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目的从氧化应激途径探讨中药复方糖肾煎治疗2型糖尿病肾病的作用机制。方法采用单肾切除+高脂饲料+小剂量链脲佐菌素(STZ)腹腔注射,并结合行为干预方式制备2型糖尿病肾病气阴两虚病证结合大鼠模型,随机分为模型组、糖肾煎组和贝那普利组,另设假手术组。观察各组大鼠一般状态及体质量、空腹血糖(FBG)、负荷后血糖(P2h BG)、空腹血清胰岛素(FINS)、负荷后血清胰岛素(P2h INS)、胰岛素抵抗指数(HOMA-IR)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)、24h尿白蛋白定量、尿β_2微球蛋白、血尿素氮(BUN)、血肌酐(Cr)、血清及肾皮质谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)及丙二醛(MDA)等指标,光镜下观察肾组织病理。结果 (1)与假手术组比较,模型组大鼠一般状态较差,且体质量、FBG、P2h BG、FINS、P2h INS、HOMA-IR、TC、TG、HDL-c、LDL-c、24h尿白蛋白定量、尿β_2微球蛋白、血清及肾皮质GSH-Px、SOD及MDA均有显著变化(P<0.01);(2)糖肾煎组一般状态较好,BUN、Cr无明显变化(P>0.05),余指标均有所改善(P<0.01或P<0.05);贝那普利组24h尿白蛋白定量、尿β_2微球蛋白、血清及肾皮质GSH-Px、SOD及MDA等指标有所改善(P<0.01或P<0.05),而余指标无明显变化(P>0.05);(3)糖肾煎组与贝那普利组比较,HOMA-IR明显降低(P<0.01),TC明显降低(P<0.05),24h尿白蛋白定量及尿β_2微球蛋白有减少但无统计学意义(P>0.05);(4)光镜结果:模型组肾组织出现了较明显的病理变化,而糖肾煎组及贝那普利组病变程度有所减轻。结论中药复方糖肾煎对2型糖尿病肾病气阴两虚型大鼠能调节糖脂代谢、减轻胰岛素抵抗、降低尿白蛋白及尿β_2微球蛋白、改善肾组织病理,其机制可能是通过改善氧化应激途径来实现的。
Objective To explore the mechanism of Chinese medicine compound Tangshen Jian on type 2 diabetic nephropathy from oxidative stress pathway. Methods Single nephrectomy + high-fat diet + low-dose streptozotocin (STZ) intraperitoneal injection combined with behavioral intervention in the preparation of type 2 diabetic nephropathy Qi and Yin Deficiency Syndrome combined rat model were randomly divided into model group, Sugar kidney fried group and benazepril group, another set of sham operation group. The general state and body weight, fasting blood glucose (FBG), P2h BG, FINS, P2h INS, HOMA-IR, Cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c), 24h urinary albumin, urine β_2 microglobulin, blood urea nitrogen BUN, serum creatinine, GSH-Px, SOD and MDA in serum and renal cortex, Histopathology. Results Compared with the sham operation group, the rats in the model group were generally in poor condition and the body weight, FBG, P2h BG, FINS, P2h INS, HOMA-IR, TC, TG, HDL-c and LDL-c Urinary albumin, urinary β_2 microglobulin, serum and renal cortex GSH-Px, SOD and MDA were significantly changed (P <0.01); (2) Tangjian decoction group generally good state, BUN, Cr no significant change (P <0.05 or P <0.01 or P <0.05). 24h urine albumin, urinary β_2 microglobulin, GSH-Px, SOD and MDA in serum and renal cortex in benazepril group were significantly higher than those in control group (P <0.01 or P <0.05), while the remaining indexes did not change significantly (P> 0.05). (3) Compared with benazepril group, HOMA-IR decreased significantly (P < (P <0.01), TC was significantly lower (P <0.05), 24h urinary albumin and urinary β_2 microglobulin was reduced but not statistically significant (P> 0.05); (4) Light microscopy results: Significant pathological changes, and sugar kidney fried group and benazepril group lesions reduced. Conclusion Chinese medicine compound Tangshen Decoction on type 2 diabetic nephropathy Qi and Yin Deficiency rats can regulate glucose and lipid metabolism, reduce insulin resistance, reduce urinary albumin and urinary β 2 microglobulin, improve renal pathology, the mechanism may be improved Oxidative stress pathway to achieve.