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目的:探讨活血化瘀通络中药对糖尿病肾病大鼠肾小管间质纤维化的影响,分析中药在肾小管损伤及间质纤维化过程中的肾保护作用及可能的作用机制。方法:研究时间为2015年1月—2015年12月,选择健康雄性SD大鼠60只,所有大鼠给予自由饮水进食适应1周,随机分组为正常组、模型组、活血化瘀通络组,每组大鼠20只,模型组、活血化瘀通络组行大剂量注射链脲佐菌素一次性腹腔注射建立糖尿病肾病模型,活血化瘀通络组造模后给予活血化瘀通络中药处理,观察与记录肾小管间质纤维化的变化。结果:正常组大鼠一般状态良好,模型组大鼠出现了明显的多尿、消瘦、多饮、多食症状;与模型组相比,活血化瘀通络组的大鼠一般情况好转。与正常组相比,模型组24 h尿蛋白定量明显增多(P<0.05),与模型组相比活血化瘀通络组24 h尿蛋白定量明显减少(P<0.05)。病理学显示正常组大鼠肾小球结构完整清晰;模型组大鼠:肾小球的毛细血管球肥大,基底膜增厚;与模型组相比,活血化瘀通络组的大鼠肾小球病理改变较轻。免疫组化显示正常组AngII和AT1R在大鼠肾脏的表达主要位于肾小管内,与正常组相比,模型组、活血化瘀通络组的AngII和AT1R表达明显增加(P<0.05);与模型组相比,活血化瘀通络组的AngII和AT1R表达明显降低(P<0.05)。结论:活血化瘀通络中药可以改善糖尿病肾病大鼠的一般情况,减少糖尿病肾病大鼠尿蛋白的排泄,减少肾脏组织中AngII和AT1R的表达,减轻肾功能的损伤,从而减缓对于肾小管间质纤维化的影响。
Objective: To investigate the effect of traditional Chinese medicine for promoting blood circulation to remove blood stasis on tubulointerstitial fibrosis in rats with diabetic nephropathy and to explore the renal protective effect of traditional Chinese medicine on tubulointerstitial injury and interstitial fibrosis and its possible mechanism. Methods: The study was conducted from January 2015 to December 2015. Sixty healthy male SD rats were selected and all rats were given free access to drinking water for 1 week. The rats were randomly divided into normal group, model group, blood-activating and stasis-clearing group , 20 rats in each group. The model group and Huoxue Huayu Tongluo group were given high-dose streptozotocin injection to establish the model of diabetic nephropathy. The models of promoting blood circulation to remove stasis and blood stasis Chinese medicine treatment, observation and recording of tubulointerstitial fibrosis changes. Results: The rats in normal group were generally in good condition. The rats in the model group developed obvious symptoms of polyuria, weight loss, drinking and eating more. Compared with the model group, the general condition of the rats in activating blood circulation and removing stasis group was improved. Compared with the normal group, 24 h urinary protein in the model group increased significantly (P <0.05), and 24 h urinary protein in the Huoxue Huayu Tongluo group was significantly decreased (P <0.05) compared with the model group. The histopathology showed that the structure of glomerulus of rats in normal group was intact and clear. In model group, the glomerular capillaries hypertrophy and basement membrane thickening. Compared with model group, Ball pathological changes lighter. Immunohistochemistry showed that the expressions of Angll and AT1R in the normal kidneys were mainly located in the renal tubules. Compared with the normal group, the expressions of Angll and AT1R in the model group and the Huoxue Huayu Tongluo group were significantly increased (P <0.05); and Compared with model group, the expression of Angll and AT1R in Huoxue Huayu Tongluo group was significantly lower (P <0.05). Conclusion: Traditional Chinese medicine can improve the general condition of diabetic nephropathy rats, reduce urinary excretion of diabetic nephropathy rats, reduce the expression of AngII and AT1R in kidney tissues, reduce the damage of renal function, Effect of fibrosis.