| Objective:Nephrotic syndrome (Nephrotic syndrome, NS) was a common disease, treatment with Western medicine was difficult, and traditional Chinese medical treatment had achieved significant results, so to sum up the new theory, carried out research of this topic. This topic was divided into two parts:theoretical studies and experimental studies. According to Professor Xingfan Qiu proposed "ZangXuLuoBi" pathogenesis theory, developed OnyangLishiTongluoFang.In this study, using modern detection methods, to study the OnyangLishiTongluoFang for Adriamycin-induced nephrotic syndrome in rats of the therapeutic effect and mechanism. The purpose of this study was to provide for the treatment of nephrotic syndrome in new theoretical and experimental basis.Theory probing:1.Based on a Basic Theory of TCM and the "ZangXuLuoBi" sick machine theory, "ShiYuZuLuo" was the basic pathogenesis of NS.①"ShenPiYangXu" was the root cause of the disease. "ShenPiYangXu" was the basic pathogenesis of NS.②"ShiYuZuLuo" as the external factors caused disease. "ShiYuZuLuo" was an important factor in NS occurs.③"ZangXu" and "LuoBi" mutual influenced reciprocal causation.2. According to the patient machine, that "WenshenBupi, LishiXiezhuo, HuayuTongluo" was the basic treatment of NS.①"BuZang" to treat its fundamental:"BuZang" referred to compensation "yin and yang, qi and blood." Compensation "Yang of Shen and Pi" was the basic.②"TongLuo" to treat the symptoms: "TongLuo" was an important part of treatment of NS; "LiShiHuaYu" was the key to treatment of NS.Methods:In this study, single tail vein injection of Adriamycin 6mg/kg method to establish model of adriamycin-induced nephropathy, according to Bertani's modeling method, conducted the OnyangLishiTongLuoFang to intervene in the model experiments.40 Wistar male rats were randomly divided into normal group (n=10), model group (n=10), TCM group (traditional Chinese medicine group, n=10), western medicine group (n=10). Modeling was successful, normal group and model group were gavaged with normal saline (1ml/100g body weight); TCM group was gavaged with OnyangLishiTongluoFang (1ml/100g body weight); Western medicine group was gavaged Benazepril hydrochloride (0.3mg/100g body weight), all of the rats were gavaged once a day, administered orally 4 weeks. During treatment, observed their daily food intake, body hair, stool, mental state, body weight and edema. Urine specimens:a 24-hour urinary protein (24HUPQ),β2 micro globulin (β2-MG), urinary albumin (ALB), dry chemical method detection; blood samples:serum creatinine (Scr), blood urea nitrogen (Bun), total protein (TP), albumin (ALB), triglyceride (TG) and cholesterol (CHOL), using automatic biochemical analyzer. ET-1, VEGF, and TGF-β1 changes studied by immunohistochemistiy. The expression of TGF-β1mRNA was observed using RT-PCR.Results:1. On the general observation in rats:Normal group rats of the activities were flexible; they responded freely, their dense fur shined without edema. Model group rats, after modeling in the first 3 days appeared to reduce activity, mental difference, turning messy hair, loosed stool, food intake, after 3 weeks arid gradually increased edema, ascites was particularly significant; After treatment, TCM group and western medicine group rats, compared with model group, the spirit was better, ate better, stool granular, activities were better, lighter, and edema. Model group, TCM group and western medicine treatment group after the success inmodeling, body weight decreased significantly compared with the normal group (P＜0.01); At the end of the experiment, TCM group and western medicine group body weight were significantly higher than model group;(P＜0.05), while the TCM group and western medicine group there iwas no significant difference;2.The impact of proteinuria in rats:model group, TCM group; western medicine group at 7 days after modeling,24HUPQ were significantly higher than the normal group (P＜0.01), shows the model was successful.14,21,28 days after treatment, TCM group 24HUPQ significantly lower than model group (P＜0.01),TCM group and western medicine group showed no significant difference.At the end of the experiment, the Medicines for urinaryβ2-MG was significantly lower than model group (P＜0.01), urinary ALB compared with model group (P＜0.05). TCM group and western medicine group showed no significant difference;3. On serum lipids in rats:At the end of the experiment, the model group TG, CHOL results were significantly higher than the normal group (P＜0.01), Western medicine group and TCM group were significantly lower than the model group TG (P＜0.01),TCM group and western medicine group showed no significant difference; Western medicine group and TCM group the results of CHOL were significantly lower than model group (P＜0.05). TCM group and western medicine group showed no significant difference;4.On renal function:At the end of the experiment, the model group,TCM group, Western group compared the results with the normal group,,blood Scr, BUN results were not significantly different;5.On serum protein: At the end of the experiment,the model group, TCM group, Western group of rats TP, ALB results were significantly lower than normal group (P＜0.01), TCM group and western medicine group rats TP, ALB results than model group (P<0.05), TCM group and western medicine group showed no significant difference;6.Rat ET-1,VEGF,TGF-β1 and TGF-β1mRNA levels:Model group and TCM group of ET-1, VEGF, TGF-β1 and TGF-β1mRNA levels were significantly increased (compared with the normal group,P＜0:01); but the TCM group ET-1, VEGF,TGF-β1 and TGF-β1mRNA levels were significantly higher than the model group lower (P＜0.05), TCM group and western medicine group there was no significant difference;7. In the pathological study, in the light microscope could be observed:Model group rats of HE and PAS staining biopsy had mild mesangial proliferation, glomerular and renal tubular other groups were no significant pathological changes. In the electron microscope could be observed:the normal group was not thickened glomerular basement membrane, mesangial proliferation was not enough to suddenly clear and complete, not integration. Model group rat glomerular basement membrane was not thickened, partial mesangial cells, stromal hyperplasia, foot processes of the gap disappeared, extensive foot process fusion, was still visible part of endothelial cells in heterochromatin stain deeper into the block, trend edge, nuclear pore widened, there apoptosis; Model group visible part of the renal tubular cells in rat peripheral edema, increased lysosome. TCM group, western medicine group had a similar level of glomerular lesions, basement membrane smooth, no thickening, mesangial no hyperplasia, some foot process fusion, renal tubular cell structure of normal, compared with model group, lesions significantly lesser degree.Conclusion:The results suggested that OnyangLishiTongluoFang could be significantly improved in rats with adriamycin nephropathy general nutritional status; could enhance adriamycin-induced nephropathy rat serum albumin, total protein levels, reduced proteinuria in rats, triglyceride cholesterol level; their treatment might be associated with reduced ET-1, VEGF, TGF-β1 and TGF-β1mRNA related to the level; the party treated adriamycin nephrotic rats were morphological evidence, there might be a network mechanism for immune regulation. Prompt "OnyangLishiTongluo" treatment was an effective traditional Chinese medicine treatment of nephrotic syndrome. |
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