| Objective: Shenshuai Mixture (SSM) was an experience compound prescription invented by Prof Jinwen Tu, who aimed at the chief pathogenesis characteristics of acute renal failure (ARF), namely, "heat, blood stasis, damp, poison", with the therapeutic methods of clearing away heat, detoxicating, removing blood stasis, diuresis ^ removing heat from the blood and nourishing yin, moreover, combined with modern research results. It made good curative effect in clinic. In order to explore effective methods which combine dialysis with Chinese drug compound prescription to cut down mortality of serious ARF, this research emphasized on studying the effect of SSM on ARF in rats, and made an inquiry into its possible mechanism at the aspects of renal hymodynamics, free radical, calcium overload, phlogotic cell factor, epidermal growth factor (EOF) and so on, which provided amply experimental basis for broadly applying SSM in clinic.Methods: male SD rats were allocated into four groups at random: normal group,model group,Western medicine group and SSM group. Except normal group, the others were injected glycerin into the musculi to make a model of ARF. At the same time, Rats in normal and model groups were given a dose (O.lml ?kg"1) of normal saline, rats in other two groups were given Verapamil (Vp) 0.4mg 'kg'1 -. SSM 22.5mg ?kg'1 respectively by gastric gavages. In this way they were administrated once every day till killed. At 24hr of making model, they were observed and detected:(1) survival rate, renal function (BUN, Scr) of rats in every group, and renal issue appearance changes by optical microscope at the time of 24hr, 3d, 5d after modeling;(2) renal ultrastructure by electron microscope; (3) contents of ET, TNF- a and NO in blood by radioimmunoassay and nitrate reductase assay respectively; (4) [Ca2+]j by fluorospectrophotometry after separating single TEC with sieve and enzymolysis; (5) SOD activity and MDA contents in renal cortex with the methods based on xanthine oxidase and thiobarbituric acid respectively; (6) the expression of PCNA and EGFmRNA in renal at the time of 24hr, 3d, 5d after modeling by immunohistochemical and in situ hybridization technique.Results: in contrast with model group, SSM can (1) increase the survival rate of ARF in rats, cut down Scr and BUN at 24hr, improve renal function, slightly surpass Vp in its therapeutic effect; (2) mitigate the extent of renal pathologicchanges, decrease the numbers of renal tubule necroses and casts; (3) protect renal ultrastructure such as microvilli, mitochondria, endoplasmic reticulum of TEC, podocytic process of glomerulus epithelial cell,endothelial cell etc, better than Vp; (4) enhance SOD activity, lower MDA contents in renal cortex; (5) enhance NO contents in serum, reduce ET levels in plasma; (6) evidently cut down TNF- a contents in serum, superior to Vp; (7) antagonize calcium overload in TEC; (8) alleviate renal pathological changes in ARF metaphase (at 3d), advance regeneration and recovery of TEC, restore renal structure in ARF convalescence (at 5d), and better than Vp; (9) increase the expression of TEC PCNA and prepro EGFmRNA in ARF metaphase. consequently increase synthesizing and releasing EOF, whereas Vp didn't have this function.Conclusions: it was indicated that SSM could: (1) adjust the proportion of EDCF and EDRF, better blood and oxygen supply to renal, so lighten damage to TEC. antagonize calcium overload and oxygen free radical injury, and clear away initiate inflammatory medium, consequently improve renal function, alleviate renal pathological changes, heighten survival rate of ARF; (2) in the meantime, impel TEC to manufacture and release EGF, promote and accelerate its proliferation, shorten the time of renal injury, advance renal issue regeneration and recovery from injury, for this reason shorten course, but Vp had no evident effects.In short, SSM played protective and accelerating recovery roles in ARF. It had definite effect and broadly applying prospect.
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