| Objective: The serum levels of P-selectin/ PSGL-1 were measured in patients with chronic renal failure(CRF)syndrome of damp-heat before and after taking Qingshen granule(QSG).To explore whether QSG can alleviate renal injury and delay the progression of CRF by inhibiting the levels of P-selectin/ PSGL-1 in patients with CRF,providing objective indicators for the treatment of CRF with QSG.Methods: According to the diagnostic criteria of CRF,60 cases of CRF patients with damp-heat syndrome were collected and randomly divided into control group(general treatment of Western medicine + retention enema of TCM)and treatment group(general treatment of Western medicine + retention enema of TCM + QSG)by random number produced by SPSS17.0.And 30 cases in the normal group,The samples came from the health management center of our hospital center of our hospital.Both groups had to be treated continuously for 12 weeks.At the end of the course of treatment,the clinical efficacy of QSG was evaluated by comparing the clinical efficacy,TCM syndrome integral,serum creatinine(Scr),estimated glomerular filtration rate(eGFR),P-selectin and PSGL-1 before and after treatment between the two groups.All data were analyzed by SPSS17.0.Results: 1.Clinical disease efficacy,TCM syndrome efficacy: The total effective rate of clinical disease efficacy in treatment group(75.86%)was better than the control group(53.57%),which had significant difference(P<0.05).The total effective rate of TCM syndrome efficacy in treatment group(79.31%)was better than the control group(57.14%),which had significant difference(P<0.05).2.TCM syndrome score: there was no significant difference between the two groups before treatment(P > 0.05),but after treatment,the score in the treatment group was significantly lower than that before(P < 0.01),and the score in the control group was lower than that before(P > 0.05).The scores in the treatment group were significantly lower than those in the control group(P < 0.01).3.Scr,eGFR :There was no significant difference between the two groups before treatment(P > 0.05),but the Scr of patients taking QSG after treatment was significantly lower than that before treatment(P < 0.01),which eGFR was significantly higher than that before treatment(P < 0.01).After 12 weeks of treatment,Scr decreased and eGFR increased in the control group,but there was no significant difference(P >0.05).Compared with the control group at the same time,Scr decreased significantly(P< 0.01),eGFR increased significantly(P < 0.01).4.Before treatment,the serum levels of P-selectin and PSGL-1 in the normal group were significantly lower than those in the treatment group and the control group(P < 0.01),but there was no significant difference between the treatment group and the control group(P > 0.05).After treatment,the serum levels of P-selectin and PSGL-1 in the treatment group were significantly lower than those in the same group before treatment(P < 0.01),and there was no significant difference between the control group and the same group before treatment(P > 0.05).There was no significant difference between the treatment group and the control group before treatment(P > 0.05).Compared with the control group,the treatment group decreased significantly(P < 0.01).5.Analysis of safety observation items: after treatment,all the safety indexes of the patients in the treatment group were not significantly changed compared with those before treatment.Conclusion:1.Compared with the normal group,the serum levels of P-selectin and PSGL-1 in the patients with CRF damp-heat syndrome were significantly higher than those in the normal group(P < 0.01).2.QSG has a significant improvement on the clinical manifestations and renal function of patients with CRF damp-heat syndrome.3.QSG could reduce the levels of P-selectin and PSGL-1 in serum of patients with CRF damp-heat syndrome,which indicated that the down-regulation of P-selectin and its glycoprotein ligand could be one of the mechanisms on QSG to reduce renal damage.4.No adverse drug reaction was observed after taking QSG,and no special changes were found in all safety indexes,which indicated that the drug was safe.Objective: The rat model of 5/6 nephrectomized renal fibrosis was prepared.The expression of P-selectin/PSGL-1 in renal tissue was observed.It was explored whether the QSG could inhibit the expression of P-selectin/PSGL-1.In turn,it exerts anti-kidney fibrosis.Methods: 72 male SD rats,weighing 200 ±20 g,were randomly divided into normal group,model group,QSG group(high,middle and low dose group)and losartan group(n = 12).The rats in the losartan group were given losartan potassium tablet suspension by gastric perfusion,and the other three groups were given the corresponding dose of QSG aqueous solution in turn.12 weeks later,the rats were killed.Observe the general situation of rats,eating,defecating,mental state.Serum creatinine,blood urea nitrogen(BUN)and 24-hour urine protein(24-hoururine protein,24 h Upro)were measured.P-selectin/PSGL-1 protein expression in renal tissue were measured by Western blot(WB).The expression of p-selectin and PSGL-1 m RNA was detected by Reverse Transcription-Polymerase Chain Reaction,(RT-PCR).The pathological changes of kidney were observed by HE,MASSON,PAS staining.Results:1.General Situation of Rats: Rats in the normal group had vigorous energy,smooth and glossy body hair,normal stool and urine;rats in the model group had low activity,mental retardation,less glossy body hair,and feces were significantly less than those in the normal group.The general situations of drug intervention groups are better than those in the model group,the general condition of rats in the high dose group of QSG was the best.2.Scr,BUN and 24 h Upro in blood of rats in each group: Compared with normal group,Scr,BUN and 24 h Upro in each group increased significantly after modeling(P < 0.01);Scr,BUN and 24 h Upro in QSG group and losartan group decreased significantly compared with model group(P < 0.01);Scr,BUN and 24 h Upro in QSG high group decreased significantly compared with losartan group(P < 0.01);Scr,BUN and 24 h Upro in QSG high group decreased significantly compared with losartan group(P < 0.01).There was statistical significance(P < 0.01 or P < 0.05);the Scr,BUN and 24 h Upro of QSG group were lower than those of high,middle and low groups(P < 0.01 or P < 0.05).3.The expression of P-selectin/PSGL-1 protein in rats of each group(Western blot method): Compared with the normal group,the relative expression of P-selectin and PSGL-1 protein in the model group was significantly higher(P<0.01);compared with the model group,the expression of P-selectin and PSGL-1 protein in each dose group of QSG and losartan group was significantly lower(P<0.01).Compared with losartan group,the expression of P-selectin and P SGL-1 protein in QSG group was significantly lower(P < 0.05).Compared with each group,the expression of P-selectin and P SGL-1 protein in the high group of QSG decreased significantly(P <0.01).4.The expression of P-selectin/PSGL-1 in rats of each group(RT-PCR): Compared with the normal group,the relative expression levels of P-selectin and PSGL-1 in the model group were significantly higher(P< 0.01);compared with the model group,the expression levels of P-selectin and PSGL-1 in each dose group of QSG and losartan group were significantly lower(P< 0.01 or P< 0.05).Compared with losartan group,the expression levels of P-selectin and PSGL-1 in high-dose group of QSG were significantly lower(P<0.01),Compared with losartan group,the expression of P-selectin and PSGL-1 protein in high-dose Qingshen Granule group decreased significantly(P<0.01).The expression of P-selectin protein in low-dose QSG increased significantly(P<0.05),and the expression of PSGL-1 protein was not significantly different from that in losartan group(P>0.05).The expression of P-selectin and PSGL-1 protein in middle-dose QSG was not significantly different from that in losartan group(P>0.05).Compared with the three groups,the expression of P-selectin and PSGL-1 protein in the high dose group of QSG was the lowest(P<0.01).5.Pathological changes of the kidneys of rats in each group: The glomeruli of the normal group were intact,without degeneration,necrosis,tubular type,normal tubular structure,no inflammation and fibrosis in the interstitium.Compared with the normal group,the size and shape of glomerulus in the model group were different,mesangial cell proliferation,matrix increase,and partial focal glomerulosclerosis were observed.Renal tubular epithelial cells were exfoliated,tubular dilatation was obvious,interstitial inflammatory infiltration and fibrosis were obvious.The degree of glomerular mesangial hyperplasia,basement membrane thickening,tubular atrophy,interstitial inflammatory infiltration and fibrosis in each treatment group were milder than those in the model group,and the lesion in the high group of QSG was the lightest.Conclusion:1.P-selectin and PSGL-1 participate in the process of renal fibrosis in 5/6nephrectomy rats.2.QSG can reduce blood Scr,BUN and 24-hour urinary protein in 5/6 nephrectomy renal fibrosis rats.3.QSG can reduce the protein and m RNA expression of P-selectin and PSGL-1,and reduce the degree of renal fibrosis.4.QSG can significantly alleviate the degree of pathological changes of kidney tissue in 5/6 nephrectomy model rats,and then play a role in delaying renal fibrosis. |
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