益气养阴活血方对糖尿病肾病大鼠肾功能及足细胞的影响

Effects of Yiqi Yangyin Huoxue Recipe on Renal Function and Kidney Podocyte in Diabetic Nephropathy Rat Model

[目的]观察益气养阴活血方(Yiqi Yangyin Huoxue Recipe)对糖尿病肾病(diabetic nephropathy,DN)大鼠肾功能及足细胞的影响。[方法]将32只雄性SD大鼠随机分为正常组和DN造模组,DN造模组采用腹腔注射链脲佐菌素(strepotozotocin,STZ)方法制备DN大鼠模型。将造模成功的24只大鼠均分为模型组、中药组和厄贝沙坦组。中药组以益气养阴活血方水煎液10mL/(kg·d)灌胃,厄贝沙坦组以厄贝沙坦混悬液10mL/(kg·d)灌胃,正常组和模型组予以等体积的蒸馏水灌胃。8周后处死大鼠,并分别检测肾脏指数(kidney index,KI)、空腹血糖(fasting blood-glucose,FBG)、血清肌酐(serum creatinine,SCr)、血尿素氮(blood urea nitrogen,BUN)水平;电镜观察肾小球足细胞超微结构变化。[结果]与正常组比较,模型组KI明显增高(P<0.01);与模型组比较,中药组和厄贝沙坦组KI降低(P<0.01)。与模型组比较,中药组和厄贝沙坦组大鼠FBG、SCr和BUN水平显著降低(P<0.01,P<0.05)。与正常组比较,电镜下模型组肾小球基底膜明显增厚,基底膜内有少量电子致密物沉积,足细胞数量减少,足突广泛融合甚至消失,足突裂孔数减少,细胞质中线粒体减少、空泡变性、脂滴沉积;中药组基底膜与正常组相近,足细胞损伤较模型组和厄贝沙坦组轻,形态上总体规则,仅有足突部分融合;厄贝沙坦组基底膜部分增厚,足突部分融合甚至消失。[结论]益气养阴活血方能有效降低DN大鼠FBG水平,改善DN大鼠肾功能,并且减轻足细胞损伤程度从而减缓肾脏病变进程,提示其对肾脏具有保护作用。

[Objective] To investigate the effect of Yiqi Yangyin Huoxue Recipe on renal function and kidney podocyte in diabetic nephropathy(DN) rat model.[Methods] Thirty two Sprague-Dawleg(SD) rats were randomly divided into normal group and diabetic nephropathy model group.Diabetic nephropathy model rats were intraperitoneal injected with strepotozotocin(STZ).All rats successfully modeled and were assigned into model group,Chinese herb group and irbesartan group.Rats in Chinese herb group were intragastric administrated with Yiqi Yangyin Huoxue Recipe water decoction 10 mL/(kg·d),rats in irbesartan group were intragastric administrated with irbesartan suspension 10 mL/(kg·d),and rats in normal group and model group were intragastric administrated with distilled water of the same volume.All rats were killed after 8 weeks of intervention,the kidney index(KI),fasting bloodglucose(FBG),serum creatinine(SCr) and blood urea nitrogen(BUN) were examined,and the podocyte ultrastructure was observed by electron microscope.[Results]Compared with normal group,KI of model group increased obviously(P <0.01);compared with model group,KI of Chinese herb group and irbesartan group decreased(P<0.01).Compared with model group,levels of FBG,SCr and BUN decreased obviously in Chinese herb group and irbesartan group(P<0.01,P<0.05).Compared with normal group,model group’s glomerular basement membrane was thickened obviously and had the electron dense deposited in.The podocytes decreased and the foot processes were fused or even disappeared.Mitochondria were significantly reduced and vacuolar degeneration and lipid droplets were found in the cytoplasm of podocytes.Chinese herb group’s glomerular basement membrane was close to normal group.Injury of podocytes in Chinese herb group was less than that in model group and irbesartan group,and podocytes’s form is generally regular with partly podocytic foot processes fused.The irbesartan group’s basement membrane thickened partly and part of podocytic processes were fused or disappeared.[Conclusion] The Yiqi Yangyin Huoxue Recipe can decrease the level of FBG efficiently and has kidney protection effect which is contributed by alleviating the lesions of podocytes.