苏茵解毒方对肾脏的保护作用初探  

Preliminary Study on Renal Protection Effect of SYJDP

作　　者：黄国顺 盛琴 王晓芳 雍晨 祝一叶 陈玮 姚敏[1] 束洋 舒亮辉 周恩超[1] HUANG Guoshun;SHENG Qin;WANG Xiaofang;YONG Chen;ZHU Yiye;CHEN Wei;YAO Min;SHU Yang;SHU Lianghui;ZHOU Enchao(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《中医药学报》2023年第1期67-72,共6页Acta Chinese Medicine and Pharmacology

基　　金：国家自然科学基金项目(81873270);江苏省“六大人才高峰”高层次人才项目(WSN-012);南京市科技发展计划项目(202002051);江苏省中医院“高峰学术”人才项目(y2021rc26);南京中医药大学中医学优势学科(三期)专项基金项目(ZYX03KF076)。

摘　　要：目的:初探苏茵解毒方(SYJDP)对肾脏的保护作用。方法:临床观察共纳入于江苏省中医院门诊就诊的74例慢性肾脏病(CKD)3~4期患者,时间从2020年6月—2021年1月。按随机分配法分成对照组和观察组,对照组采用常规治疗,观察组则在对照组基础上联合苏茵解毒颗粒治疗,疗程共12周。观察指标为总有效率、血肌酐(Scr)、血尿素氮(BUN)。利用高效液相色谱-串联色谱(HPLC-MS/MS)分析SYJDP的有效成分,再以阿霉素(1μg/mL)体外诱导NRK-52e损伤,建立肾损伤模型,在SYJDP安全干预质量浓度范围内通过加入不同质量浓度的SYJDP水提物(0.125、0.25、0.5、1 mg/mL)作用后,采用细胞增殖毒性检测法(CCK-8法)检测SYJDP对细胞的保护作用。结果:(1)两组的治疗均具有临床疗效,但观察组的临床疗效更为明显,且其总有效率(97.37%,37/38)高于对照组(77.78%,28/36)(P<0.05);(2)两组都可以改善患者肾损伤的标准生物标志物Scr、BUN水平,但是在治疗12周后观察组对Scr、BUN水平改善程度较对照组显著(P<0.05);(3)通过HPLC-MS/MS分析SYJDP(500μg/mL)中成分,绿原酸、阿魏酸、对羟基苯乙酮、槲皮素、芹菜素、芦荟大黄素、大黄酸的含量分别为0.016、0.087、11.500、0.071、0.015、0.014、0.568μg/mL;(4)与空白组比较,给予SYJDP干预后,阿霉素诱导的细胞活性明显降低可得到明显的改善(P<0.05)。结论:SYJDP对CKD患者的疗效较常规治疗好,能显著改善患者的血清Scr、BUN水平,同时对NRK-52e也具有明显的保护作用。Objective: To explore the protective effect of Suyin Jiedu Prescription(SYJDP) on kidneys. Methods: 74 patients with chronic kidney disease(CKD) of phase 3-4 were randomly assigned into the control group and the observation group. The control group was treated with conventional treatment;on which basis, the observation group was also treated with SYJDP. The course of treatment was 12 weeks. The observation indexes included total effective rate, serum creatinine(Scr) and blood urea nitrogen(BUN). The effective components of SYJDP were analyzed by using HPLC-MS/MS, and then NRK-52 e injury was induced by ADR(1 μg/mL) in vitro to establish kidney injury model, and cell proliferation toxicity assay(CCK-8 method) was used to detect the protective effect of water extract of SYJDP(0.125 mg/mL, 0.25 mg/mL, 0.5 mg/mL, 1 mg/mL) on cells. Results: The total effective rate was 97.37%(37/38) in the observation group, which was statistically higher than 77.78%(28/36) in the control group(P<0.05). The levels of Scr and BUN, the standard biomarkers of renal injury, were improved in both groups. After 12 weeks of treatment, the levels of Scr and BUN in the observation group were improved more significantly than those in the control group(P<0.05). Components of SYJDP(500 μg/mL) analyzed by HPLC-MS/MS included Chlorogenic acid(0.016 μg/mL), Ferulic acid(0.087 μg/mL), 4-Hydroxyacetophenone(11.500 μg/mL), Quercetin(0.071 μg/mL), Apigenin(0.015 μg/mL), Aloe emodin(0.014 μg/mL) and Emodin(0.568 μg/mL). Compared with that in the blank group, Adriamycin induced cell activity was significantly decreased after SYJDP intervention(P<0.05). Conclusion: SYJDP has a better therapeutic effect on patients with CKD than conventional treatment, it can significantly improve the levels of Scr and BUN, and has a significant protective effect on NRK-52 e.

关 键 词：苏茵解毒方 肾脏保护 临床试验 阿霉素 肾小管上皮细胞 

分 类 号：R256.5[医药卫生—中医内科学]