麻黄附子细辛汤合苓桂术甘汤治疗糖尿病肾病大鼠的实验研究  

Experimental Study on Treating Rats’Diabetic Nephropathy with Mahuang Fuzi Xixin Decoction and Linggui Zhugan Decoction

作　　者：高俊丽 刘国香[1] 朱赟洁 戚怡沁 徐艳秋[2] 王巍巍[1] GAO Junli;Liu Guoxiang;Zhu Yunjie(Department of Kidney,the 455th Hospital of the Chinese People's Liberation Army,Shanghai 201203,China)

机构地区：[1]中国人民解放军第四五五医院肾脏科,上海201203 [2]上海中医药大学附属岳阳中西医结合医院肾脏科,上海201203

出　　处：《四川中医》2020年第10期62-67,共6页Journal of Sichuan of Traditional Chinese Medicine

基　　金：上海市高级中西医结合人才培养计划(编号:ZY3-RCPY-4-2039);南京军区医学科技创新项目重大课题(编号:14ZX05)。

摘　　要：目的:探讨麻黄附子细辛汤合苓桂术甘汤加菟丝子水蛭对糖尿病肾病(DN)大鼠的保护作用及可能的机制。方法:健康雄性SD大鼠随机分为正常对照组(N组)、模型组(M组)及中药治疗组(Z组),M组及Z组建立DN大鼠模型。Z组予麻黄附子细辛汤合苓桂术甘汤加菟丝子水蛭灌胃治疗4周。实验结束时留取血尿及肾脏标本,检测血尿生化指标,HE、Masson染色观察肾脏病理特点及肾小球面积,WT-1染色观察肾小球中足细胞的密度。结果:实验结束时,与N组比较,M组及Z组大鼠体质量显著降低,24h尿量、UACR及BUN水平显著升高(P<0.01)、24h-Upro水平升高(P<0.05);M组TC及TG的水平均升高(P<0.05),Z组TC及TG的水平均升高(P>0.05)。与M组比较,Z组大鼠体重升高,24h-Upro、UACR、BUN及TC水平降低(P<0.05);血TG水平降低(P>0.05),24h尿量增加(P>0.05)。HE及Masson染色提示:Z组大鼠肾小球基底膜增厚、系膜基质增生及血管内膜增厚均减轻,肾小管空泡样变性、间质纤维化及炎性细胞浸润程度显著降低。与N组比较,M组及Z组大鼠肾脏指数显著升高,肾小球截面积显著增加,足细胞的密度显著降低(P<0.01);与M组比较,Z组大鼠的肾脏指数降低,肾小球截面积缩小,足细胞密度升高(P<0.05)。结论:麻黄附子细辛汤合苓桂术甘汤加菟丝子水蛭可有效延缓DN大鼠的病程进展,可能与其改善DN大鼠的血脂及尿蛋白水平,保护足细胞形态及功能,从而减轻肾脏病理损伤程度密切相关。Objective:To explore the protective effect and possible mechanism of Mahuang Fuzi Xixin Decoction,Linggui Zhugan Decoction and Dodder Hydrazone for rats with diabetic nephropathy.Methods:Healthy male Sprague-Dawley rats were randomly divided into normal controlled group(N group),model group(M group)and Chinese medicine treatment group(Z group).The M group and the Z group were established to establish DN rat model.The Z group was treated with Mahuang Fuzi Xixin Decoction,Linggui Zhugan Decoction and Cuscuta sinensis for 4 weeks.At the end of the experiment,hematuria and kidney specimens were taken,blood and urine biochemical indexes were detected,renal pathological features and glomerular area were observed by HE and Masson staining,and the density of podocytes in glomeruli was observed by WT-1 staining.Results:At the end of the experiment,compared with the N group,the body weight of the M group was significantly decreased,the 24h urine volume,urine ACR and BUN levels were significantly increased(P<0.01),24hUpro level was increased(P<0.05).The levels of TC and TG increased(P<0.05),and the levels of TC and TG in the group Z increased(P>0.05).Compared with the group M,rats in the group Z gained weight,24hUpro,urinary ACR,BUN and TC levels decreased(P<0.05),blood TG levels decreased(P>0.05),and 24-hour urine volume increased(P>0.05).HE and Masson staining showed that glomerular basement membrane thickening,mesangial matrix hyperplasia and intimal thickening were all attenuated in the Z group,and the degree of tubular vacuolar degeneration,interstitial fibrosis and inflammatory cell infiltration were significantly reduced.Compared with the group N,the kidney index of rats in the group M and the group Z increased significantly,the glomerular cross-sectional area increased significantly,and the density of podocytes decreased significantly(P<0.01).Compared with the group M,the kidney index of the group Z rats decreased,the glomerular cross-sectional area decreased,and the podocyte density increased(P<0.05).Conclusion:Mah

关 键 词：糖尿病肾病 麻黄附子细辛汤 苓桂术甘汤 菟丝子 水蛭 WT-1 

分 类 号：R285.5[医药卫生—中药学]