【作者】 李淑菊；

【导师】 张琪；

【作者基本信息】 黑龙江中医药大学 ， 中医内科学， 2004， 博士

【摘要】 目的：通过临床及实验研究观察肾功能、血常规、细胞外基质、细胞因子的表达情况，探讨肾衰胶囊延缓慢性肾衰竭进展及抗肾间质纤维化的机理。方法：74例氮质血症期慢性肾衰竭患者随机分为肾衰胶囊治疗组和尿毒清对照组，观察血清BUN、Scr、Ccr、Hb、RBC、ColⅣ、PCⅢ、LN的变化，尿蛋白、β₂-微球蛋白及临床症状和体征的改善情况。实验研究采用腺嘌呤致慢性肾衰竭肾间质纤维化模型，观察血清BUN、Scr、ColⅣ、PCⅢ、FN的变化；运用免疫组化二步法观察肾组织中Ⅰ、Ⅲ型胶原蛋白的表达情况；采用原位杂交法检测肾组织CTGFmRNA的表达情况；利用半定量RT-PCR检测肾组织内TGF-β₁mRNA表达水平。结果：肾衰胶囊治疗后CRF患者BUN、Scr下降，Ccr上升，Hb、RBC均较疗前升高，血清ColⅣ、PCⅢ、LN下降，尿蛋白、β₂-微球蛋白下降，与对照组比有显著性差异，临床症状和体征改善明显。肾衰胶囊降低大鼠BUN、Scr，减弱肾组织Ⅰ、Ⅲ型胶原蛋白的表达，抑制CTGFmRNA、TGF-β₁mRNA的表达水平，降低血清ColⅣ、PCⅢ的含量。结论：肾衰胶囊通过降低血清BUN、Scr，升高Ccr，改善肾功能，从而延缓慢性肾衰竭进展；通过抑制肾组织CTGFmRNA、TGF-β₂mRNA的表达，减少细胞外基质Ⅰ、Ⅲ型胶原、ColⅣ、LN的沉积，从而干预肾间质纤维化。更多还原

【Abstract】 Objective: To investigate the mechanism of Shenshuai Capsule delaying evolve of chronic renal failure and interstitial renal fibrosis by observing the renal function, routine examination of blood, extracellular matrix and cytokine expression in clinical and experimental study. Methods: Seventy four patients with chronic renal failure in azotemia period were divided randomly into treated group and control group which were respectively treated with Shenshuai Capsule and Uremic Clearance Granule. We observed the changes of BUN, Scr, Hb, RBC, ColIV, PCIII, LN, uPro, 2-m in blood serum and improvement of clinical symptom and physical signs. In the experimental study, we took the model of interstitial renal fibrosis in chronic renal failure caused by adenine. Changes of BUN, Scr, ColIV, PCIII, FN in blood serum were observed; expression of I, III type collagen protein, CTGFmRNA and TGF- 1mRNA in nephridial tissue were examined respectively by immunohistochemistry with two steps, in situ hybridization and semi-quantitative RT-PCR. Results: After treated by Shenshuai Capsule, BUN and Scr of patients of CRF declined, Ccr, HB and RBC raised, ColIV, PCIII, LN, uPro, 2-m in blood serum declined which had obvious difference with control group. The clinical symptoms and phydical were obviously improved. Shenshuai Capsule could reduce BUN, Scr in rat blood, and relieve I ,m type collagen protein expression in nephridil tissue. It could also inhibite the CTGFmRNA and TGF- 1mRNA expression and reduce the content of ColIV, PCIII in blood serum. Conclusions: Shenshuai Capsule can improve renal function and delay chronic renal failure by reducing BUN, Scr and rising Ccr inblood serum. It can interfere in interstitial renal fibrosis by inhibiting the CTGFmRNA, TGF- 1mRNA expressions in nephridial tissue and reducing I ,III type collagen protein in extracellular stroma and deposit of ColIV, LN.更多还原