滋肾解毒活血中药对狼疮性肾炎系膜增殖的影响

Effect of Kidney-nourishing,Toxicity-removing and Blood-activating Herbal Medicines on Parameters Associated with Mesenteric Proliferation in Lupus Nephritis

【目的】探讨滋肾解毒活血中药四草汤煎剂(SCT)(由白花蛇舌草、丹参、半枝莲、旱莲草、紫草根、益母草、桃仁、川芎、赤芍、全蝎组成)对狼疮性肾炎(LN)患者系膜增殖及产生纤维连接蛋白(FN)、Bcl-2基因表达等的影响。【方法】选择LN患者60例随机分为治疗组与对照组各30例。2组均采用激素标准疗程加环磷酞胺冲击治疗,治疗组在此基础上加服滋肾解毒活血中药四草汤煎剂治疗。观察治疗前后Bcl-2抗原及Fas抗原的表达、血清FN、血清和尿Ⅳ胶原(CⅣ)以及血瘀证计分情况等指标的变化。【结果】SCT煎剂可使外周血T淋巴细胞亚群CD4+和CD8+上的Fas、Bcl-2表达减弱。肾组织病理切片免疫组化显示治疗组系膜细胞增殖程度减轻,Bcl-2阳性个数、Bcl-2蛋白值降低(P<0.01);血清FN、血清和尿CⅣ水平均较对照组低(P<0.01)。治疗后治疗组血瘀证计分低于对照组(P<0.01)。【结论】滋肾解毒活血中药SCT煎剂对LN患者系膜增殖及产生FN、CⅣ有明显的抑制作用,并通过影响Fas、Bcl-2抗原的表达等途径来防止肾小球硬化的发生、发展,从而治疗狼疮性肾炎。

[ Objective] To observe the effect of S/caotang Decoction which is mainly composed of kidney-nourishing, toxicity-removing and blood-activating herbal medicines on parameters associated with mesenteric proliferation, fibronectin （FN）, and Bcl-2 gene expression in lupus nephritis （LN）. [ Methods ] Sixty LN patients were equally randomized into two groups . The two groups received treatment with hormones and cyclophosphamide , and group A received S/caotang Decoction additionally. The changes of Bcl-2 and Fas expression in CD4^＋ and CD8^＋ of T lymphocyte subtypes, serum fibronectin （FN）, serum and urine collagen IV （C IV） as well as score of blood stasis were observed. [Results] S/caotang Decoction reduced the expression of Bcl-2 and Fas expression in CD4^＋ and CD8^＋, relieved the proliferation of mesenteric cells, and decreased Bcl-2 positive rate, serum FN level, serum and urine CIV levels and score of blood stasis （P 〈0.01 as compared with those in group B）. [Conclusion] Sicaotang Decoction has an inhibitory effect on the proliferation of mesenteric cells and the formation of FN and CIV in the mesenteric cells, and its therapeutic mechanism w, ay be related to the regulation of Bcl-2 and Fas expression, thus prevents the development of glomerular sclerosis.