Effects of Huanshuai Recipe Oral Liquid (缓衰口服液) on Restructuring Glomerular Microvasculature and Expression of Vascular Endothelial Growth Factor in Subtotal Nephrectomized Rats

Objectives：To explore the effects and significance of Huanshuai Recipe Oral Liquid（缓衰口服液,HSR）,a formula with supplementing qi,nourishing blood and activating blood on restructuring glomerular microvasculature and expression of vascular endothelial growth factor（VEGF）in subtotal nephrectomized（SNX） rats.Methods：A total of 76 male Wistar rats were randomly divided into four groups：16 in the sham-operated group and fed with tap water 10 mL/kg per day; 20 in the model group were operated with 5/6 SNX and fed with tap water 10 mL/kg per day; 20 SNX rats in the HSR group were treated with HSR 10 mL/kg per day; 20 SNX rats in the losartan group were treated with losartan 40 mg/kg per day.Serum creatinine（SCr）and urinary protein excretion（Upro）were examined at the 2nd,4th,8th,and 12th weeks of the treatment,and the remnant kidneys were harvested.Changes in histological microstructure were evaluated using light microscopy,and the expression of VEGF was detected by using ELISA.Results：Upro,microvasculature injury and glomerulosclerosis were found to be alleviated in HSR and Losartan groups,respectively.The change of VEGF expression showed positive correlation with glomerular capillary area and peritubular capillary number（r=0.448,r=0.422,P〈0.01）, but negative correlation with that of SCr and Upro（r=-0.592,r=-0.481,P〈0.01）.Conclusions：HSR could regulate the VEGF expression,reduce the loss of microvasculature,which demonstrated similar renal protective effects to losartan in SNX rats.Examination of Chinese herbal medicine influence on VEGF signaling and restructuring renal microvasculature may elucidate the molecular mechanism of renal protection to a certain degree.

Effect of Huanshuai Recipe Oral Liquid (缓衰口服液) on Renal Dysfunction Progression in Patients with Atherosclerotic Renal Artery Stenosis

Objective： To investigate the effect of Huanshuai Recipe Oral Liquid （缓衰口服液, HSR） on retarding the progression of renal dysfunction in patients with atherosclerotic renal artery stenosis （ARAS）. Methods： A total of 52 ARAS patients with the Chinese medicine （CM） syndrome of qi deficiency and blood stasis, phlegm and dampness retention were recruited and randomly assigned into the treatment group （36 cases） and the control group （16 cases）. Both groups received a basic treatment （high-quality low-protein diet, blood pressure control, lipid-lowering, correcting the acidosis, etc.）. In addition, the treatment group received 20 mL HSR and the control group received placebo, 3 times a day for 6 months. Renal function （serum creatinine, blood urea nitrogen and uric acid） and blood lipids （cholesterol, triglycerides and low density lipoprotein） were examined monthly. The estimated glomerular filtration rate （eGFR） and CM syndrome score were compared between groups. Results： After treatment, compared with the control group, the serum creatinine level, uric acid level and CM syndrome score of the treatment group were significantly decreased （P〈0.05 or P〈0.01）, and the eGFR in the treatment group were significantly increased （P〈0.05）. Conclusion： HSR can effectively improve the renal function and clinical symptoms of ARAS patients.