糖肾安防治早期糖尿病肾病的实验研究

Preventive Treatment Effect of Tangshenan Decoction on the Early Stage of Diabetic Nephrology in Experimental Diabetic Nephrology Rats

目的:研究糖肾安对早期糖尿病肾病大鼠的治疗作用并探讨其可能机制。方法:采用单肾切除、高糖高脂饲料喂养、小剂量STZ(35mg/kg)腹腔注射"三联"方法建立糖尿病肾病大鼠模型。随机分为正常对照组、模型对照组、糖肾安组、福辛普利组、联合干预组,每组9只。用药6周后观察各组大鼠体重、肾重、血糖、24h尿蛋白定量、血浆Ⅳ型胶原蛋白(ColⅣ)水平的差异及肾脏病理改变、肾脏转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)mRNA的表达。结果:模型组大鼠体重、肾重、肾重/体重、血糖、24h尿蛋白定量及血浆ColⅣ水平、肾脏TGF-β1、VEGFmRNA表达与正常对照组比较,差异均有统计学意义(P<0.01);各用药组上述指标有所改善,与模型组比较差异均有统计学意义(P<0.05)。糖肾安组与福辛普利组比较上述指标差异均没有统计学意义。肾脏病理变化以模型组最为明显,系膜细胞重度增生,各用药组均有不同程度减轻。结论:糖肾安对早期糖尿病肾病具有良好的防治作用,其效果与福辛普利相当,中西医结合治疗能取得更好的效果。其肾保护作用可能是通过影响肾脏促纤维化生长因子TGF-β1、VEGF表达实现的。

Objective：To investigate the preventive treatment effect and its possible mechanism of Tangshenan decoction in experimental diabetic nephrology rats. Methods： Fifty male Sprague - Dawley rats were involved, forty of which were prepared by uni- lateral nephrectomy, high - glucose - high - fat diet and intraperitoneal injection of STZ 35 mg/kg. Then the survived thirty six dia- betic nephrology rats were randomly divided into STZ - induced diabetic nephrology （ model, n = 9 ）, Fosinopril - treated STZ - in- duced diabetic nephrology（ Fosinopril, n = 9）, Tangshenan decoction - treated STZ - induced diabetic nephrology（ Tangshenan decoc- tion, n = 9）, and joint intervention（ Fosinopril ＋ Tangshenan decoction, n = 9） groups. The rats were sacrificed at the 6th weekend. The body weight, kidney weight, blood sugar, 24 -hour urinary protein excretion, plasma collagen IV （Col IV ）concentration and the pathological change of nephridial tissue were examined. Reverse transcription polymerase chain reaction（ RT- PCR） was used to val- ue the expression of renal transforming growth factor - 131 （ TGF - 131 ） and vascular endothelial growth factor （VEGF） mRNA. Results： The difference of body weight, kidney weight, kidney/body weight, blood sugar, 24 - hour urinary protein excretion, plasma collagen IV （Col IV ）concentration, TGF - 131 and VEGF mRNA expression between model group and normal group were significant （P 〈 O. O1 ）. Those differences between the three treated -group and model group are of statistical significance （P 〈 0.05 ）. There is no statistical significance between Fosinopril group and Tangshenan decoction group in view of above differences. The renal pathologi- cal changes were observed in model group significantly, while in the three treated - group those changes were mild and there is no sig- nificant difference among them. Conclusion： The preventive treatment effect of Tangshenan decoction equivalented with Fosinopril and combinding Tangshenan decoction with Fosinopril can achieve more effective renoprotection. TGF - 131, VEGF may be involved in the mechanism of renoprotection.