【摘要】 目的 分析加味芪黄饮治疗糖尿病肾病（diabetic nephropathy,DN）的机制。方法 利用高脂食物联合向腹腔注入链脲佐菌素的方法建立肾病大鼠模型，按照随机原则分为4组，分别为正常组，模型组，加味芪黄饮低、高剂量组，给药组大鼠每天予加味芪黄饮400、800 mg·kg-1进行灌胃。12周后检杀，提取大鼠血液、尿液样本检测24 h尿微量白蛋白（UALB）、空腹血胰岛素（FIns）、胰岛素抵抗指数（HOMA-IR）等指标水平，观察肾脏组织病理变化，通过电子显微镜研究细胞中线粒体的变化情况，Western Blot检测肾组织中沉默信息调节因子1(SIRT1)、发动蛋白相关蛋白-1(Drp1)等蛋白表达。结果 与正常组相比，模型组大鼠24 h UALB、FIns水平及胰岛素抵抗指数均显著提高（P<0.01），说明肾小球基质开始积累，体积显著扩大及肾小管上皮组织明显受损（P<0.01）；加味芪黄饮低、高剂量组大鼠以上参数相比于模型组有所降低（P<0.05），肾组织病理受损情况相比于模型组有所改观（P<0.05），且呈剂量依赖。与正常组比较，模型组大鼠肾组织中SIRT1表达升高，Drp1表达下降（P<0.05）；加味芪黄饮低、高剂量组大鼠以上蛋白表达相比模型组都有所改善（P<0.05），并伴随给药剂量的提高，其改善态势更显著。结论 加味芪黄饮可延缓糖尿病肾病进展，可能通过减轻线粒体损伤，改善胰岛素抵抗状态发挥作用。更多还原

【Abstract】 Objective To analyze the mechanism of Jiawei Qihuang Yin（加 味 芪 黄 饮,JWQHY）in treating diabetic nephropathy(DN). Methods DN rat models were established by a high-fat diet combined with an intraperitoneal injection of streptozotocin,and were randomly classified into four groups,normal group,model group,JWQHY low-dose group and high-dose group. Mice in low-dose(400mg·kg-1)and high-dose groups(800 mg·kg-1)were treated with Jiawei Qihuang Yin by oral gavage.After 12 weeks,blood and urine samples were collected,and 24-hour urinary albumin(UALB),fasting blood glucose(FBG),fasting insulin(FIns),and insulin resistance index(HOMA-IR)were detected.The renal pathological characteristic and the changes of mitochondria in cells were observed by electron microscope. The protein expressions of silent information regulator 1(SIRT1)and dynamin-related protein 1(Drp1)were measured via Western blot. Results Compared with the normal group,remarkable increases were detected in 24-hour UALB,FIns and HOMA-IR in model group(P<0.01),suggesting an onset of glomerular mesangial matrix accumulation,volume expansion and damage to tubular epithelial tissue in renal tubular epithelial cells(P<0.01). After the interventions with JWQHY,the above parameters were decreased and the pathological damages of renal tissue were alleviated in two treatment groups in a dose dependent manner(P<0.05). An up-regulation of SIRT1 expression along with a down-regulation of Drp1 expression were observed in model group compared with normal group(P<0.05),while the expression of two proteins were improved in two treatment groups in a dose-dependent manner(P<0.05).Conclusion Application of Jiawei Qihuang Yin can delay the progression of DN,which may be related to the alleviation of mitochondrial damage and amelioration of insulin resistance.更多还原