The Effect Of Mahuang Fuzi Xixin Decoction On Rats With Nephropathy And Patients With Chronic Nephritis Of Yang Deficiency Type Was Studied Based On The Theory Of "there Is No Death"

ObjectiveAlthough Fuzi and Xixin have a certain degree of nephrotoxicity,the theory of "You Gu Wu Yun " in traditional Chinese medicine believes that "when the human body is sick,the disease bears the medicinal properties and the toxicity of the drug does not damage the human body".This study was to investigate the relationship of the "sickness-proof-effect" between the rats with focal segmental sclerosing nephropathy and the patients with yang deficiency type chronic nephritis treated with Mahuang Fuzi Xixin Decoction.MethodIn the animal experiment,32 male Sprague-Dawley(Wistar)rats were randomly divided into 4 groups : normal group,normal drug-administered group,model group and model-administered group,with 8 rats in each group.In the model group,puromycin aminonucleoside(PAN)reagent was used to establish the model of focal segmental sclerosing nephropathy.The normal administration group and the model administration group were administered with Mahuang Fuzi Xixin Decoction at the same time.At the 2nd week,4th week,and 8th week after model establishment,the urine of rats in each group was collected for 24 hours,and at the 8th week of modeling,the rats were killed,blood samples and kidney tissues were taken.The changes of 24 h urinary protein,serum albumin,renal function,serum lipid parameter,glomeruli,tubulointerstitial tissue and foot process were examined.In the clinical study,to make a retrospective cohort study of the 72 patients with yang deficiency type chronic nephritis,patients were divided into control group(Western medicine group)and observation group(Chinese and Western medicine combined group),with 36 cases in each group.They were treated with conventional western medicine(sartan)and western medicine plus Mahuang Fuzi Xixin Decoction.The course of treatment was 6 months.The changes of 24 h urinary protein,liver and kidney function,e GFR,serum albumin,heart rhythm and TCM syndrome score were observed.ResultThe results of animal experiments showed that: 1.Comparison between normalgroup and model group,we found that the 24 h urine protein level of the model rats increased significantly(p<0.01),plasma albumin decreased(p<0.05),serum creatinine and serum lipid parameter were elevated(p<0.01),and the degree of glomerular sclerosis(p<0.01),tubulointerstitial injury(p<0.01),and the fusion rate of the foot process were significantly increased in the model rats(p<0.01).Renal pathological changes were consistent with focal segmental glomerular sclerosis,and a good model of focal segmental sclerosing nephropathy was obtained.2.Comparison between normal group and normal drug-administered group,we found that the effect of Mahuang Fuzi Xixin Decoction on normal rats(unreasonable)can lead to a quantitative increase in the quantity of 24 h urinary protein(p<0.05),aggravate the degree of glomerulosclerosis(p<0.01)and the fusion rate of foot process(p<0.01),at this time,the toxic and side effects(toxicity)of the drug were brought into play.3.Comparison between model group and model-administered group,we found that the effect of Mahuang Fuzi Xixin Decoction on focal segmental sclerosing rats(when there is a reason)can reduce the24-hour urine protein quantitation(p<0.05)and blood triglyceride decline(p<0.01),and improved glomerular sclerosis(p<0.01),tubulointerstitial injury(p<0.05)and increased foot fusion rate(p<0.01),which was the therapeutic effect of the drug(Medicinal).The results of clinical study showed that:1,Mahuang Fuzi Xixin Decoction can reduce 24 h proteinuria and urine erythrocyte(p<0.05)and increase plasma albumin level(p<0.05)in patients with yang deficiency type chronic nephritis,and has no effect on serum creatinine level(p>0.05).2.Mahuang Fuzi Xixin Decoction has a role in reducing the 24-hour urine protein quantitation(p<0.01)and increasing plasma albumin(p<0.05)in patients with chronic nephritis yang deficiency type CKD1-2.The effect of CKD 3-4 patients was not significant(p>0.05).3.Mahuang Fuzi Xixin Decoction can effectively improve the TCM syndrome scores and clinical symptoms of edema in patients with yang deficiency chronic nephritis(p<0.05).4.During the treatment of Mahuang Fuzi Xixin Decoction,there was no toxic side effects such as liver function damage,doubling of blood creatinine,abnormal heart rhythm,digestive tract reaction and allergic reaction in the Western medicine group and the integrated Chinese and Western medicine group.Conclusion1.When Mahuang Fuzi Xixin Decoction containing nephrotoxic drugs was used in normal rats,it could aggravate the urinary protein and renal pathology in rats.However,it does not aggravate renal function damage when it is applied to focal segmental sclerosing rats.On the contrary,the urine protein and renal pathological changes in rats were improved.This provides a theoretical basis for the clinical safety application of“toxic” Chinese medicine under the guidance of the theory of “You Gu Wu Yun".2.The first dose of PAN reagent was intravenously injected with PAN90mg/kg,for 56days(8 weeks)on the 14 th,17th,20 th,23rd and 26 th day after the peak of proteinuria(about 13 days).This modeling method can obtain a better model of focal segmental sclerosing nephropathy.3.Mahuang Fuzi Xixin Decoction can improve the clinical symptoms and laboratory results of patients with chronic glomerulonephritis of yang deficiency type,especially for CKD1-2 patients,and the safety is good.