Effect And Mechanism Of Yiqi Huoxue In The Defence And Treatment Of Glomerular Sclerosis

The chronic glomerulonephritis is a common disease which is usually lingering, slowly progressive, it's one of the main cause which leads to chronic renal failure finally. The renal fibrosis is the end-result of all chronic renal disease and the primary cause of the end-stage chronic renal failure. No matter what kind of primary glomerulopathy, diabetes mellitus, or ureter blockage, the impairment of renal fuction correlated closely with the extent of renal fibration. Mitogen-activated protein kinases(MAPKs)can be classified into three classes:extracellular signal-regulated kinase(ERK1/2), stress-activated protein kinase (SAPK)/c-Jun N -terminal kinase (JNK)and P38MAPK. MAPKs play a very important role in inducing the process of cell growth, development, division, differentiation and apoptosis. Abnormity of MAPK signal -transmitting pathway certainly will cause imbalance between cell proliferation and apoptosis, thus lead to hyperplasia of cell which is accord with the process of glomerular sclerosis.To explore the effect and mechanism of Yiqi Huoxue in the defence and treatment of glomerular sclerosis, We select TongMai Oral Solution as the study object. The previous study have confirmed that the patients of the Deficiency of Qiand Yin or Deficiency of Spleen Yang and Kidney Yang whose serum level of fibrous index rised up significantly. The patients of the Blood Stasis whose serum level of â…¢ precollagen, â…£ collagen and lamininrised obviously. All of this had provided the substantial theory for Tongmai Oral Solution which is composed according to Strengthening-Qi and Activating-Blood Method in treatment of chronic glomerulonephritis.Clinical study:Objective:To observe the curative effect of TongMai Oral Solution on the chronic glomerulonephritis patients which syndrome differentiation of TCM was belong to Deficiency of Qi and Blood Stasis.Methods:The clinic study with comparison, randomized control was taken.60 patients was randomly divided into treat group and contrast group. There were no significant difference between the two groups in sex, age, degree of diseases and laboratory indexs. The two groups also were taken the therapeutic measures such as depressurization, anticoagulation and symptomatic treatment, and the TongMai Oral Solution was added in the treat group. The course of treatment was 3 months. Serum III precollagen,IV collagen and laminin level and clinical symptoms were measured.Results:In a certain extent,the patients' clinic symptoms and the index of Kidney fibrous were ameliorated in two groups after 3 months, and the effect of treat group was more predominance than the contrast group. Conclusion: TongMai Oral Solution can lessen the degree of Kidney fibrous of the chronic glomerulonephritis patients which syndrome differentiation of TCM was belong to Deficiency of Qi and Blood Stasis.Tongmai Oral Solution consist of multiple kind of Traditional Chinese Medicine, for example, Milk vetch Root and Sanchi eta. The previous clinical and experimental study have confirmed that the Tongmai Oral Solution can improve the patient' s clinical symptom and renal function, decrease the proteinuria, adjust the immune function, ameliorate the bloodrheology, lessen the renal pathological lesion, defer the glomerular sclerosis. In experiment study, the author explored the mechinesm of Tongmai Oral Solution in treatment of CGN and defer the glomerular sclerosis by cell biological and molecular biological theory and technology.Experimental Study:Objective:To explore the inhibitory effect of TongMai Oral Solution (TM) on rat mesangial cell (MsC) growth and on the expression of mitogen-activated protein kinases (MAPKs).Methods:Mesangial cell stimulated with lipopolysaccharide (LPS) were cultured with TM pharmacological serum and with different duration (12h, 24h, 48h, 72h). MsC proliferation were measured by MTT. MsC were incubated with TM pharmacological serum for 12h, genistein was added to the MsC separately in the presence of TM pharmacological serum for 12h, interleukin-1 3 for 0,5,15,30min, respectively. Activities of p38, ERK were assessed by Western bolt analyses.Results:MsC proliferation was inhibited by TM pharmacological serum under normal and pathological condition, and TM pharmacological serum inhibited the expression of phospho-ERKl/2, this inhibited expression was enhanced by genistein, while the expression of phospho-p38 had no manifest change. Conclusions: TM-mediated transduction possibly by signaling moleculeERK1/2 can suppress the cultured mesangial cell growth.