地灵丹汤对单侧输尿管梗阻大鼠模型肾间质纤维化的防治作用

目的：研究中药复方地灵丹汤对单侧输尿管梗阻（unilateral ureteral obstruction，UUO）致肾间质纤维化模型大鼠肾间质纤维化的防治作用及其可能机制。方法：将60只SD大鼠随机分为假手术组、模型组、依那普利组及地灵丹组。采用UUO法建立肾间质纤维化大鼠模型，观察血尿素氮、血清肌酐和24h尿蛋白定量及肾组织病理改变，并采用免疫组织化学法检测转化生长因子β1（transforming growth factor-β1，TGF-β1）、α-平滑肌肌动蛋白（α-smooth muscle actin，α-SMA）、纤维连接蛋白（fibronectin，FN）及层黏连蛋白（laminin，LN）的表达。结果：第7天模型组肾间质大量炎症细胞浸润及胶原表达，TGF-β1、FN和LN表达面积百分率较假手术组明显增加（P＜0．05）；地灵丹组间质纤维化面积较模型组减少（P＜0．05）。第14天地灵丹组和依那普利组肾间质TGF-β1、α-SMA、FN和LN表达面积百分率较模型组减少（P＜0．05），BUN、SCr和24h尿蛋白无明显差异。第21天地灵丹组SCr、肾间质纤维化和TGF-β1表达面积百分率较依那普利组和模型组下降（P＜0．05）。结论：地灵丹能减轻单侧输尿管梗阻模型大鼠的蛋白尿和肾间质纤维化，抑制TGF-β1、α-SMA、FN和LN的表达。在较长时间应用后，地灵丹对模型大鼠的肾功能保护作用优于依那普利。

Dilingdan Decoction prevents renal interstitial fibrosis in a rat model of unilateral ureteral obstruction

OBJECTIVE: To investigate the preventive and therapeutic effects and the possible mechanisms of Dilingdan Decoction (DLDD), a compound Chinese herbal medicine, on rats with renal tubulointerstitial fibrosis induced by unilateral ureteral obstruction (UUO). METHODS: Sixty SD rats were randomly divided into sham-operated group, untreated group, enalapril-treated group and DLDD-treated group. Blood urea nitrogen (BUN), serum creatinine (SCr), urine protein quantization in 24 hours and pathological changes of the obstructed kidney were observed. The expressions of transforming growth factor-beta1 (TGF-beta1), alpha-smooth muscle actin (alpha-SMA), fibronectin (FN) and laminin (LN) were detected by immunohistochemical method and colored-multimedia pathological image analysis system. RESULTS: Massive inflammatory infiltrates and collagen expression in renal interstitial in the untreated group were observed on the 7th day. Compared with the sham-operated group, percentages of area of TGF-beta1, alpha-SMA, FN and LN expressions in the untreated group were markedly increased (P<0.05), while the percentage of area of interstitial fibrosis was decreased in the DLDD-treated group as compared with the untreated group (P<0.05). On the 14th day, the percentages of area of TGF-beta1, alpha-SMA, FN and LN expressions were declined in two treated groups as compared with the untreated group (P<0.05), but had no statistical difference in biochemical indicators, including BUN, SCr and 24-hour urinary protein. On the 21st day, the level of SCr and the percentage of area of TGF-beta1 expression in the DLDD-treated group were lower than those of the enalapril-treated group (P<0.05). CONCLUSION: DLDD can reduce the excretion of urinary protein and the degree of interstitial fibrosis, and significantly inhibit the expressions of TGF-beta1, alpha-SMA, FN and LN. DLDD is superior to enalapril in protecting renal function after long-time application in rats.