The Clinical And Experimental Study Of CAN In Treatment By Glucosida Tripterygii Total

The occurrence of chronic allograft nephropathy (CAN) is related with immune and nonimmune factors. The CAN's experimental and clinical preventive and therapeutic strategies will be expounded in this paper, and the influence of related pathology molecule to CAN, the pharmacologic actions of Tripterygium Glycosides and its preventive and therapeutic effect to the CAN's occurrence factors will be represented. And also further through the clinical and experimental research to observe the Tripterygium Glycosides' influence to the CAN, discuss the mechanism of the Tripterygium Glycosides, and evaluate its therapeutic effect.Objective:Through the clinical and experimental research to observe the Tripterygium Glycosides' curative effect to CAN, and further explore a better way to prevent and treat the CAN.Methods:1. Clinical research:collect from September 2009 to March 2011 to Jiangsu provincial Hospital for treatment, diagnosis of CAN and patients met the inclusion criteria were 20 cases. In accordance with the principles of randomized, the 20 patients were divided into two group on average, the therapy group and the control group. All patients were routinely adjusted the immunodepressant dosage, blood fat, blood pressure, blood glucose according to the blood drug level. On this basis, the treatment group took Tripterygium Glycosides 20mg every time, and 3 times a day, and the time of therapy is 6 months. They were adjusted the doses according to the blood common practice and the hepatic function. But the control group without using any additional drugs. We respectively recorded their blood common practice, urine common practice, hepatic and renal function, renal pathology.2. Empirical study:F344 rats were used as donor mice, LWISE rats as recipient mice. And we chose 14 rats as CAN rats. In accordance with the principles of randomized, the 14 rats were divided into two groups, the experimental (6 rats) group and the control group (8 rats). The experimental group rats were laved by Tripterygium Glycosides,3mg/kg/d, and the control group rats were laved by physiological saline. We reared the two groups of kidney transplantation rats for 4 months and collected urine and blood as specimens from 24-hour. After this 4 months, we killed them for pathological kidney transplantation, detected transplant renal graft biopsy tissues epimatrix collagenⅠ,Ⅲ,FN (mRNA detection) by RT-PCR before the treatment and after 6 months' treatment, All data were statistically processed and analyzed by SPSS17.0.Findings:The Clinical observations:The comparison in the related indicators (P>0.05) of blood common practice and hepatic function between therapy group and control group or in the same group has no statistics significance no matter before or after the therapy. Few patients in the Tripterygium Glycosides group have been slightly abnormal in the blood common practice and hepatic function. However when those patients stopped using the medicine their symptoms has been lightented and they have no other severe complications. The indicators of Urine protein in 24 hours in the therapy group have obviously reduced from 2021.22±942.91 mg/L to 220.00±120.00 mg/L after treatment while the control group has no difference. Meanwhile the indicators of Cr in the therapy group have reduced from 182.58±15.07umol/L to 136.94±17.92umol/L, BUN from 10.89±1.36mmol/L to 8.12±1.07mmol/L after treatment, and the indicators of the creatinine and urea nitrogen have also reduced (P<0.01). However the indicators of the creatinine and urea nitrogen in the control group have not reduced at all. The experimental research findings:The indicators of renal function of Rats in test group have been better than those in model group. In particular the urine protein excretion within 24 hours in the test group has obviously less than that in the control group. The allogrdft nephropathy of Rats in the test group has injured less than that in the model group, especially the indicators in terms of renal tissue cells extracellular matrix collagenⅠ,Ⅲ,FN mRNA has lower than those of model group.Conclusion:1. Tripterygium Glycosides can protect renal function, and delay the progress of CAN. The mechanism may be related to reduce renal extracellular matrix collagenⅠ,Ⅲ, FN mRNA expression of anti-renal fibrosis.2. Tripterygium Glycosides immunosuppressive agents can assist prevent and treat CAN, found no adverse reactions during the experimental period.