基于“浊毒理论”探讨加味四君子汤对肾病综合征的治疗  

To explore the treatment of nephrotic syndrome with Modified Sijunzi Decoction based on"turbid poison theory"

作　　者：陈虹[1] 陈敏[1] 郑京[1] CHEN Hong;CHEN Min;ZHENG Jing(General Practice Department,the Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine,Fujian,Fuzhou 350004,China)

机构地区：[1]福建中医药大学附属人民医院全科医学科,福建福州350004

出　　处：《中国医药科学》2021年第23期31-34,共4页China Medicine And Pharmacy

基　　金：福建省中医药科技项目(2017FJZYJC203);福建省卫健委创新课题(2017-CX-41)。

摘　　要：目的从“浊毒理论”探讨加味四君子汤对肾病综合征的治疗。方法40只SPF级大鼠以随机数字表法分为正常组8只、造模组32只。造模组大鼠造模成功后再次随机分为模型组8只、激素组8只、中药组8只、联合组8只。正常组和模型组大鼠以生理盐水灌胃,剂量为20 ml/(kg·d),激素组大鼠以泼尼松灌胃,剂量为10 mg/(kg·d);中药组大鼠以中药灌胃,剂量为20 ml/(kg·d);联合组以中药和泼尼松联合灌胃,剂量分别为20 ml/(kg·d)和10mg/(kg·d)。在灌胃第14天、第28天取血备用。用双缩脲比色法测定各组大鼠24 h尿总蛋白定量;电子显微镜下观察各组大鼠肾脏的病理改变。结果与模型组比较,灌胃第14天、第28天激素组、中药组、联合组24 h尿蛋白均降低(P<0.05)。灌胃28 d与灌胃14 d比较,模型组24 h尿蛋白升高,激素组、中药组、联合组均降低(P<0.05)。模型组大鼠肾脏组织电镜下表现为足突增宽、足突部分融合或弥漫性融合,足细胞肿胀;而激素组、中药组、联合组电镜下肾小球的病变明显减轻,只见足突部分融合。结论加味四君子汤可有效减少蛋白尿,减轻肾小球病变。Objective To explore the treatment of nephrotic syndrome with Modified Sijunzi Sijunzi Decoction from"turbid poison theory".Methods A total of 40 SPF rats were divided into normal group(n=8)and model group(n=32)by random number table.After successful modeling,the rats in the modeling group were again randomly divided into model group(n=8),hormone group(n=8),TCM group(n=8)and combined group(n=8).Normal group and model group were given normal saline intragastric administration at a dose of 20 ml/(kg·d),while hormone group was given prednisone intragastric administration at a dose of 10 mg/(kg·d).Chinese medicine group was given Chinese medicine intragastric administration at a dose of 20 ml/(kg·d).The combined group was given Chinese medicine and prednisone combined gavage at 20 ml/(kg·d)and 10 mg/(kg·d),respectively.Blood was collected on the 14th and 28th day of intragastric administration.Diuret colorimetric method was used to determine the 24 h urine total protein of rats in each group.The pathological changes of kidney were observed under electron microscope.Results Compared with model group,24 h urinary protein was decreased in hormone group,Chinese medicine group and combined group at 14 d and 28 d(P<0.05).Compared with 14 d after 28 d of gavage,24 h urine protein was increased in model group,and decreased in hormone group,TCM group and combination group(P<0.05).Under electron microscope,the kidney tissues of the model group showed widened foot processes,partial fusion or diffuse fusion of foot processes,and swelling of podoccytes.However,the pathological changes of glomerulus in hormone group,Chinese medicine group and combined group were significantly reduced and only partial fusion of foot process was observed.Conclusion Modified Sijunzi Decoction can effectively reduce proteinuria and glomerular lesions.

关 键 词：浊毒理论 加味四君子汤 肾病综合征 蛋白尿 

分 类 号：R285.5[医药卫生—中药学]