化瘀通络中药不同配伍对糖尿病大鼠肾小球电荷屏障影响的比较  

Comparison of Different Combinations of Huayu Tongluo Decoction on Glomerular Charge Barrier in Diabetic Rats

作　　者：任莹莹 李俊瑶 冯文博 王研初 苏琳洪 郭卓 郭倩[1] REN Yingying;LI Junyao;FENG Wenbo(Hebei Medical University,Shijiazhuang,050017)

机构地区：[1]河北医科大学,石家庄050017

出　　处：《中国中西医结合肾病杂志》2024年第4期295-299,I0002,共6页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：河北省自然科学基金面上项目(No.H2021206179);河北省中医药管理局科研计划项目(No.2023130);河北医科大学大学生创新性实验计划项目(No.USIP2022244)。

摘　　要：目的:探讨化瘀通络中药不同配伍对糖尿病肾病蛋白尿作用差异的机制。方法:75只SD大鼠随机选取10只做为对照组,其余大鼠采用高糖高脂饲料联合腹腔注射链脲佐菌素建立糖尿病模型。将成模大鼠随机分为模型组15只、全方组15只、化瘀组15只、通络组15只。中药组给予化瘀通络中药颗粒剂灌胃,对照组及模型组给予等量饮用水灌胃,每日1次,共16周。16周末测体重、饮水量、进食量、尿量、随机血糖、24 h尿蛋白定量;取肾组织行光镜电镜病理学检查,检测肾组织乙酰肝素酶(HPA)、肾小球上皮细胞蛋白1(GLEPP1)、足盂蛋白(PCX)的表达及尿PCX含量。结果:与模型组比较,各治疗组24 h尿蛋白定量均减少(P<0.05);与全方组比较,化瘀组和通络组均增多(P<0.05)。与模型组相比,全方组、通络组HPA蛋白表达减少(P<0.05);全方组GLEPP1、PCX蛋白表达增多(P<0.05);各治疗组尿PCX含量均减少(P<0.05),且全方组、通络组尿PCX含量少于化瘀组(P<0.05)。与模型组相比,全方组、通络组HPA mRNA表达减少(P<0.05);全方组PCX mRNA表达增多(P<0.05)。结论:化瘀通络中药减少糖尿病肾病尿蛋白的作用机制可能与维持肾小球电荷屏障的完整性有关,化瘀通络中药全方及拆方均有不同程度的治疗作用,且全方优于化瘀、通络药物单独应用。Objective:To explore the mechanism of different combinations of huayu tongluo decoction on proteinuria in diabetic kidney disease.Methods:10 of 75 SD rats were randomly selected as control group,and the rest rats were fed with high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin to establish diabetic disease model.The diabetic rats were randomly divided into 15 rats in model group(M group),15 rats in huayu tongluo decoction group(Q group),15 rats in huayu decoction group(H group)and 15 rats in tongluo decoction group(T group).The Chinese medicine group was given huayu tongluo decoction by gavage,and the control group and model group were given the same amount of drinking water by gavage once a day for a total of 16 weeks.Body weight,water intake,food intake,urine volume,random blood glucose,and 24-hour urine total protein(24 h UTP)were measured at the end of 16 weeks;and heparanase(HPA)、Glomerular epithelial protein 1(GLEPP1)、podocalyxin(PCX)in kidney and PCX in urinary were detected.Results:Compared with M group,24 h UTP decreased in each treatment group(P<0.05);compared with Q group,it increased in both H group and T group(P<0.05).Compared with M group,the expression of HPA protein decreased in Q group and T group(P<0.05);the expressions of GLEPP1 and PCX protein increased in Q group(P<0.05);the urinary PCX content decreased in each treatment group(P<0.05),and the content in Q group and T group was lower than in H group(P<0.05).Compared with M group,the HPA mRNA expression decreased in Q group and T group(P<0.05);the expression of PCX mRNA increased in Q group(P<0.05).Conclusion:The mechanism of huayu tongluo decoction to reduce proteinuria in diabetic kidney disease may be related to maintaining the integrity of the glomerular charge barrier.Different combinations of huayu tongluo decoction have different degrees of therapeutic effect,and the effect of the whole decoction is better than huayu decoction and tongluo decoction used alone.

关 键 词：化瘀通络 糖尿病肾病 电荷屏障 尿蛋白 

分 类 号：R692.6[医药卫生—泌尿科学]