Clinical Nursing Intervention of Moxibustion on Abdominal Distension Symptoms in Heart Failure (Heart and Kidney Yang Deficiency and Blood Stasis Blocking Collaterals Syndrome)

Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.

Transcriptomic and metabolomic analysis of the effects of Zhenwu decoction on kidney yang deficiency pattern in chronic kidney disease

Objective:To explore the kidney yang deficiency pattern(KYDP)in a chronic kidney disease(CKD)rat model and the mechanisms underlying the effects of Zhenwu decoction(ZWD)by conducting tran-scriptomic and metabolomic analyses.Methods:Adriamycin(ADR)combined with hydrocortisone(HC)was used to induce CKD with KYDP in rats.ADR was injected into the tail vein twice.HC was injected intramuscularly for 8 weeks.ZWD was administered by gavage for 8 weeks.The general condition was observed,24-h urine protein was detected,serum corticosterone,triiodothyronine,thyroxine,TSH,testosterone,cAMP,and cGMP levels were determined,and pathological analysis was conducted.Transcriptomic and metabolomic analyses were conducted to screen differentially expressed genes(DEGs),differentially expressed metabolites(DEMs),and differentially expressed pathways(DEPs).The core DEMs and DEGs were input to Metab-oanalyst 5.0 to identify the pathways affected by ZWD.Results:In the HC group,KYDP symptoms were observed.Compared with control group,the levels of 24-h urine protein,TSH,and cGMP significantly increased(all P<0.01),and corticosterone,triiodothyronine,thyroxine,and cAMP significantly decreased(all P<0.01)in the HC group.After ZWD intervention,the levels of above-mentioned indicators could be reversed to some extent.Pathological analysis in the HC group revealed kidney lesions.DEGs in the ZWD group were mainly associated with pathways such as nucleotide synthesis and endocrine pathways.In the ZWD group,differences in biosynthesis of unsat-urated fatty acids and butanoate metabolism were observed.The following pathways were significantly affected by ZWD:arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.Conclusion:ZWD can be used to treat KYDP in CKD through regulating arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.

Clinical Research of Zhenwu Decoction Combined with Tingli Dazao Xiefei Decoction in the Treatment of Chronic Heart Failure with Edema Syndrome due to Yang Deficiency

[Objectives]The paper was to investigate the clinical effects of Zhenwu Decoction combined with Tingli Dazao Xiefei Decoction in the treatment of chronic heart failure with edema syndrome due to yang deficiency.[Methods]Eighty patients with chronic heart failure were randomly divided into 2 groups(control group and treatment group),with 40 cases in each group.The patients in the control group were treated with conventional western medicine for 14 d,and the patients in the treatment group were treated with Zhenwu Decoction and Tingli Dazhao Xiefeng Decoction on the basis of the control group for 14 d.The curative effect of traditional Chinese medicine(TCM)syndrome score,left ventricular ejection fraction(LVEF),plasma N-terminal brain natruretic peptide precursor(NT-proBNP)and New York Heart Association(NYHA)functional class were compared between the two groups before and after treatment.Minnesota living with heart failure questionnaire in the principle of Chinese civilization and traditional medicine characteristics(C-MLHF)at admission and 1 month after discharge were compared between the two groups.[Results]After treatment,the total effective rate of TCM syndrome score in the treatment group was 82.50%,and that in the control group was 67.50%.The curative effect of TCM syndrome score in the treatment group was better than that in the control group(P<0.05).After treatment the LVEF in both groups was increased compared with that before treatment,and the NT-proBNP level was decreased compared with that before treatment(P<0.05),and those in the treatment group were better than those in the control group.The total effective rate of cardiac function in the treatment group was 87.50%,and that in the control group was 65.00%.The improvement of cardiac function in the treatment group was better than that in the control group(P<0.05).One month after discharge,C-MLHF scores in both groups were decreased compared with those before treatment,and that in the treatment group was lower than in the control group(P<0.05).[Conclusions]Zhenwu Decoction combined with Tingli Dazao Xiefei Decoction based on traditional western medicine treatment could improve the clinical efficacy,symptoms and quality of life of patients in the treatment of chronic heart failure with edema syndrome due to yang deficiency.

Proteomics analysis of IBS-D with spleen and kidney yang deficiency

Objective:To investigate the molecular mechanism underlying the development of diarrhea-predominant irritable bowel syndrome (IBS-D) with spleen and kidney yang deficiency (SKYD) using a proteomics approach.Methods:Male Sprague-Dawley rats (n =22) were divided into IBS-D (n =12) and normal control (n =10) groups.SKYD was then modeled in IBS-D rats by a combination of acetic acid enema,bondage,rectal dilation,tail stimulation,and Senna gavage.Colon tissue samples were subsequently collected and examined by Q Exactive mass spectrometry to identify differentially expressed proteins between the two groups.Results:The occurrence of SKYD/IBS-D was associated with ribosomal protein S23 (Rps23),protein phosphatase 2 catalytic subunit alpha (Pp2a),and growth factor receptor-bound protein 2 (Grb2),which are involved in the ribosome,neurotrophin signaling,and Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathways.Conclusion:These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation,cell growth,apoptosis,stress granule formation,immune activation,loss of epithelial cell integrity,and visceral hypersensitivity.

Clinical observation on efficacy of compound of warming yang, descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with Yin-Yang deficiency and blood stasis syndrome

Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Methods:Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into observation group and control group,thirty-eight cases in each group.The control group was given conventional western medicine treatment,while the observation group took compound of owarming yang,descending turbidity and dredging collaterals orally on the basis of conventional western medicine treatment.The course of treatment covered for one month.Before and after treatment,we observed the scores of traditional Chinese medicine symptoms,indicators of renal function[serum creatinine(Scr),blood urea nitrogen(BUN),microalbuminuria(MALB)],indicators of glucose metabolism[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],indicators of hemorheology[plasma viscosity(PV),platelet aggregation rate(PAR),fibrinogen(FIB)],Cystatin-C(Cys-C),C-reactive protein(CRP)in the two groups.Results:After treatment,the clinical effect of the observation group was significantly better than the control group(P<0.05).The scores of traditional Chinese medicine symptoms,indicators of renal function(Scr、BUN、UAER),indicators of glucose metabolism(FPG、2hPG、HbAlc),indicators of hemorheology(PV、PAR、FIB),Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).Conclusion:Compound of warming yang,descending turbidity and dredging collaterals has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms,glucose metabolism,renal function and microcirculatory disturbance,and the mechanism related to alleviation of microinflammation.

浅议肺饮病之论治

肺饮病病位在肺,涉及脾、肾、心等脏,病性为本虚标实之证,病机以肺阳亏虚为本,气、血、水紊乱为标,西医中的肺水肿即属于肺饮病范畴。肺水肿是指肺内组织液的生成和回流平衡失调,大量肺毛细血管内的组织液经过外渗,积聚在肺泡、肺间质和细支气管内,使肺血管外液量增多,从而造成肺的通气与换气功能严重障碍的病理状态。中医在治疗上需要分清标本虚实,注重肺与其他脏腑联系,急性期以温阳利水、化痰理气为主,缓解期以温肺助阳、健脾益肾为主,突出“以温药和之”的治疗原则,用药应标本兼顾、补虚泄实,使得复杂病症得以合理有效的治疗。

温阳利水方治疗慢性心力衰竭阳虚水泛证的临床研究

目的探讨温阳利水方治疗阳虚水泛证慢性心力衰竭的临床疗效。方法纳入2020年11月-2021年11月收治的心功能分级为Ⅱ~Ⅲ级的慢性心力衰竭患者82例,采用随机数字表法,分为治疗组和对照组各41例。2组均予常规西药治疗,治疗组加服温阳利水方,2组均治疗14d后评价其临床疗效,比较2组治疗前后中医证候疗效、血清N末端前脑钠肽(NT-proBNP)、生活质量评分、6 min步行距离。结果治疗后,2组血清NT-proBNP明显下降,治疗组较对照组下降更为显著(P<0.05);2组患者的活动耐力、生活质量均明显改善,治疗组改善较对照组更为显著(P<0.05);治疗组总有效率90.24%,显著高于对照组78.05%(P<0.05)。结论在常规西药治疗基础上加用温阳利水方能改善患者的临床症状和降低NT-proBNP、提高生活质量和活动耐力。

温氏奔豚汤加味联合火龙灸对脾肾阳虚型肾性水肿的疗效分析

目的:探讨温氏奔豚汤加味联合火龙灸对脾肾阳虚型肾性水肿的疗效分析。方法:本次前瞻性研究的受试对象为2022年1月—2023年6月就诊于梧州市中医医院的80例肾性水肿患者,研究开始前按照就诊顺序选取信封分为治疗组和对照组,每组40例。对照组采取常规肾性水肿对症治疗方案,治疗组在此基础上行温氏奔豚汤加味联合火龙灸治疗。两组治疗周期为4周。比较两组患者中医证候评分变化及临床疗效;比较两组患者治疗前后双踝部周径、双侧大腿围周径、血浆白蛋白、血肌酐、24 h尿蛋白定量水平;比较两组患者治疗前后肌酐清除率(CCr)、β2-微球蛋白(β2-MG)含量;观察两组患者治疗期间安全性事件。结果:治疗后治疗组中医证候评分、双踝部周径、双侧大腿围周径、血肌酐、24 h尿蛋白定量、β2-MG均低于对照组(P<0.05,P<0.01)。治疗组总有效率95.00%(38/40)显著高于对照组80.00%(32/40)(P<0.05);治疗组血浆白蛋白、CCr明显高于对照组(P<0.05,P<0.01)。两组均未出现严重安全性事件。结论:温氏奔豚汤加味联合火龙灸对脾肾阳虚型肾性水肿患者疗效较好,可显著减轻患者水肿程度,改善微循环障碍,其机制可能与减轻肾小球和肾小管间质病变有关。

补肺温肾汤联合穴位埋针治疗阳虚水泛证肺胀临床研究

目的:观察补肺温肾汤联合穴位埋针治疗阳虚水泛证肺胀的临床效果。方法:选择96例阳虚水泛证肺胀患者作为研究对象,随机分为联合组和对照组各48例。对照组给予常规西医治疗,联合组在常规西医治疗基础上给予补肺温肾汤内服联合穴位埋针治疗。连续治疗2周后,比较2组临床疗效、中医证候评分、呼吸困难程度[改良版英国医学研究委员会呼吸困难量表(mMRC)评分]、生活质量[慢阻肺自我评估问卷(CAT)评分]、肺功能[用力肺活量(FVC)、第1秒用力呼气量(FEV_(1))、FEV_(1)/FVC]、心功能[左心室射血分数(LVEF)]和不良反应发生率。结果:治疗后,联合组总有效率为93.75%,对照组为79.17%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候评分、mMRC评分、CAT评分均较治疗前降低(P<0.05),且联合组中医证候、mMRC、CAT评分均低于对照组(P<0.05)。治疗后,2组FVC、FEV_(1)、FEV_(1)/FVC水平均较治疗前升高(P<0.05),且联合组3项肺功能指标均高于对照组(P<0.05)。治疗后,2组LVEF水平较治疗前升高(P<0.05),且联合组LVEF水平高于对照组(P<0.05)。联合组不良反应发生率为8.33%,对照组为6.25%,2组比较,差异无统计学意义(P>0.05)。结论:补肺温肾汤联合穴位埋针治疗阳虚水泛证肺胀可进一步减轻临床症状,改善心肺功能,提高生活质量,且安全性良好。

温阳利水活血方联合香山正骨手法复位小夹板固定治疗阳虚水泛型桡骨远端骨折肿胀临床研究

目的:观察温阳利水活血方联合香山正骨手法复位小夹板固定治疗阳虚水泛型桡骨远端骨折肿胀的临床疗效。方法:采用随机数字表法将70例阳虚水泛型桡骨远端骨折肿胀患者分为治疗组与对照组各35例。对照组采用香山正骨手法复位小夹板固定治疗,治疗组在对照组基础上加用温阳利水活血方治疗。比较2组治疗前后中医证候积分、肿胀度、腕关节活动度、桡骨高度水平,比较2组骨折愈合率、临床疗效及不良反应发生情况。结果:治疗后,2组总有效率、不良反应发生率比较,差异无统计学意义(P>0.05)。2组治疗后腕关节桡偏、尺偏、掌屈、背伸活动度及桡骨高度均较治疗前升高(P<0.05),中医证候积分降低(P<0.05);治疗组治疗后中医证候积分低于对照组(P<0.05),骨折愈合率、腕关节桡偏、尺偏、掌屈、背伸活动度及桡骨高度高于对照组(P<0.05)。2组治疗3 d、1周、2周、4周后肿胀度较治疗前降低(P<0.05),且治疗组治疗1周、2周、4周后肿胀度低于对照组(P<0.05)。结论:温阳利水活血方联合香山正骨手法复位小夹板固定治疗阳虚水泛型桡骨远端骨折肿胀疗效确切,能够有效消除肿胀,改善腕关节活动度,防止桡骨高度丢失,安全性较高。

养心益肾温阳利水法结合常规西药治疗冠心病心力衰竭临床研究

目的:观察养心益肾温阳利水法结合常规西药治疗冠心病心力衰竭(心肾阳虚水泛证)的临床疗效。方法:选取冠心病心力衰竭(心肾阳虚水泛证)患者96例,按随机数字表法分为对照组和观察组各48例,对照组脱落2例。对照组予以常规西药治疗,观察组在对照组基础上给予养心益肾温阳利水法治疗。评价2组临床疗效,比较2组治疗前后中医证候评分、心功能指标、血清N末端脑钠肽前体(NT-proBNP)、肌钙蛋白I(cTnI)、血管紧张素Ⅱ(AngⅡ)水平,观察不良反应发生情况。结果:观察组总有效率为93.75%,高于对照组78.26%(P<0.05)。治疗后,2组主症评分、次症评分和总分较治疗前降低(P<0.05),且观察组主症评分、次症评分和总分低于对照组(P<0.05)。治疗后,2组左室射血分数(LVEF)、心排量(CO)较治疗前升高(P<0.05),左室舒张末期内径(LVEDD)较治疗前降低(P<0.05);且观察组LVEF、CO高于对照组(P<0.05),LVEDD低于对照组(P<0.05)。治疗后,2组血清NT-proBNP、cTnI、AngⅡ水平较治疗前降低(P<0.05),且观察组血清NT-proBNP、cTnI、AngⅡ水平低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:养心益肾温阳利水法结合常规西药治疗冠心病心力衰竭(心肾阳虚水泛证)可减轻患者临床症状,降低血清NT-proBNP、cTnI、AngⅡ水平,改善心功能。

红参温肾助阳方对难治性心力衰竭阳虚水泛证患者血清心肌肌钙蛋白、骨桥蛋白水平的影响

目的:研究红参温肾助阳方对难治性心力衰竭阳虚水泛证患者血清心肌肌钙蛋白、骨桥蛋白水平的影响。方法:选取2020年3月~2022年3月我院收治的94例难治性心力衰竭阳虚水泛证患者作为研究对象,随机分为对照组(n=47)与观察组(n=47),对照组采用常规治疗方法(包括卧床休息、吸氧,给予醛固酮受体拮抗剂、正性肌力药、利尿剂等常规抗心力衰竭药物),观察组在对照组的基础上给予红参温肾助阳方治疗,比较两组临床疗效、中医症状积分、血清学指标、心功能及不良反应发生率。结果:观察组临床总有效率(95.74%)高于对照组(78.72%,P<0.05);治疗后,观察组各项中医症状积分均低于对照组(P<0.05);治疗后,两组患者心肌肌钙蛋白Ⅰ(cTnⅠ)、骨桥蛋白、N末端B型利钠肽前体(BT-proBNP)水平均降低,且观察组明显低于对照组(P<0.05);治疗后,两组患者左室射血分数(LVEF)、心排血量(CO)及每搏输出量(SV)水平均升高,且观察组明显高于对照组(P<0.05);两组不良反应发生率比较无明显差异(P>0.05)。结论:红参温肾助阳方治疗难治性心力衰竭阳虚水泛证临床疗效显著,可降低患者血清心肌肌钙蛋白、骨桥蛋白水平,改善心功能,且无明显不良反应发生,有较好的安全性。

参附注射液治疗心肾阳虚型冠心病慢性心力衰竭临床观察

目的探讨心肾阳虚型冠状动脉粥样硬化性心脏病(以下简称“冠心病”)慢性心力衰竭(CHF)患者应用参附注射液治疗的临床效果。方法选择2020年1月—2022年1月乌兰察布市中心医院收治的心肾阳虚型冠心病CHF患者94例,按照随机数字表法分为对照组和研究组,各47例。对照组采取常规西药对症治疗,研究组在此基础上应用参附注射液。针对2组临床疗效、治疗前后心肌肌钙蛋白(cTnI)与氨基末端脑钠肽前体(NT-proBNP)指标以及用药安全性进行对比。结果研究组总有效率95.74%(45/47)高于对照组的80.85%(38/47)(P<0.05)。治疗后,研究组cTnI与NT-proBNP指标较对照组低(P<0.01)。2组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论心肾阳虚型冠心病CHF患者应用参附注射液治疗效果确切,具有临床推广价值。

The Effect of Hormones of the Hypothalamic-pituitary-target Gland Axes in a Kidney-Yang Deficiency Syndrome Model

Kidney-yang deficiency syndrome(KYDS)is a diagnostic pattern in the traditional Chinese medicine.Studies have shown that KYDS is related to the functional disorder of hormones of the hypothalamic-pituitary-target gland axes.The standard procedure used to mimic KYDS is the injection of a high dose of exogenous glucocorticoid(hydrocortisone and corticosterone).Such a model showed symptoms such as exhaustion,body twists,cold limbs,lying crowded together,decreased rectal temperature,sexual dysfunction,decreased reaction speed,reduced spontaneous activity,hair loss,loss of appetite,and weight loss.Moreover,the model manifested an imbalance in mutual control among the hormones of the pituitary-target gland axes,including adrenocorticotrophic hormone,CORT,CRH,thyroid-stimulating hormone,triiodothyronine,thyroxine,T,E2,follicle-stimulating hormone,luteinizing hormone,and 17-OHCS.

利水强心汤治疗慢性心力衰竭阳虚血瘀水停型68例

目的探讨利水强心汤治疗慢性心力衰竭阳虚血瘀水停型临床效果。方法选取符合标准的68例阳虚血瘀水停型慢性心力衰竭患者,以信封法随机分为对照组、观察组,各34例,对照组予常规西药治疗,观察组在此基础上予利水强心汤治疗,治疗4周后观察总有效率中医证候积分、心功能指标的变化。结果治疗4周后,观察组总有效率、左心室射血分数高于对照组(P<0.05);观察组中医症状积分、血清N末端B型利钠肽原低于对照组。结论利水强心汤治疗阳虚血瘀水停型慢性心力衰竭疗效显著,能够改善心衰临床症状,提高患者的心脏功能,具有重要的临床应用意义。

白术对大鼠肾阳虚型下焦水肿影响的实验研究

目的:探究白术对于肾阳虚型下焦水肿的作用,为阐明白术利水功效奠定基础。方法:采用大鼠给予盐酸多柔比星和氢化可的松方法制备肾阳虚型下焦水肿模型,以呋塞米为阳性对照,以大鼠体征,呼吸及代谢率,环磷酸腺苷、环磷酸鸟苷、睾酮、血清肌酐、血清尿素氮、血清白蛋白、尿蛋白等为评价指标,探讨白术高、低剂量对肾阳虚型下焦水肿的影响。结果:白术高、低剂量对大鼠阳虚型下焦水肿均有显著影响,可改善环核苷酸水平,升高白蛋白水平,降低肌酐、尿素氮及尿蛋白含量。结论:白术可改善肾阳虚型下焦水肿病症。

阿霉素诱发肾性水肿病症大鼠模型的建立

目的考察复制大鼠的肾性水肿(肾阴虚、肾阳虚水肿)病症结合模型的可行性。方法采用灌胃甲状腺素片及尾静脉注射阿霉素的方法制造大鼠肾阴虚水肿模型,肌注氢化可的松和尾静脉注射阿霉素方法制造大鼠肾阳虚水肿模型。通过观察模型大鼠体征变化、24 h尿蛋白含量、三碘甲状腺原氨酸(T3)、甲状腺(T4)、环磷酸腺苷(c AMP)、环磷酸鸟苷(c GMP)、雌二醇(E2)及睾酮(T)等指标含量,判断模型是否成功。结果阴虚水肿组动物出现多动、脱毛、大便干结、体重降低和体温升高等临床表现,与空白组比较T3、T4、c AMP、E2、24h尿蛋白含量明显升高,c GMP、T含量降低,c AMP/c GMP比值显著升高,且各项指标均差异具有显著性(P<0.05)。阳虚水肿组动物则出现活动减少、大便溏泻、体重和体温下降等体征变化,与空白组相比,T3、T4、c AMP、E2含量显著降低,c GMP、T、24h尿蛋白含量明显升高,c AMP/c GMP比值降低,且各项指标均差异具有显著性(P<0.05)。结论分别由甲状腺素片联合阿霉素、氢化可的松注射液联合阿霉素诱导的动物病症结合模型,符合中医证型诊断下肾阴虚、阳虚水肿病症,造模方法可行。

肾阳虚水肿证代谢组学的研究

目的揭示肾阳虚水肿证的代谢组学。方法采用"阿霉素+氢化可的松"复合造模法建立肾阳虚水肿模型后,UPLC-Q/TOF-MS法检测正常组、肾阳虚水肿模型组、阳性药组大鼠尿液代谢物,在主成分分析和正交偏最小二乘判别分析的基础上,筛选出与肾阳虚水肿模型相关的生物标志物。然后,通过MeV软件对标志物水平进行热度图绘制,结合MBRole、KEGG等在线数据库进行通路富集分析和代谢网络构建。结果共鉴定了40个生物标志物,有3条显著相关的代谢通路(苯丙氨酸代谢、色氨酸代谢、嘧啶代谢)。在肾阴虚、阳虚水肿证共有标志物中,苯乙酰甘氨酸等7种代谢物变化趋势相同,4,6-二羟基喹啉等10种代谢物变化趋势相反。结论肾阳虚水肿模型大鼠体内多种代谢紊乱与其肾脏功能损伤、水肿发生、耗竭症状、免疫功能紊乱密切相关,而肾阴虚、阳虚水肿模型在动物形态、免疫功能紊乱中的差异可能与色氨酸、嘧啶、组氨酸代谢紊乱有关。

真武汤对肾阳虚水肿大鼠模型的保护作用及对IL-17表达的影响

目的探讨真武汤对肾阳虚水肿大鼠模型的保护作用及其机制。方法每日腹腔注射3.75 mg/kg氢化可的松溶液,同时于第1、8日通过尾静脉注射阿霉素溶液,注射剂量分别为3.5、3 mg/kg,连续14 d,将造模成功的24只大鼠随机分为模型组、真武汤组(1.9 g/mL)、阳性药组(盐酸贝那普利,1.2 mg/mL),另设正常组。各组分别给予相应药物,正常组给予等体积0.9%氯化钠注射液,连续21 d。于造模第14日和给药第21日,测量大鼠体质量、尿量、尿蛋白含量;末次给药后,检测大鼠血清尿素氮(BUN)、血清肌酐(Scr)水平;酶联免疫法检测环磷酸腺苷(cAMP)、环磷酸鸟苷(cGMP)、醛固酮(ALD)、白细胞介素-17(IL-17)水平;免疫组化法测定肾脏组织中IL-17的表达。结果造模后,与正常组比较,各组大鼠尿蛋白及尿量均显著升高(P<0.05或P<0.01),体质量增长缓慢(P<0.05或P<0.01),提示造模成功。给药后,与模型组比较,真武汤组和阳性药组体质量显著增长(P<0.05或P<0.01);真武汤组和阳性药组尿蛋白及尿量均显著下降(P<0.05或P<0.01)。与正常组比较,模型组大鼠cAMP、cAMP/cGMP显著降低,cGMP显著升高(P<0.05或P<0.01);与模型组比较,真武汤组cAMP、cAMP/cGMP显著升高,cGMP水平显著降低(P<0.05或P<0.01)。与正常组比较,模型组大鼠Scr、BUN、ALD、IL-17含量均显著升高(P<0.05或P<0.01);与模型组比较,真武汤组和阳性药组Scr、BUN、ALD、IL-17含量均显著下降(P<0.05或P<0.01);与正常组比较,模型组肾组织中IL-17在肾小管上表达显著,肾小球有少量表达,呈深棕色;与模型组比较,真武汤组和阳性药组肾组织中IL-17表达明显降低,弱阳性表达。结论真武汤对肾阳虚水肿有治疗功效且能明显改善肾功能,其机制可能与抑制IL-17介导的足细胞凋亡有关。