大黄牡丹汤对脂多糖诱导脓毒症大鼠早期急性肾损伤的保护作用  

Protective Effect of Dahuang Mudan Decoction against LPS-induced Early Acute Renal Injury in Rats with Sepsis

作　　者：彭晓辉 叶小卫[3] PENG Xiaohui;YE Xiaowei(Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Department of Geriatrics,Guangzhou First People′s Hospital,Guangzhou 510180,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学,广州510405 [2]广州市第一人民医院老年病科,广州510180 [3]广州中医药大学第一附属医院,广州510405

出　　处：《世界中医药》2024年第24期3802-3808,共7页World Chinese Medicine

基　　金：国家重点研发计划重点专项(2021YFC2009400)——主动健康和老龄化科技应对;广州市科技计划项目(202102010017);广州市医学重点学科项目(老年医学科,2021—2023年,ZDXK202103)。

摘　　要：目的:研究大黄牡丹汤对脓毒症诱导早期急性肾损伤模型大鼠肾功能的影响并初步探讨其机制。方法:通过脂多糖腹腔内注射建立脓毒症诱导急性肾损伤模型大鼠,并用不同剂量的大黄牡丹汤灌胃。通过检测各组大鼠造模给药后血清C反应蛋白(CRP)、白细胞介素6(IL-6)、肾脏肿瘤坏死因子α(TNF-α)、IL-6,尿液中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、血清肌酐(Cr)、胱抑素C(Cys C)和肾组织病理学变化,评估大黄牡丹汤对脓毒症诱导的早期急性肾损伤模型大鼠肾功能的保护作用。结果:脂多糖造模后,大鼠血清IL-6、CRP及肾脏组织TNF-α、IL-6炎症指标上升,模型组指标值高于其他组(P<0.05)。模型组尿液NGAL上升幅度最为明显;同时模型组大鼠血清CysC、Cr值最高(P<0.05)。使用大黄牡丹汤冻干粉干预后,干预A组[高剂量组,14 g/(kg·d)]及干预B组[标准剂量组,7 g/(kg·d)]炎症指标不同程度改善。干预A组肾功能评价指标(血清CysC、Cr)改善最明显(P<0.05);干预A组尿液NGAL升高幅度最低(P<0.05)。但4组大鼠肾脏组织病理学检测未提示显著差异。结论:大黄牡丹汤可以保护脓毒症诱导早期急性肾损伤大鼠肾功能,其机制可能与抑制早期过度炎症反应相关。Objective:To investigate the effects of Dahuang Mudan Decoction on renal function in a sepsis-induced early acute renal injury model in rats and to preliminarily explore its mechanisms.Methods:A sepsis-induced acute renal injury model was established in rats by intraperitoneal injection of lipopolysaccharide(LPS),followed by gavage with different doses of Dahuang Mudan Decoction.After modeling and drug administration,serum C-reactive protein(CRP),interleukin-6(IL-6),kidney tumor necrosis factorα(TNF-α),IL-6,urine neutrophil gelatinase-associated lipocalin(NGAL),serum creatinine(Cr),cystatin C(Cys C),and renal tissue pathological changes were measured to evaluate the protective effects of Dahuang Mudan Decoction on renal function in sepsis-induced early acute renal injury in rats.Results:After LPS-induced modeling,serum IL-6,CRP,and kidney tissue TNF-αand IL-6 inflammation markers were elevated,with values in the model group significantly higher than in the other groups(P<0.05).The model group showed the most significant increase in urine NGAL,and the highest serum Cys C and Cr levels(P<0.05).After intervention with Dahuang Mudan Decoction lyophilized powder,both the high-dose group[Group A,14 g/(kg·d)]and the standard-dose group[Group B,7 g/(kg·d)]showed varying degrees of improvement in inflammatory markers.The high-dose group(Group A)exhibited the most significant improvement in renal function markers(serum Cys C and Cr)(P<0.05)and the smallest increase in urine NGAL(P<0.05).However,there were no significant differences in renal tissue pathology among the four groups.Conclusion:Dahuang Mudan Decoction can protect renal function in rats with sepsis-induced early acute renal injury.Its mechanism may be related to the inhibition of early excessive inflammatory responses.

关 键 词：大黄牡丹汤 脂多糖 脓毒症 急性肾损伤 大鼠模型 炎症指标 肾脏组织病理学 炎症反应 

分 类 号：R242[医药卫生—中医临床基础]