摘要
目的观察补虚消癥汤缓解慢性肾脏病(CKD)3期中医辨证属脾肾气虚兼有血瘀证患者临床疗效及含药血清对大鼠肾小球系膜细胞基质金属蛋白酶2(MMP-2)及基质金属蛋白酶组织抑制剂2(TIMP-2)表达的影响,探讨其可能存在的药用机制。方法随机将60例CKD 3期患者分为补虚消癥汤治疗组(n=30)和对照组(n=30),比较两组患者治疗前后血红蛋白、肾功能指标、24h尿蛋白定量的变化。制取补虚消癥汤含药血清,采用肿瘤坏死因子-α(tumor necrosis factor,TNF-α)诱导大鼠肾小球系膜细胞发生增生。观察各组间MMP-2、TIMP-2mRNA表达的情况。结果治疗组血肌酐(Scr)有降低趋势,但差异无统计学意义(P>0.05),而对照组Scr较治疗前明显升高(P<0.05),治疗后治疗组肾小球滤过率(GFR)值较对照组明显改善(P<0.05);治疗组尿酸(UA)水平较对照组明显降低(P<0.05);两组治疗前后的血红蛋白水平均无明显升高(P>0.05);治疗组24h尿蛋白定量较对照组明显降低(P<0.05)。补虚消癥汤能有效提升MMP-2/TIMP-2的比值,高、中浓度组与对照组比较差异有统计学意义(P<0.05)。结论补虚消癥汤能通过影响MMP-2、TIMP-2等的表达,缓解肾小球损伤,延缓肾小球硬化,从而有效延缓CKD患者肾功能进展。
Objective To observe the clinical effect of ＂Buxu xiaozheng decoction＂ in patients with chronic kidney disease （CKD） at 3 stage who belongs to spleen and kidney deficiency and blood stasis syndrome and study the effect of this decoction on rat mesangial cell Matrix metalloproteinase（MMPs） and tissue inhibitor of metalloproteinase（TIMPs） expression,and to discuss the possible therapeutic mechanism.Methods （1） Sixty patients with CKD at 3 stage were randomly divided into treatment group （n =30） which was treated by＂ Buxu xiaozheng decoction＂ and control group （n =30）.The indexes of blood routine and renal function,and the 24h urine protein quantitation were observed.（2） Medicated serum of ＂ Buxu xiaozheng decoction＂ was prepared Tumor Necrosis Factor（TNF-α） was used as a stimulating factor to rat mesangial cells to proliferate.To observe the expression situation of MMP-2 and TIMP-2mRNA among the groups.Results （1） After treatment the level of Scr in treatment group decreased compared with before treatment,but with no statistical difference （P ＞ 0.05）,while the level of Scr in control group increased obviously （P ＜ 0.01）.The level of GFR of treatment group was higher than that of control group （P ＜ 0.05）,and the level of UA in treatment group decreased obviously compared with control group after treatment （P ＜ 0.05）.On the aspect of improving anemia,the level of hemoglobin had no significant difference between two groups before and after treatment（P ＞ 0.05）.The level of 24h urine protein quantitation in treatment group decreased obviously compared with control group （P ＜ 0.05）.（2） Buxu xiaozheng decoction could effectively enhance the MMP-2/TIMP-2 ratio and the differences in high and medium concentration group were statistically significant compared with control group （P ＜ 0.05）.Conclusion By effecting the expressions of MMP-2 and TIMP-2,Buxu xiaozheng decoction could alleviate glomerular injury,delay glomerular sclerosis
出处
《医学研究杂志》
2014年第11期84-88,共5页
Journal of Medical Research
基金
宁波市科技计划项目(2012A610222)
