灸药结合对慢性肾功能衰竭大鼠肾纤维化的影响  

Effect of Moxibustion Combined with Medicine on Chronic Renal Failure Rats with Renal Fibrosis

作　　者：孙玉霞[1] 黄迪[1] 马家怡 李林[1] 李屹[1] 

机构地区：[1]上海中医药大学附属曙光医院肾内科,上海200021

出　　处：《上海中医药大学学报》2015年第6期64-69,共6页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金项目(81102566;81302923);上海市中医药事业发展三年行动计划项目(ZYSNXD-CC-ZDYJ046);上海市教委预算内科研项目(2012JW40)

摘　　要：目的:观察灸法结合中药方(健脾清化方)对慢性肾衰竭大鼠的干预疗效,从炎症角度探讨其对肾脏纤维化影响的作用机制。方法:采用Platt法切除大鼠5/6肾组织+阿霉素注射造模,将造模大鼠随机分为模型组、缬沙坦对照组、健脾清化方组、灸法组、灸药结合组,给予高脂饮食喂养。缬沙坦对照组和健脾清化方组分别予缬沙坦、健脾清化方灌胃;灸法组隔日温和灸大鼠肾俞、足三里;灸药结合组予健脾清化方灌胃,隔日温和灸脾俞、足三里;假手术组、模型组以蒸馏水替代灌胃,隔日作与灸法组相同的固定,干预8周。检测血肌酐、尿素氮、IL-12、TNF-α及24 h尿蛋白定量,肾组织IL-12、TNF-α、TGF-β、Ⅰ型胶原、Ⅳ型胶原,观察大鼠肾组织病理变化。结果:模型组大鼠血肌酐、尿素氮、24 h尿蛋白定量较假手术组显著升高(P<0.01);健脾清化方组血肌酐较模型组降低(P<0.05);灸药结合组大鼠的血肌酐、尿素氮、尿蛋白均显著降低(P<0.05,P<0.01),其疗效优于缬沙坦对照组、健脾清化方组和灸法组,且血清IL-12、TNF-α水平(P<0.01)和肾组织中TNF-α、TGF-β、Ⅰ型胶原、Ⅳ型胶原的阳性表达(P<0.01)均明显下降。结论:灸药结合可以通过下调炎症因子、抑制机体炎症状态,从而改善肾功能,延缓慢性肾功能衰竭肾纤维化的进展。Objective： To observe the effect of moxibustion combined with medicine（ ＂Jianpi Qinghua Decoction＂） on CRF rats and discuss the function mechanism on renal fibrosis in perspective of inflammation. Methods： The rats model was set up by the resection of 5 /6 renal tissue with the method of Platt,and the rats were randomly divided into model group,control group,＂Jianpi Qinghua Decoction＂group,moxibustion group and moxibustion combined with medicine group,and loading with high fat diet. The rats in control group and ＂Jianpi Qinghua Decoction＂group were administered valsantan and＂Jianpi Qinghua Decoction＂repectively; the rats in moxibustion group was treated with moxibustion on renal acupoint and Zusanli once every other day; the rats in moxibustion combined with medicine group were administered ＂Jianpi Qinghua Decoction＂combined with moxibustion on renal acupoint and Zusanli once every other day; the rats in sham operation group and model group were treated distilled water with intragastric asministration,and treated with moxibustion on renal acupoint and Zusanli once every other day,8 week for each group. The serum creatinine,Urea Nitrogen,IL-12,TNF-α,24 h urine protein,renal tissue IL-12,TNF-α,TGF-β,type I collagen and type Ⅳ collagen were tested,the pathological changes of renal tissue were observed. Results： Compared with sham operation group,the serum creatinine,urea nitrogen,and 24 h urine protein increased obviously in model group（ P 〈0. 01）; compared with model group,the serum creatinine decreased in ＂Jianpi Qinghua Decoction ＂ group（ P〈 0. 05）; the serum creatinine,urea nitrogen and urine protein decreased obviously in moxibustion combined with medicine group（ P〈 0. 05,P 〈0. 01）,and the efficacy was better than that of control group,＂Jianpi Qinghua Decoction＂group and moxibustion group,and the levels of IL-12 and TNF-αin serum（ P 〈0. 01）,the expression of TNF-α,TGF-β,type I collagen and type Ⅳ collagen in renal tissue（ P〈 0. 01）

关 键 词：慢性肾功能衰竭 灸法 健脾清化方 炎症 肾纤维化 阿霉素 

分 类 号：R285.5[医药卫生—中药学]