【摘要】 目的 观察肾气丸对糖尿病ZDF大鼠肾脏损伤的影响及对足细胞损伤的干预作用。方法 实验分为对照组[ZDF(fa/+),14只]、模型组[ZDF(fa/fa),20只]及肾气丸组[ZDF(fa/fa)+肾气丸，20只]。对照及模型组大鼠每日灌服生理盐水(10 mL/kg),肾气丸组每天灌服肾气丸水煎液(8.12 g/kg)。饲养期间，记录大鼠一般状态，定期称重并于12、16、20周龄测定空腹血糖。治疗4周后(16周龄)或治疗8周后(20周龄)处死大鼠，收集血清及24 h尿液。检测血清中总胆固醇(CHOL)、甘油三酯(TG)、血肌酐(CREA)、血尿酸(UA)、血尿素氮(BUN)及尿微量白蛋白的含量，取肾组织进行形态学观察，免疫荧光法检测足细胞标志物nephrin的表达水平。结果 与对照组比较，16周龄和20周龄模型组大鼠体重增长率明显下降(P<0.05),空腹血糖水平显著升高(P<0.05),血清总胆固醇、甘油三酯、肌酐、尿酸及尿微量白蛋白水平显著升高(P<0.05);肾脏形态学表现为肾小球毛细血管扩张，肾小球纤维化、硬化，系膜区增宽，肾小管上皮细胞空泡样改变及糖原沉积，肾小管萎缩，管腔内蛋白管型，间质胶原组织增多；超微结构显示肾小球基底膜增厚，足细胞线粒体肿胀，足突融合；模型组肾组织足细胞标志物nephrin表达减少；相较模型组，肾气丸治疗4或8周后，大鼠体重增长率明显上调(P<0.05),空腹血糖水平显著降低(P<0.05),血清甘油三酯、肌酐、尿酸及尿微量白蛋白水平显著减少(P<0.05),肾组织病理损伤减轻，nephrin表达增强。结论 肾气丸可减轻糖尿病大鼠肾脏病理损害，改善肾功能，维护足细胞结构和功能，发挥肾脏保护作用。更多还原

【Abstract】 Objective To investigate the interventional effect of Shenqi Pills on kidney injury, and its effect on podocyte damage in rats with diabetic kidney disease.Methods The 12-week-old male ZDF rats were divided into Control(ZDF(fa/+),14),Model(ZDF(fa/fa),20),and Shenqi pill(ZDF(fa/fa) + Shenqi pill, 20) groups.Rats in Control and Model groups were given orally with normal saline(10 ml/kg),and the rats in Shenqi pill group were administered orally with Shenqi pill decoction(8.12 g/kg) daily for 4-8 weeks.The general state and body weight of the rats was recorded, the fasting blood glucose was measured at 12,16,and 20 weeks of age.Rats were killed after 4-week of treatment(16-week of age) or 8-week of treatment(20-week of age) to collect serum and the 24-hour urine.The contents of serum total cholesterol(CHOL),triglyceride(TG),creatinine(CREA),uric acid(UA),urea nitrogen(BUN),and urinary microalbumin were measured.Kidney tissue was taken for morphological observation.The expression of podocyte marker nephrin was detected via immunohistochemistry.Results Compared with Control, rats in the 16-week-old and 20-week-old Model group displayed decreased body weight gain(P<0.05),increased fasting blood glucose levels(P<0.05),and the levels of total cholesterol, triglyceride, creatinine, uric acid, and urinary microalbumin(P<0.05).Renal morphology showed glomerular capillary dilation, glomerular fibrosis, glomerulosclerosis, widening of the mesangial area, renal tubular epithelial cell vacuole-like changes and glycogen depositions, tubular atrophy, protein cast in the tubular lumen, and increased collagen in the interstitial matrix.Ultrastructure showed glomerular basement membrane was thickened, the mitochondria of podocytes were swollen and the foot processes was fused.The expression of the podocyte marker nephrin in the Model group was down-regulated.Compared with Model rats, Shenqi pill treatment for 4-and 8-weeks increased body weight gain(P<0.05),decreased levels of fasting blood glucose, serum triglyceride, creatinine, uric acid and urinary microalbumin(P<0.05); Morphological lesions were alleviated, the expression of nephrin was increased.Conclusion Shenqi pill can improve the renal function of diabetic rats, reduce pathological damage of the kidney, maintain the structure and function of podocytes, demonstrating renal protective effects.更多还原