張明柱等

[摘要] 目的 探討健脾滋腎開郁散結(jié)中藥對(duì)鏈脲佐菌素（STZ）誘導(dǎo)糖尿病腎?。―N）大鼠腎臟病變的影響。 方法 采用高脂高糖飲食加STZ腹腔注射方法建立DN大鼠模型，實(shí)驗(yàn)設(shè)正常對(duì)照組、模型組、健脾滋腎開郁散結(jié)中藥組（中藥組）和鹽酸苯那普利加格列喹酮組（西藥組），每組10只。給藥后每4周末尾靜脈取血，測(cè)定各組大鼠的血糖；連續(xù)給藥12周后，代謝籠收集24 h尿液，檢測(cè)24 h尿蛋白定量，處死大鼠取血清檢測(cè)尿素氮（BUN）、肌酐（Scr）、三酰甘油（TG）、膽固醇（TC）、白蛋白（Alb）；另取腎臟組織制石蠟切片行蘇木精-伊紅（HE）、過(guò)碘酸希夫（PAS）染色，觀察腎組織的病理改變。 結(jié)果 實(shí)驗(yàn)結(jié)束時(shí)模型組大鼠體重較正常對(duì)照組明顯降低（P < 0.01），血糖持續(xù)升高，至12周末，血糖升至（31.67±5.27）mmol/L，24 h尿蛋白及血清BUN、Scr、TC、TG水平顯著升高，與正常對(duì)照組比較差異有高度統(tǒng)計(jì)學(xué)意義（P < 0.01），其中24 h尿蛋白定量升高至（56.75±10.08）mg/24 h，血清Scr升至（42.63±14.49）mmol/L；光鏡下顯示腎組織病理變化：腎小球系膜基質(zhì)增多，部分腎小球系膜細(xì)胞增生，毛細(xì)血管腔變窄，腎小管上皮細(xì)胞水腫，可見空泡變性，腎間質(zhì)可見炎癥細(xì)胞增多。與模型組比較，中藥組大鼠體重顯著升高（P < 0.05），血糖和24 h尿蛋白定量明顯降低（P < 0.05或P < 0.01），其中血糖從第8周即開始下降，至12周末降至（22.10±3.30）mmol/L；血清BUN、Scr、TC、TG顯著降低（P < 0.05或P < 0.01），Alb顯著升高（P < 0.05），其中血清Scr降至（19.63±4.37）mmol/L。腎組織病理?yè)p害亦明顯減輕，腎小球系膜基質(zhì)減少，系膜細(xì)胞增生不明顯，間質(zhì)少見炎癥細(xì)胞浸潤(rùn)。中藥組與西藥組差異均無(wú)統(tǒng)計(jì)學(xué)意義（P > 0.05）。 結(jié)論 健脾滋腎開郁散結(jié)中藥干預(yù)治療后可降低DN大鼠尿蛋白，改善腎臟功能，在DN的腎損傷過(guò)程中具有保護(hù)作用。

[關(guān)鍵詞] 健脾滋腎開郁散結(jié)；中醫(yī)藥；糖尿病腎??；腎組織病理學(xué)；大鼠

[中圖分類號(hào)] R587；R692.3 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1673-7210（2015）05（b）-0022-05

Protective effects of Chinese medicine of nourishing spleen and kidney， eliminating stagnation on kidney injury in rats with diabetic nephropathy

ZHANG Mingzhu1 ZHANG Shuping2 LI Wang3 JIN Cunting4 ZHANG Xiaoli5 LI Yingchun2 ZHAO Dongwei2

1.Hebei North University， Hebei Province， Zhangjiakou 075000， China； 2.TCM College， Hebei North University， Hebei Province， Zhangjiakou 075000， China； 3.Academic Affairs Office， Hebei North University， Hebei Province， Zhangjiakou 075000， China； 4.College of Basic Medicine， Heibei North University， Hebei Province， Zhangjiakou 075000， China； 5.Life Sciences Center， Hebei North University， Hebei Province， Zhangjiakou 075000， China

[Abstract] Objective To explore the protective effect of nourishing spleen and kidney， eliminating stagnation on kidney injury in rats with Streptozocin （STZ） induced diabetic nephropathy （DN）. Methods High fat and high sugar forage and injection of STZ to abdominal cavity were adopted to establish DN rats model. The animals were assigned randomly to normal control group， model group， therapeutic group treated with decoction of nourishing spleen and kidney， eliminating stagnation （referred to as Chinese herbs group） and therapeutic group treated with Lotensin and Gliguidone （referred to as western medicine group）， with 10 rats per group. Blood was drawn from vein to test blood glucose of rats from each group every 4 weeks； after 12 weeks' successive administration， 24 h urine was collected by metabolism cage to detect 24 h urine protein， and rats were killed to draw blood serum to test blood urea nitrogen （BUN）， serum creatinine （Scr）， triglyceride （TG）， total cholesterol （TC） and albumin （Alb）； kidney tissue was used to make paraffin section to observe renal pathological change by adopting HE and PAS staining. Results As for the rats from model group at the end of the experiment， the weight obviously decreased （P < 0.01） compared with that from normal control group； the blood glucose reached to （31.67±5.27） mmol/L after 12 weeks' continuous increasing； the levels of 24 h urine protein， BUN， Scr， TC and TG significantly increased compared with those from normal control group （P < 0.01）， in which 24 h urine protein increased to （56.75±10.08） mg/24 h and serum creatinine to （42.63±14.49） mmol/L； under optical microscope， the pathological change of renal tissue included glomerular mesangial matrix increase with part of the mesangial cell proliferation， lumen of capillary constriction， hydrops of renal tubular epithelial cell， vacuolar degeneration and more inflammatory cells in renal interstitium. Compared with model group， the weight of Chinese herbs group increased significantly （P < 0.05）； the blood glucose and 24 h urine protein obviously decreased （P < 0.05 or P < 0.01）， in which， the blood glucose started to decrease since the 8th week and dropped to （22.10±3.30） mmol/L at the end of the 12th week； the levels of BUN， Scr， TC and TG significantly decreased （P < 0.05 or P < 0.01）， Alb increased significantly （P < 0.05）， with serum creatinine decreasing to （19.63±4.37） mmol/L； the pathological damage of renal tissue was significantly alleviated， including glomerular mesangial matrix decrease， with slight mesangial cell proliferation and interstitial inflammation. There was no significant difference between two therapeutic groups （P > 0.05）. Conclusion The result of our research shows that treatment with nourishing spleen and kidney， eliminating stagnation can reduce DN rats' urine protein， improve its renal function and protect kidney during diabetic-induced kidney injury.