益气活血药对阿霉素肾病大鼠凝血机制的影响

Effect of the chinese herbal remedy for invigorating Qi on blood coagulation of nephrotic syndrome rats induced by adriamycin

目的 探讨益气活血方药（简称肾舒）对阿霉素诱导的肾病综合征大鼠的治疗作用和对凝血机制的影响。方法 将Wistar雄性大鼠随机分为正常组、模型组（A组）、3个治疗组[肾舒组（B组）、肾舒加激素组（C组）、激素加双嘧达莫组（D组）]。按Bertani法制作肾病综合征模型。以24h尿蛋白定量、血清白蛋白、总蛋白、甘油三酯、胆固醇、尿素氮、血肌酐作为观察指标，观察肾舒对肾病综合征模型的治疗作用；以D-二聚体（D-Dimer）及血小板a-颗粒膜蛋白（GMP-140）为观察指标，观察肾舒对凝血机制的影响；取肾组织作光、电镜检查，观察肾脏组织结构的变化。结果B、C、D组与A组比较，24h尿蛋白定量、甘油三酯、胆固醇、D-Dimer及GMP-140含量下降，差异有统计学意义（P〈0．05，P〈0．01）；血浆白蛋白、总蛋白含量均升高（P〈0．01）。C组与B、D组比较，在升高血浆总蛋白、白蛋白，降低24h尿蛋白定量、血甘油三脂、胆固醇方面，差异有统计学意义（P〈0．05）。B组在降低D-Dimer及GMP-140方面，与C、D组比较差异有统计学意义（P〈0．01）。病理结果显示，B、C、D组见足突仅少部分融合，与A组比较，差异有统计学意义。结论益气活血治疗，能改善阿霉素诱导的肾病综合征大鼠全身和肾脏局部凝血机制，并与激素协同作用，提高对肾病综合征的疗效。

Objective To study the theraputic effects and the influence coagulation mechanism of the recipe of invigorating Qi （abbreviated as shenshu） on NS rats induced by Adriamycin. Method Male wistar rats were randomly divided into five groups： the normal group, the model group induced by Adriamycin,shenshu group treated with shenshu alone, shenshu and prednisone group treated with shenshu plus prednison,prednisone and persantine group treated with prednisone plus persantine. The model was established by means of Bertani＇ s method. The five groups were observed for three weeks, their 24h urine protein quantity, serum albumin, total protein, plasma creatinine, urea nitrogen, cholesterol, triglyceride,D-Dimer,GMP-140 and pathological changes of renal tissues were observed. Results Compared with the model group,each of treatment groups showed significant decreasing in 24 h urine protein quantity, cholesterol, triglyceride, D-Dimer, GMP-140, and increasing in serum albumin, and total protein （P〈0. 01 ）. Compared with the other treatment groups, shenshu and prednisone group got better theraputic effects in decreasing 24 h urine protein quantity, blood cholesterol, triglyceride, and increasing serum albumin and total protein （P〈0. 05 ,P〈0. 01 ）. D-Dimer and GMP-140 in the shenshu group demonstrated the most significant decrease（P（0.01） among treatment groups. Pathological studies showed obvious fusion of footprotrusion without remarkble thickening of glomercular basement membrance in the model group and the fusion of footprotrusion was few in the treatment groups. Conclusions The chinese herbal remedy of invigorating Qi to promote blood circulation could improve the general and local coagulation conditions of NS in rats induced by Adriamycin, furthermore it can promote theraputic effects when combined with prednisone.