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目的通过Ig A肾病大鼠模型,研究麻黄连翘赤小豆汤对Ig A肾病大鼠的治疗作用和机制。方法雄性SD大鼠60只,分为5组,即正常组、模型组、氯沙坦钾组、伪麻黄碱组、麻黄连翘赤小豆汤组。除正常组外,其余各组采用牛血清白蛋白(BSA)加脂多糖(LPS)加四氯化碳(CCl_4)复合免疫法建立SD大鼠实验性Ig A肾病模型。各组采取相应干预措施。观察大鼠24 h蛋白定量、肾功能、肾脏病理情况,采用酶联免疫(ELISA)法检测相关细胞因子的变化。结果(1)与模型组比较,伪麻黄碱组、麻黄连翘赤小豆汤组、氯沙坦钾组的尿蛋白差异有统计学意义(P<0.05),说明伪麻黄碱、麻黄连翘赤小豆汤、氯沙坦钾能够明显降低Ig A肾病大鼠蛋白尿。(2)与模型组比较,伪麻黄碱组、麻黄连翘赤小豆汤组大鼠血清肌酐(Scr)、尿素氮(BUN)差异有统计学意义(P<0.05),说明伪麻黄碱和麻黄连翘赤小豆汤能够明显降低Ig A肾病大鼠血清Scr、BUN。(3)与模型组比较,伪麻黄碱组、麻黄连翘赤小豆汤组、氯沙坦钾组的血清IL-21差异有统计学意义(P<0.05),说明伪麻黄碱、麻黄连翘赤小豆汤组、氯沙坦钾能够明显降低Ig A肾病大鼠血清IL-21。(4)模型组肾小球系膜细胞轻度增生,肾小管可见嗜酸性变,肾小管上皮细胞有肿胀。麻黄连翘赤小豆汤组、氯沙坦钾组、伪麻黄碱组的病理改变较模型组改变程度轻。结论麻黄连翘赤小豆汤能够明显降低Ig A肾病大鼠的蛋白尿以及血清肌酐和尿素氮,保护肾功能,其机制与降低Ig A肾病大鼠血清IL-21的水平,调控IL-21参与的免疫反应有关。伪麻黄碱作为本方的主要有效成分表现出与中药复方相同的作用。
Objective To study the therapeutic effect and mechanism of ephedra forsythia Chinensis decoction on IgA nephropathy rat model by IgA nephropathy rat model. Methods Sixty male Sprague-Dawley rats were randomly divided into five groups: normal group, model group, losartan potassium group, pseudoephedrine group and ephedra forsythia Chi Xia bean soup group. Except for the normal group, experimental rats with IgA nephropathy were established by BSA plus lipopolysaccharide (LPS) plus CCl 4 immunization. Each group to take appropriate interventions. The protein expression of 24 h, renal function and renal pathology were observed. The changes of related cytokines were detected by enzyme-linked immunosorbent assay (ELISA). Results (1) Compared with the model group, the urinary protein of pseudoephedrine group, ephedrine Chixiaodou soup group and losartan potassium group had statistical significance (P <0.05), which indicated that pseudoephedrine, ephedrine forsythiaside, Potassium can significantly reduce proteinuria in rats with IgA nephropathy. (2) Compared with model group, the difference of serum creatinine (Scr) and blood urea nitrogen (BUN) between pseudoephedrine group and ephedra forsythia Chi Xiao Dou Tang group was statistically significant (P <0.05), which indicated that pseudoephedrine and ephedra forsythia Significantly reduce serum IgA nephropathy rats Scr, BUN. (3) Compared with model group, the difference of serum IL-21 in pseudoephedrine group, ephedra forsythia chidexuetang decoction group and losartan potassium group was statistically significant (P <0.05), which indicated that pseudoephedrine, ephedrine forsythia chidexiao decoction group, Sartan potassium can significantly reduce the IgA nephropathy rat serum IL-21. (4) Glomerular mesangial cells in the model group were mildly hyperplastic, with eosinophilic changes in renal tubules and tubular epithelial cells with swelling. Ephedra forsythia Chixiaodou soup group, losartan potassium group, pseudoephedrine group than the model group pathological changes in light. Conclusion Mahuang Lianqiao Chixiaodou Decoction can significantly reduce proteinuria, serum creatinine and blood urea nitrogen in rats with IgA nephropathy and protect renal function. Its mechanism is related to the decrease of serum IL-21 level in IgA nephropathy rats and the regulation of IL-21 Immune response related. Pseudoephedrine as the main active ingredient shows the same role with traditional Chinese medicine compound.