海南医科大学学报

目的:探讨当归芍药散加味黄芪对肾病综合征(nephrotic syndrome,NS)大鼠的治疗效果。方法:尾静脉注射阿霉素建立NS大鼠模型。建模成功大鼠分为模型组、福辛普利组、当归芍药散组、黄芪组、当归芍药散加味黄芪组,每组10只,另取10只大鼠作为正常组,连续给药4周。BCA法测定24 h尿蛋白;实验动物体组成测定分析仪测定大鼠总含水率、细胞内液含水率、细胞外液含水率;全自动生化分析仪检测血清和尿液Na+、K+、Cl-,血清尿素氮(BUN)、肌酐(Scr)、总胆固醇(TC)、甘油三酯(TG)、总蛋白(TP)、白蛋白(ALB)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)水平;苏木精伊红染色观察肾组织形态。结果:与模型组比较,当归芍药散加味黄芪组尿蛋白显著降低(P<0.01);总含水率、细胞外液含水率显著升高,细胞内液含水率显著降低(P<0.01);尿液Na+、K+、Cl-显著降低,血清Na+、K+、Cl-显著升高(P<0.01);血清BUN、Scr、TC、TG显著降低(P<0.01),TP和ALB显著升高(P<0.01),IgM和IgG显著升高(P<0.01);病理组织学显示肾组织病变明显减轻。组间比较发现当归芍药散加味黄芪组较当归芍药散组血清Na+明显上升、尿液Na+显著降低(P<0.01);较黄芪组血清Na+、Cl-显著上升,尿液K+显著降低(P<0.01);与当归芍药散组和黄芪组相比,当归芍药散加味黄芪组大鼠BUN、Scr、TC、TG含量降低和TP、ALB含量升高更为明显,且BUN含量显著降低(P<0.05),TP含量显著升高(P<0.01)。结论:当归芍药散加味黄芪能益气、活血、利水,可显著改善NS大鼠水肿、蛋白尿、血脂及免疫功能,与单用当归芍药散、单用黄芪相比治疗作用更优,表明当归芍药散与黄芪合用具有协同增效作用。

Objective:To determine the therapeutic effect of Danggui Shaoyao San with Huangqi on rats with nephrotic syndrome(NS). Methods:The NS rat model was established by i.v. administration of adriamycin. The rats were divided into the model group,the positive drug group(Fosinopril),the Danggui Shaoyao San group,the Huangqi group,the Danggui Shaoyao San with Huangqi group,and the control group,with 10 rats in each group. Drugs were continuously administrated for 4 weeks.BCA method was applied to measure 24 h urine protein. The total water content,extracellular water content,and intracellular water content were measured by an experimental animal body composition analyzer. An automatic biochemical analyzer was used to measure serum and urine electrolytes(Na+,K+,Cl-),blood urea nitrogen(BUN),creatinine(SCr),total cholesterol(TC),triglyceride(TG),total protein(TP),albumin(ALB),immunoglobulin M(IgM)and immunoglobulin G(IgG). Besides,hematoxylin-eosin staining was used to observe the renal morphological changes. Results:Compared with the model group,the urine protein in the Danggui Shaoyao San with Huangqi group significantly decreased(P<0.01);Total water content and intracellular water content significantly increased;extracellular water content significantly decreased(P<0.01);Urine electrolytes(Na+,K+,Cl-)were significantly decreased and serum electrolytes(Na+,K+,Cl-)were significantly increased(P<0.01);Serum BUN,Scr,TC and TG significantly decreased(P<0.01),while TP,ALB were significantly increased(P<0.01);The levels of IgM and IgG significantly increased(P<0.01). Histopathological study showed that the pathological changes of renal tissue were alleviated. Compared with the Danggui Shaoyao San group,the Danggui Shaoyao San with Huangqi group showed a significantly higher serum Na+,and significantly lower urine Na+(P<0.01). Compared with the Huangqi group,the Danggui Shaoyao San with Huangqi group displayed a significantly higher serum Na+and Cl-,and significantly lower urine K+(P<0.01). Compared with the Danggui Shaoyao San group and the Huangqi group,the Danggui Shaoyao San with Huangqi group showed a lower BUN,Scr,TC,TG,and a more remarkable increase in TP and ALB. Besides,significantly lower BUN(P<0.05)and higher TP were noted(P<0.01). Conclusion:Based on the traditional Chinese medicine theory of invigorating Qi as well as promoting blood and water circulation,Danggui Shaoyao San with Huangqi can significantly improve the edema,proteinuria,blood lipid,and immune function of NS rats,and the effect is better than that of single administration with Danggui Shaoyao San or Huangqi. All in all,the combination of Danggui Shaoyao San and Huangqi has synergic therapeutic effect on NS.