| Objective: The incidence of diabetes with diet, improved livingstandards, working and living conditions change,the aging of thepopulationincreased rapidly,patients with diabetic nephropathy also increased.DN is the most common chronic complication in diabetic vascularcomplications,is the main cause of end stage renal failure.DN basicpathological changes in the glomerular basement membrane thickening,mesangial cellproliferation and extracellular matrix(ECM) accumulation leadto glomerulosclerosis.DM, as the glomerular hyperfiltration, high blood sugar,oxidative stress, led a stimulation of the factors, injury of renal intrinsic cellskidney tissue ICAM-1, VCAM-1express rise, white blood cells andendothelial cell adhesion mediated increase, The capillary narrow, jams.Glomerular endothelial dysfunction, and may be caused by the release ofinflammatory mediators,vasoconstriction,increased permeability,promotingglomerulosclerosis.Clansen and other studies have indicated that intercellularadhesion molecule (ICAM-1) and vascular cell adhesion molecule (VCAM-1)involved in the development of diabetic nephropathy.Can increase the urineprotein, promote the deposition of the extracellular matrix, accelerate theglomerular sclerosisp.Studies have shown that ICAM-1and VCAM-1isupregulated in diabetic nephropathy,Promote the development ofinflammation, inflammatory cell infiltration in renal tissue, leading toglomerulosclerosis.So far,not yet clear to completely prevent or cure ofdiabetic nephropathy.So to explore the effective treatment of diabeticnephropathy,Improve patients' quality of life is the main target of diabeticnephropathy medical research,many clinical studies have shown traditional Chinese medicine to the disease have great potential and prospects.Theirknowledge and research in recent years gradually emerge,traditional Chinesemedicine treatment of DN has significant advantages and features,not onlyimproved the clinical symptoms, protection of renal function,delay theprogress of diabetic nephropathy.Improve the quality of life in patients withDN,and side effects is small, concern by the medical profession at domesticand abroad.And traditional Chinese medicine with its many targets,muchways,the overall regulation and individualized treatment programs have greatpotential in the prevention and treatment DN.In clinical practice,according tothe Chinese medicine theory of the etiology and pathogenesis,and combinedwith the clinical manifestations of the DN.The pathogenesis and pathologicalcharacteristics, gradually realize that the main pathogenesis of DN is diabetesdamages the body fluid,depleting gases.Lead to Qi and Yin have beendamaged,and the blood stasis resistance, blood stasis falling unhealed chronicillness into the network,the basic pathogenesis. Treatment qi and nourishingyin circulation collaterals,The party in the clinical treatment of early and middiabetic nephropathy,achieved good clinical efficacy.To further confirm thetherapeutic effect of the side,to explore its possible mechanism.Observed inexperimental animals to clear the role of the traditional Chinese medicinetreatment of DN,and the impact of development and possible pathogenesis ofthis side of DN.Methods: Healthy male Sprague-Dauley rats40,weight120g~150g,the applicability of feeding a week,respectively test the blood sugar,urinesugar and urinary protein are negative for the experiment.By weightrandomly divided into10only,Given normal feed,30high-fat diet group, givenhigh fat diet.After12weeks,High fat feed rats,fast12h (can't give water)according to30mg/kg one-time STZ intraperitoneal injection. Normal groupwas injected with the same volume of citrate buffer.72h after tail vein bloodwas collected to measure blood sugar.Blood sugar≥16.7mmol/L for the DMmodel was successful.Will become the model rats were randomly divided intomodel group,Yiqiyangyin circulation collaterals treatment group,Qi and nourishing yin meridians of Chinese medicine treatment group.DM model were administed to medicine. The herbs of supplementing qiand nourisging yin and dredging meridians according to1g/kg administration,The herbs of supplementing qi and nourisging yin and dredging meridians ofChinese medicine according to0.77g/kg administration,Group of Chinesemedicine granules dissolved with water gavage, every day.Administration ofthe amount of body surface area converted.Normal group and model group fedwith the corresponding amount of saline,32weeks of continuousadministration.During the experiment, don't give insulin and other intervention,from time to time detection of tail vein blood glucose,Glucose remission beremoved.The normal group was given normal diet,Model group, The herbs ofsupplementing qi and nourisging yin and dredging meridians treatment groupwere given high fat feed.After the treatment in32weekend, fasted for12hours,Can't give water.Collect24hours urine,Kill for animals. Specimensfrom blood, kidney tissue,determination of experimental animals24-hoururine protein quantitative,Renal function,Light and electron microscopy toobserve the pathological changes of the rat kidney. ICAM-1,VCAM-1ofexpression was detected by immunohistochemical staining method in thekidney tissues.Results:1The rat weight,hypertrophy index (renal heavy/weight) in each groupCompared with normal group,model group and two treatment groupsignificant weight loss (P <0.05);,Compared with model group,the twotraditional Chinese medicine treatment group,significant weight gain (P<0.05),No significant difference in weight between the two treatment group(P>0.05). Compared with normal group, model group and two treatmentgroup hypertrophy index was significantly higher (P <0.05). Compared withmodel group, the two treatment group hypertrophy index was significantlylower (P <0.05), Two Chinese medicine treatment group was no significantdifference between hypertrophy (P>0.05).2The24hour urinary protein quantity in each group Compared with normal group, model group and two treatment group24hours urinary protein quantitative were significantly increased(P<0.05).Compared with model group, the two treatment group24hoursurinary protein excretion was significantly decreased (P <0.05), no significantdifference between the two treatment group (P>0.05).3The renal function in each groupCompared with normal group,the model group and two treatment groups'serum creatinine(Scr) and BUN were obviously increased(P<0.05);Compared with model group, Two treatment groups were significantly decreased(P<0.05);Two treatment groups was not statistically significant(P>0.05).4Kidney pathological morphology observation4.1Microscopic ObservationNormal rats kidney glomerular structural integrity,brane of cells, thenumber of film and film substrate no significant changes.Model rats, renalglomerulus hypertrophy obvious,the glomerular capillary the thickenedbasement membrane,the film area broade.The treatment group are differentdegree of pathological change,but compared with model group light,for mildenlargement of the glomerulus,a small amount of the deposition of the matrixcells and increasing,each group has no obvious difference between.4.2Electron microscopeThe normal group kidney tissue structure normal, glomerular basementmembrane even without add thick, epithelial foot Tu distribution even, modelrats, the glomerular capillary basement membrane high thickening, most arewell quality sample thickening, part of a high hyperplasia nose-like uplifts;Podocyte foot processes are widely fusion; Endothelial cell fusion windowmost disappear.Two Chinese traditional medicine group rats than normalglomerular capillary basement membrane is well quality sample thickening,sufficient local cell fusion, fusion of endothelial cells,window part disappear.5Immunohistochemical staining method to detect the kidney tissues ICAM-1,VCAM-1expressionICAM-1:Normal group: glomerular endothelial cells, mesangial cells,Bowman's wall a little staining, glomerular mesangial basement membrane, asmall amount of expression. Model group: kidney ball endothelial cells,mesangial cells seen strong positive brown yellow particle deposition, andglomerular and wall adhesion, adhesion at the positive, showing tubulardegeneration and necrosis. ICAM-1expression of the scope and extent of thetwo treatment groups compared with model group were reduced.VCAM-1:Normal group: visible glomerular endothelial cells andmesangial cells, renal tubular epithelial cells, a small amount of coloring;Positive brown particles deposition. Model group: visible most of theglomerular endothelial and tubular with small vascular endothelial positivebrownish yellow coloring; VCAM-1expression of the scope and extent of thetwo treatment groups compared with model group were reduced.Conclusion:1Herbs of supplementing qi and nourishing yin and dredging meridians Canbe reduced in DN rats Scr and BUN, reduce the excretion of U-Pro, toimprove the pathological damage of diabetic nephropathy, slow the progressof DN.2Herbs of supplementing qi and nourishing yin and dredging meridians areable to reduce ICAM-1and VCAM-1expression, reduce the accumulation ofextracellular matrix, delay DN progress to achieve the protective effect of DNin rat kidney. |
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