| Objective: To probe into the serum FSP-1,VIM and urine FSP-1 levels in damp heat syndrome in patients with chronic renal failure and the effects of Qingshen granules.Methods: 1.According to the diagnostic criteria and inclusion criteria for chronic renal failure,64 patients with CRF damp-heat syndrome were randomly divided into a control group(basic treatment of western medicine + enema of Chinese medicine)and 32 cases of Qingshen granule group using random numbers generated by SPSS 26.0(Western medicine basic treatment + Chinese medicine enema + Qingshen granule)32 cases,the course of treatment was 12 weeks,and the actual number of cases was 60 cases.Another 30 cases in the normal group(specimen from our hospital health management center,used to detect serum FSP-1,VIM and urine FSP-1 content).2.To observe the serum FSP-1,VIM and urine FSP-1 levels of the Qingshen Granule group and the control group before and after treatment;3.Observe the clinical efficacy of the Qingshen Granule group and the control group,TCM syndrome scores,Scr,and e GFR to assess the clinical efficacy of Qingshen granules.All data were analyzed with SPSS26.0.Results: 1.Clinical efficacy: The difference between the total effective rate of qingshen granules group(80.00%)and the rate of the control group(60.00%)is striking(P<0.05).TCM syndrome efficacy: the total effective rate of qingshen granule group(86.67%)and the control group(53.33%),with notable difference(P <0.01).2.TCM syndrome score: Before treatment,there was no otherness between the two groups(P >0.05).12 weeks later,the score of qingshen granule group was distinctly reduced(P <0.01),while the score of control group was not significantly lower than that before treatment(P >0.05).The improvement of qingshen granule group was superior to the score of another group(P <0.01).3.Comparison of Scr and e GFR levels:There was no visible discrepancy between the two groups before treatment(P >0.05).After 12 weeks of continuous administration,Scrin Qingshen granules group decreased significantly(P <0.05)and e GFR increased significantly(P <0.01).In the control group,Scr showed a decreasing trend and e GFR level increased slightly compared with that before treatment,they has no statistical difference(P >0.05).Scr of Qingshen granules group cutted compared with another group(P<0.05)and e GFR increased(P<0.05).4.Comparison of serum fsp-1 and VIM levels:fusion protein expression quantity of serum FSP-1 and VIM in CRF patients with damp-heat syndrome grow in number than those of the normal group(P<0.01).Renal granule group and the control group had no differentiation(P>0.05).When 12 weeks passed,compared with before treatment,both Qingshen granule group and the control group has dropped remarkably(P<0.01),and the qingshen granule group had a significant decrease compared with the control group(P<0.01).5.Urine FSP-1 level comparison: The urine FSP-1 level of patients with CKD damp-heat syndrome tendency increase obviously than FSP-1 level of the normal group(P <0.01);Qingshen granule group compared with control group,there was no statistically significant difference(P> 0.05);Treatment 12 After one week,the Qingshen Granule group and the control group had a significant decrease compared to the same group before treatment(P <0.01),and the Qingshen Granule group had a significant decrease compared with the control group at the same period(P <0.01).6.Safety analysis: after 12 weeks of drug intervention,there was no significant change in the safety indexes of Qingshen granules group.Conclusion: 1.Compared with the normal group,the serum fsp-1 level,VIM level and urine fsp-1 level of CRF patients were increased(P<0.01).2.Qingshen granules can significantly improve the clinical manifestations of patients with damp-heat syndrome of CRF and have a protective effect on renal function.3.Qingshen granules can reduce serum fsp-1,VIM and urine fsp-1 levels in patients with CRF syndrome.4.No adverse drug reactions occurred during the use of Qingshen granules in this study,indicating that the drug was safe.Objective: To observe the expression of Fibroblast specific protein-1(FSP-1)and ?-smooth muscle actin(?-SMA)in the kidney tissue of 5/6 nephrectomized rats.Level,revealing the relationship between endothelia-to-mesenchymal transition(End MT)and renal fibrosis,and the intervention effect of Qingshen granules.Methods: 72 male SD rats with weight of 200±20g were selected and randomly divided into sham operation group,model group,high,medium and low dose Qingshen granules group and losartan group,with 12 rats in each group.In the sham operation group,12 rats were stripped of renal capsule without renal tissue resection.The rats in each group except the sham operation group were constructed with 5/6 nephrectomy model.Sham operation group and model group were fed with normal saline;the valsartan group was intragastrically administered with valsartan suspension;The other three groups were given the corresponding dose of Qingshen granule aqueous solution in order,and rats were sacrificed after 12 weeks.Observe the general condition of rats,measure Scr,BUN,24 h urinary protein quantification(24h Upro),estimate rat endogenous creatinine clearance(Ccr);Reverse Transcription-Polymerase Chain Reaction,RT-PCR)method,immunohistochemical method and immunofluorescence method to detect the expression of FSP-1 and ?-SMA in kidney tissue;hematoxylin eosin(HE),MASSON,periodine The renal pathological changes were observed by Periodic Acid-Schiff(PAS)staining.Results: 1.Comparison of Scr,BUN,24 h Upro and Ccr: compared with the sham operation group,Scr,BUN and 24 h Upro in other groups increased,and Ccr decreased,with significant differences(P <0.01).Compared with the drug intervention group,Scr,BUN and 24 h Upro decreased and Ccr increased in the model group(P <0.01).The levels of Scr,BUN and 24 h Upro in the high-dose Qingshen granules group were lower than those in the losartan group,and the Ccr was higher than that in the losartan group(P <0.01 or P <0.05).Comparison among the three groups showed that Scr,BUN and 24 h Upro significantly decreased and Ccr significantly increased in the high-dose group(P < 0.01 or P < 0.05).2.FSP-1 and ?-SMA m RNA expression(RT-PCR): compared with the sham operation group,the expression of FSP-1 and ?-SMA m RNA in the renal tissues of 5/6 nephrectomy rats in each group was significantly increased(P<0.01).Compared with the model group,the m RNA expression of FSP-1 and ?-SMA in each drug intervention group decreased to different degrees(P<0.01 or P<0.05).Compared with the losartan group,the expression of FSP-1 and ?-SMA m RNA in the high-dose Qingshen granule group was decreased(P<0.05).The lowest range of Qingshen granules in the high-dose group was the largest(P<0.05).3.Immunohistochemical detection results showed that: FSP-1 and a-SMA were mainly expressed in renal tubular endothelial cells and epithelial cells in sham operation group.The expression of FSP-1 in model group increased significantly.The positive expression of FSP-1 and a-SMA in losartan group and Qingshen granule groups decreased to different degrees compared with model group.Semi-quantitative analysis showed that the expression of FSP-1 and a-SMA in model group was significantly higher than that in sham operation group(P < 0.01).Compared with the model group,the expressions of FSP-1 and a-SMA in losartan group and Qingshen granule groups increased significantly(P < 0.01).The FSP-1 and a-SMA expressions in the high dose group were the least(P < 0.01)compared with the other dose groups.Compared with losartan group,the expression of FSP-1 and a-SMA protein in rats in high dose group of Qingshen granules was significantly reduced(P<0.05).4.Immunofluorescence results of CD31+a-SMA+FSP-1 showed that FSP-1 was almost not expressed in the sham operation group,while A-SMA was weakly expressed in the sham operation group.FSP-1 showed bright orange fluorescence in the model group and a-SMA showed bright red fluorescence in the model group.The fluorescence intensity of FSP-1 and a-SMA in each dose group of Qingshen granules and losartan group decreased to different degrees.5.Pathological and morphological changes of the kidneys of rats: No obvious pathological changes were observed in the kidney tissue of rats in the sham operation group.In the model group,the glomerular structure was incomplete,and different degrees of glomerulosclerosis were observed.The epithelial cells of the renal tubules were exfoliated,the lumen was dilated,the epithelial cells were vacuolized and deformed,and the stroma showed obvious inflammatory infiltration and blue-dyed collagen fibers.Compared with the model group,all the above pathological changes were improved in the drug intervention group,and the group with high dose of Qingshen granules had the lightest lesions.Conclusion:1.Qingshen granules can significantly reduce the blood Scr,BUN,24-hour urine protein quantification in 5/6 nephrectomized rats,and increase Ccr in rat-s.2.In the model group,the expression of FSP-1 and ?-SMA in the endothelial cells of the renal tissues of the rats was significantly enhanced,indicating that End MT occurred in the renal tissues of the 5/6 nephrectomy rats.3.Qingshen granules can down-regulate the expression of FSP-1 and?-SMA in renal tissue,and reduce the degree of renal fibrosis.4.Qingshen granule can obviously reduce the pathological damage of kidney in 5/6 nephrectomized rats,delay the progress of renal fibrosis,and reduce E-nd MT of renal tissue is one of its mechanisms. |
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