪贝复元饮组血清BUN及Scr明显高于正常组(6.42±0.87)mmol/L对(5.00±0.24)mmol/L,(28.0±2.37)μmol/L对(22.5±2.07)μmol/L,P<0.01]。(2)肾脏VEGF光密度:仅芪贝复元饮组小于正常组(4.98±1.99对6.60±2.14,P<0.05),补中益气汤组明显高于模型组(7.79±2.82对5.31±2.09,P<0.01)。(3)PAS染色比较:21d成模时模型组系膜轻度增生,处理56d时模型组轻至中度增生,有部分毛细血管扩张,用药组以芪贝复元饮组增生最重,毛细血管扩张明显,基底膜增厚,补中益气汤组增生最轻,毛细血管开放良好。结论:补中益气汤能够促进肾脏VEGF分泌并且对甲减的肾脏功能、形态恢复都优于芪贝复元饮,温肾健脾法是治疗甲减的首选方法。

The Effect of the Two Different Therapeutical Principles to Hypothyroid Rats with Kidney Damages on the Function, Morphous and the VEGF Expression of the Kidney

Objective:To study the mechnisms of hypothyroid kidney damages.Methods:The rats are grouped randomly by test team and normal team,and the test team is randomly separated by model team,Qibei Fuyan Yin team,Buzhong Yiqi Tang team.The observing indexs should be made when the hypothyroid model is found 21days later and the medication period is 56 days.The observing indexs include the morphous of the kidney,the VEGF expression,the serum TT3,TT4,,TSH,BUN,Scr.Results:56 days after medcation:(1) Only the BUN and Scr levels in Buzhong Yiqi Tang team have no variance with that in normal team(4.87±0.27 vs 5.00±0.24)mmol/L,(23.81±2.83vs22.5±2.07)μmol/L,P>0.05].(2) Compared to normal team the IODA of Qibei Fuyan Yin team is lower(4.98±1.99 vs 6.60±2.14,P<0.05).Compared to model teamonly Buzhong Yiqi Tang team has a higher IODA (7.79±2.82vs5.31±2.09,P<0.01).(3) There is a medium hyperplasia on the mordel team.We can see the expanding capillaries on it,the numbers of the opening capillories are at most in Buzhong Yiqi Tang team,the hyperplasia is leviss in it.The hyperplasia is severest in Qibei Fuyan Yin team and the protruding capillaries is most apparent in it.Conclusion:The effect of Buzhong Yiqi Tang to hypothyroid rats with kidney damages on the function,morphous and the VEGF expression of kidney is better than Qibei Fuyan Yin team.Warm kidney and strengthen spleen is the first selected therapy proposal.