益气通络汤对Heymann肾炎大鼠蛋白尿及炎症因子的影响  

Effect of Yiqi Tongluo Decoction on proteinuria and inflammatory factors in Heymann rats with nephritis

作　　者：甘露 张春戬 李莹 李娜 尚婧 董壮[2] 郑佳新 Gan Lu;Zhang Chunjian;Li Ying;Li Na;Shang Jing;Dong Zhuang;Zheng Jiaxin(Heilongjiang Academy of Traditional Chinese Medicine,Harbin 150036,China;Department of Nephrology,The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,China)

机构地区：[1]黑龙江省中医药科学院,哈尔滨150036 [2]黑龙江中医药大学附属第二医院肾内科,哈尔滨150001

出　　处：《保健医学研究与实践》2023年第12期16-22,共7页Health Medicine Research and Practice

基　　金：黑龙江省重点研发计划项目(NO.2022ZX06C16);黑龙江省中医药科研项目(ZHY2020-049)。

摘　　要：目的采用益气通络汤治疗被动型Heymann肾炎大鼠模型,观察其对蛋白尿的作用和对炎症因子[白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α)]的影响,初步探讨益气通络汤治疗膜性肾病(MN)的作用机制。方法将大鼠随机分为空白对照组,模型组,阳性药对照组,低、中、高剂量益气通络汤组。给药21 d后检测大鼠24 h尿蛋白、血清白蛋白(ALB)、血肌酐(Scr)及IL-6、TNF-α水平;通过PAS、Masson染色观察肾脏组织形态;采用Western blot检测法测定相关蛋白的表达。结果与空白对照组相比,模型组大鼠肾脏产生严重病理损伤:肾小球系膜及基底膜增生明显,肾小球硬化、结缔组织增生明显;p-IKB/IKB、p-p65/p65蛋白表达上调提高,24 h尿蛋白、Scr、IL-6与TNF-α水平上升(P<0.05),ALB降低(P<0.05)。与模型组相比,阳性药对照组及低、中、高剂量益气通络汤组大鼠的p-IKB/IKB、p-p65/p65表达均有不同程度的下调(P<0.05);大鼠尿蛋白定量、Scr、TNF-α、IL-6水平有明显降低(P<0.05),ALB有明显升高(P<0.05);肾小球硬化及结缔组织增生程度减轻。结论益气通络汤能有效降低Heymann肾炎模型大鼠尿蛋白及Scr,升高ALB,通过下调p-IKB/IKB、p-p65/p65的表达,降低大鼠IL-6、TNF-α水平来改善肾脏组织炎症反应,保护肾脏。Objective This study aimed to observe the effect of Yiqi Tongluo Decoction on proteinuria and inflammatory factors[interleukin-6(IL-6)and tumor necrosis factor-alpha(TNF-α)]in a passive Heymann nephritis rat model and to preliminarily explore its mechanism in treating membranous nephropathy(MN).Methods Rats were randomly allocated to a blank control group,a model group,a positive drug control group,and low,medium,and high dose groups of Yiqi Tongluo Decoction.After 21 days of administration,24-hour urinary protein,serum albumin(ALB),blood creatinine(Scr),IL-6,and TNF-αlevels were measured in rats.Kidney tissue morphology was observed by PAS and Masson staining.The expression of relevant proteins was determined by Western blot.Results Compared with the blank control group,the model group rats showed severe pathological damage in the kidneys.Specifically,we found significant proliferation of glomerular mesangium and basement membrane,glomerulosclerosis,and connective tissue proliferation;we also found significant increase in the expression of p-IKB/IKB and p-p65/p65 proteins,and 24-hour urinary protein,and Scr,IL-6,and TNF-αlevels(P<0.05).Meanwhile,ALB was significantly decreased(P<0.05).Compared with the model group,the rats in the positive drug control group and low,medium,and high dose groups of Yiqi Tongluo Decoction showed varying degrees of downregulation in the expression of p-IKB/IKB and p-p65/p65(P<0.05).A significant decrease was observed in urinary protein quantification,Scr,TNF-α,and IL-6 levels(P<0.05).A significant increase was observed in ALB(P<0.05).The degree of glomerulosclerosis and connective tissue proliferation was reduced.Conclusion Yiqi Tongluo Decoction can effectively reduce proteinuria and Scr in the Heymann nephritis rat model,increase ALB,and improve renal tissue inflammation by downregulating the expression of p-IKB/IKB and p-p65/p65 and decreasing IL-6 and TNF-αlevels in rats,thus protecting the kidneys.

关 键 词：益气通络汤 膜性肾病 蛋白尿 白细胞介素6 肿瘤坏死因子Α 

分 类 号：R285.5[医药卫生—中药学] R692[医药卫生—中医学]