温脾汤对5/6肾切除大鼠残余肾脏的保护作用

摘要背景:肾纤维化是几乎所有肾脏疾病进展到终末期肾衰的共同通路,大多数抗肾纤维化的治疗尚处于实验阶段。研究表明中药具有良好的抗肾纤维化应用前景,温脾汤是临床上治疗慢性肾衰、保护肾功能的有效方剂。目的:探讨温脾汤对5/6肾切除大鼠残余肾脏功能和形态学的影响。设计:随机对照的实验研究。地点、材料和干预:本实验在北京中医药大学细胞与生化实验室完成。实验选用雄性Wistar大鼠44只,质量(200±20)g。实验动物于术前按质量随机分组,其中36只大鼠接受5/6肾切除术(分别为温脾汤组、尿毒清组),8只留作假手术组。采用5/6肾切除大鼠模型,动态观察温脾汤对病理大鼠质量、血清肌酐、尿素氮以及24h尿蛋白的影响。并对肾组织六铵银染色(PAM)结果进行光镜观察和图像分析,观察大鼠组织形态学变化。主要观察指标:假手术组大鼠与其他3组肾切除术前,术后4,8,12,16周血清肌酐、尿素氮、24h尿蛋白、体质量比较。结果:温脾汤组术后12,16周时血清肌酐犤(9.4±1.0),(12.8±2.2)mg/L犦显著低于模型组犤(11.7±1.7),(16.1±1.7)mg/L犦,差异有显著性意义(t=4.052,P<0.01)。温脾汤组大鼠血清尿素氮在术后呈缓慢上升趋势,但在术后12,16周时仍明显低于模型组(t=6.504～15.498,P<0.05)。温脾汤和尿毒清组大鼠24h尿蛋白呈缓

Protective effect oftraditional Chinese medicine wenpi tang on remnant kidney of 5/6 nephrectomized rats

BACKGROUND: Renal fibrosis is almost the most conmmon pathway of all the renal diseases from early period to telophase. However, the majority of treatments on anti renal fibrosis are still in the experimental period. Research showed that the traditional Chinese medicine has great prospect on anti renal fibrosis, and wenpi tang is an effective clinical agent for chronic renal failure and to protect renal function.OBJECTIVE: To explore the effect of wenpi tang on the function and morphology of remnant kidney of rats after 5/6 renal ablation.DESIGN: Randomized controlled experiment.SETTING, PARTICIPANTS and INTERVENTIONS: The experiment was completed in Cell and Biochemistry Laboratory of Beijing Traditional Chinese Medicine University. Forty-four Wistar rats, male, weighing(200 ±20) g were selected and randomized into several groups according to their ( wenpi tang group and niaoduqing group), and the rest 8 rats were in the pseudo operation. In 5/6 nephrectomized rats model, the effect of wen.pi tang on bodymass, serum creatinine(Ser), blood urea nitrogen(BUN) and 24 bours' urine protein at different time point of pathological rats was dynamically investigated. Periodic acid methenaminesilver PAM staining result of renal tissue was studied by light microscope and image analysis technique in order to observe histomorphological changes.MAIN OUTCOME MEASURES: Comparison of serum creatinine, blood urea nitrogen, 24 hours' urine protein and body mass before nephrectomy between pseudo operation group and other 3 groups.RESULTS: The serum creatinine[ (9.4±1.0), (12.8 ± 2. 2)mg/L]of rats in wenpi tang group 12 and 16 weeks after operation was remarkably lower than thai of model group [ ( 11.7 ±1.7), ( 16. 1 ± 1.7) mg/L], which indicated significant difference( t = 4.052, P ＜ 0. 01 ). The serum urea nitrogen of wenpi tang rats increased gradually after operation, but it was still obviously lower than that ofmodelgroup(t=6.504-15.498, P ＜0.05) 12and 16 weeks later. Twenty-four hour urine protein of rats in wenpi tang and Niaoduqing groupsgradually went up while obviously lowered than that of model group at different time point( t =9. 548 - 19. 595, P ＜ 0.01). Under light microscope, we found that wenpi tang alleviated the pathological damage such as glomerular hypertrophy, mesangial proliferation, glomerulosclerosis and tubulointerstitial damage.CONCLUSION: Wenpi tang can ameliorate renal pathological damage of 5/6 nephrectomized rats and protect renal function of the remnant kidney.