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目的观察通脉益肾方对肾间质纤维化模型大鼠肾脏肾上腺髓质素及肾小管上皮细胞表型转化的影响,探讨其拮抗肾间质纤维化的作用机理。方法采用单侧输尿管结扎的方法复制大鼠肾间质纤维化模型,将其随机分为假手术组、模型组、通脉益肾方组和缬沙坦组。通脉益肾方组、缬沙坦组分别给予通脉益肾方1.5 g/(kg.g)和缬沙坦10 mg/(kg.d)灌胃治疗,假手术组及模型组给予等量的生理盐水。观察梗阻侧肾脏肾上腺髓质素(ADM)、肾小管上皮细胞表型转化标志物α-平滑肌肌动蛋白(α-SMA)的蛋白表达,做相关性分析;采用HE及天狼星红染色观察各组大鼠肾脏的病理改变。结果模型组及各治疗组大鼠肾脏中ADM蛋白表达较假手术组明显降低(P<0.05),通脉益肾方组、缬沙坦组的ADM的蛋白含量及表达均高于模型组(P<0.05),但两治疗组之间无显著性差异。模型及各治疗组α-SMA的蛋白表达较假手术组明显升高(P<0.05),通脉益肾方组、缬沙坦组的表达均低于模型组(P<0.05),但两治疗组之间无显著性差异。ADM与α-SMA的表达呈明显负相关。结论通脉益肾方可能通过上调间质纤维化大鼠肾脏ADM的表达、抑制肾小管上皮细胞的表型转化起到拮抗肾间质纤维化的作用。
Objective To observe the effect of Tongmai Yishen Recipe on renal adrenomedullin and renal tubular epithelial phenotype in renal interstitial fibrosis rats and to explore its mechanism of antagonizing renal interstitial fibrosis. Methods The rat model of renal interstitial fibrosis was duplicated by unilateral ureteral ligation, and then randomly divided into sham-operation group, model group, Tongmaishenzhengfang group and valsartan group. Tongmai Yishenfang group and valsartan group were treated with 1.5 g / (kg · g) Tongmaishenzheng Decoction and 10 mg / (kg.d.d) valsartan respectively, while those in sham-operation group and model group were given The amount of saline. Observe the protein expression of adrenomedullin (ADM) and α-smooth muscle actin (α-SMA) in renal tubular epithelial cells in obstructed side. The correlation analysis was done. HE and Sirius red staining were used to observe the expression of α- Rat kidney pathological changes. Results The protein expression of ADM in model group and each treatment group was significantly lower than that in sham operation group (P <0.05). The protein content and expression of ADM in Tongmaishenzheng group and valsartan group were higher than those in model group P <0.05), but no significant difference between the two treatment groups. The expression of α-SMA in the model group and each treatment group was significantly higher than that in the sham operation group (P <0.05). The expression of Tongmaishenzhengfang group and valsartan group was lower than that in the model group (P <0.05) There was no significant difference between treatment groups. ADM and α-SMA expression was significantly negatively correlated. Conclusion Tongmai Yishen Recipe can antagonize renal interstitial fibrosis by up-regulating the expression of ADM in the kidney of interstitial fibrosis rats and inhibiting the phenotypic transformation of renal tubular epithelial cells.