大黄延缓慢性肾衰的临床及实验研究  

Clinical and ExPerimental Studies of Rheum on Preventing Progression of Chronic Renal Failure

作　　者：黎磊石[1] 刘志红[1] 张景红[1] 姚建[1] 杨俊伟[1] 郑丰[1] 

机构地区：[1]南京金陵医院,南京210002

出　　处：《中西医结合杂志》1991年第7期392-396,共5页

摘　　要：通过前瞻性临床观察及实验研究证实大黄提取物对延缓慢性肾衰有确切疗效。应用大黄治疗后6～22个月。1/Scr 直线斜率值为—6.06×10^(-4)(西药组为—31.86×10^(-4)),进展速度明显延缓。大鼠整体动物实验,离体肾灌注、肾小管及系膜细胞培养等实验说明大黄能延缓肾衰进展,其机理包括:(1)缓解"残余肾"高代谢状态;(2)影响氮质代谢;(3)影响系膜细胞的增殖及功能:(4)对脂质代谢的良性效应。Rheum,a well known herb unique in its carthartic effect is now introduced to prevent progres- sion of uremia.A clinical prospective trial was conducted to evaluate itseffect in comparison with the Captopril.30 cases with initial Scr level of 344.8±114.0μmol/L were allocated randomly to 3 groups.Rheum E treated group,Captopril treated group and Rheum E+Captopril group.The long term(6～22mos)follow-up results showed that the progression rate of renal failure,calculated by regression analysis of 1/Scr vs time,was found to be retarded after treatment,being more marked in both Rheum E and Rheum E+Captopril group.Uremic symptoms improved after the treatment with serum albumin level increased.To explore the mechanism of therapeutic effects of Rheum on CRF,a series of experimental studies were performed.Rheum can suppress the proliferation of glomerular mesangial cells in culture.In 5/6 nephrectomized rats,the O_2,consumption of remnant kidney was obviously decreased by feeding the animal Rheum E and the hypermetabolic state was ameliorated as well.A group of 5/6 nephrectomized rats were fed with Rheum E for 28 wks.It was found that the level of azotemia of this treated group was lessened remarkably as compared with the controls.The serum albumin and transferrin contents of the treated animals were much higher than the controls while the blood cholesteral and triglycerides decreased unekpectedly.In conclusion,both the in vivo and in vitro studies have proved the effectiveness of Rheum in preventing the progression of CRF.

关 键 词：肾衰竭 大黄 离体肾灌注 

分 类 号：R692.5[医药卫生—泌尿科学]