中药补肾活血汤对2型糖尿病肾病大鼠血清胱抑素C及血、尿β2微球蛋白的机制研究

Effect of Bushen Huoxue Decoction on serum cystine C and blood and urine β2 microglobulin in rats with type 2 diabetic nephropathy and its renal protective mechanism

关键词:  2型糖尿病肾病  大鼠模型  补肾活血汤  氧化应激  血清胱抑素C  β2微球蛋白

Key words:  type 2 diabetic nephropathy  rat model  Bushen Huoxue Decoction  oxidative stress  serum cystine C  β2-microglobulin

摘要:

[目的] 探讨补肾活血汤对早期2型糖尿病肾病大鼠血清胱抑素c（Cys-c）及血、尿β2微球蛋白（β2-MG）的影响，并分析其可能的肾保护作用机制。[方法] 采用单肾切除+高脂饲料+小剂量链脲佐菌素（STZ）腹腔注射，结合行为干预（饥饱失常、劳逸无度、惊吓）建立2型糖尿病肾病气阴两虚型病证结合大鼠模型，共65只。随机数字表法将其分为假手术组（15只）、模型组（15只）、补肾活血组（20只）、贝那普利组（15只）。检测上述各组大鼠干预处理后血糖[空腹血糖（FBG）、餐后2 h血糖（PBG）]、血清和肾皮质超氧化物歧化酶（SOD）、丙二醛（MDA）、尿素氮（BUN）、血肌酐（Cr）、24 h尿白蛋白（24 h-UAlb）、Cys-c及血、尿β2-MG等指标，光镜下观察各组大鼠肾组织病理特征。[结果] 与假手术组比较，模型组BUN、Cr升高并不显著（P>0.05），FBG、PBG、血清和肾皮质MDA、24 h-UAlb、Cys-c及血、尿β2-MG均明显上升，血清和肾皮质SOD显著下降（P<0.05或P<0.01）；与模型组比较，补肾活血组、贝那普利组血清和肾皮质MDA、24 h-UAlb、Cys-c及血、尿β2-MG均明显较低，血清和肾皮质SOD明显较高（P<0.05）；与贝那普利组比较，补肾活血组血清和肾皮质MDA更低，SOD较高，差异有统计学意义（P<0.05），24 h-UAlb、Cys-c及血、尿β2-MG比较无统计学意义（P>0.05）；4组肾脏组织病变程度由正常至严重依次为假手术组、补肾活血组、贝那普利组、模型组。[结论] 中药补肾活血汤能有效降低2型糖尿病肾病大鼠的血糖、24 h-UAlb、Cys-c及血、尿β2-MG，对早期糖尿病肾病肾脏具有保护作用，其机制可能是通过改善氧化应激实现的。

Abstract:

[Objective] To investigate the effect of Bushen Huoxue Decoction on serum cystine c (Cys-c) and blood and urine β2 microglobulin (β2-MG) in rats with early type 2 diabetic nephropathy,and to analyze the possible mechanism of renal protection.[Methods] Sixty five rats with type 2 diabetic kidney disease with deficiency of both qi and yin were established by intraabdominal injection of low dose streptozotocin with single kidney resection and high fat diet,combined with behavioral intervention. The patients were randomly divided into three groups:false operation group (n=15),model group (n=15),tonifying kidney and activating blood circulation group (n=20) and benazepril group (n=15). Blood glucose,including fasting blood glucose (FBG) and postmeal 2 h blood glucose (PBG),were measured in each group after intervention. Serum and renal cortex (SOD),malondialdehyde (MDA),blood urine nitrogen (BUN),serum creatinine (Cr),24-hour urinary albumin (24 h-UAlb),Cys-c and blood,urine β2-MG,etc. The pathological characteristics of renal tissue in each group were observed under light microscope.[Results] BUN and Cr increased significantly (P>0.05),FBG,PBG,serum and renal cortex MDA,24 h UAlb,Cysc and blood,urinary β2-MG increased significantly,and the serum and renal cortex SOD decreased significantly (P<0.05 or P<0.01). Compared with the model group,the serum and renal cortex MDA,24 h UAlb,Cysc and blood,urinary β2MG were significantly lower,and the serum and renal cortex SOD were significantly higher (P<0.05). Compared with benazepril group,MDA in serum and renal cortex was lower and SOD was significantly higher in kidney-tonifying and activating blood group (P<0.05),but there was no significant difference in 24-hour UAlb,Cys-c,blood and urine β2-MG(P>0.05),and the degree of renal pathological changes in four groups was false operation group,kidney tonifying and activating blood circulation group,benazepril group and model group.[Conclusion] Bushen Huoxue Decoction can effectively reduce blood glucose,24 h-UAlb,Cys-c,blood and urine β2-MG in rats with type 2 diabetic nephropathy. The mechanism of Bushen Huoxue Decoction may be achieved by improving oxidative stress.