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真武汤合五皮饮加减对糖尿病肾病患者肾脏纤维化、肾小管氧化损伤和PI3K/Akt/NF-κB信号通路的影响
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作者 周丰宝 马群 《中国医院用药评价与分析》 2024年第4期451-454,458,共5页
目的:观察真武汤合五皮饮加减对糖尿病肾病患者肾脏纤维化、肾小管氧化损伤和磷脂酰肌醇3激酶(PI3K)/蛋白激酶B(Akt)/核因子κB(NF-κB)信号通路的影响。方法:选择2021年2月至2023年2月该院收治的糖尿病肾病患者100例,所有患者均采用随... 目的:观察真武汤合五皮饮加减对糖尿病肾病患者肾脏纤维化、肾小管氧化损伤和磷脂酰肌醇3激酶(PI3K)/蛋白激酶B(Akt)/核因子κB(NF-κB)信号通路的影响。方法:选择2021年2月至2023年2月该院收治的糖尿病肾病患者100例,所有患者均采用随机数字表法分组。基础干预组50例患者(脱落3例,最终纳入47例)给予常规西医治疗,观察组50例患者(脱落2例,最终纳入48例)在基础干预组的基础上给予真武汤合五皮饮加减治疗。治疗前后对两组患者进行中医证候评价,检测谷胱甘肽过氧化物酶(GSH-Px)、结缔组织生长因子(CTGF)、活性氧(ROS)、糖化血红蛋白(HbA1c)、透明质酸(HA)、层粘连蛋白(LN)、尿白蛋白排泄率(UAE)、尿β2-微球蛋白(β2-MG)水平及24 h尿蛋白定量,PI3K、Akt和NF-κB的mRNA表达水平,比较两组患者的临床疗效。结果:观察组患者的总有效率较基础干预组明显升高[97.92%(47/48)vs. 82.98%(39/47)],差异有统计学意义(P<0.05)。治疗后,观察组患者神疲畏寒、尿浊、腰膝酸冷、肢体浮肿、下肢尤甚、小便清长或短少、面色白光白、夜尿增多及五更泄泻的评分较基础干预组明显降低,差异均有统计学意义(P<0.05)。治疗后,观察组患者的HbA1c、UAE和24 h尿蛋白定量较基础干预组明显降低,GSH-Px水平较基础干预组明显升高,ROS、β2-MG水平较基础干预组明显降低,NF-κB mRNA表达水平较基础干预组明显降低,PI3K、Akt mRNA表达水平较基础干预组明显升高,CTGF、HA和LN水平较基础干预组明显降低,差异均有统计学意义(P<0.05)。结论:真武汤合五皮饮加减用于糖尿病肾病患者,可调节PI3K/Akt/NF-κB信号通路,减少肾小管氧化损伤,改善肾脏纤维化病情,调节HbA1c、UAE和24 h尿蛋白定量,提高临床疗效。 展开更多
关键词 真武汤合五皮饮加减 糖尿病 PI3K/Akt/NF-κB信号通路 肾小管氧化损伤 脏纤维化
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Preventive and therapeutic effects of Aerva lanata(L.) extract on ethylene glycol-induced nephrolithiasis in male Wistar albino rats
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作者 Ankul Singh S Chitra Vellapandian Gowri Krishna 《Digital Chinese Medicine》 2022年第2期199-209,共11页
Objective Nephrolithiasis is a common urological disease. This study aims to evaluate the preventive and therapeutic effects of hydro-alcoholic extract of Aerva lanata(L.) roots(HAEAL) on ethylene glycol-induced nephr... Objective Nephrolithiasis is a common urological disease. This study aims to evaluate the preventive and therapeutic effects of hydro-alcoholic extract of Aerva lanata(L.) roots(HAEAL) on ethylene glycol-induced nephrolithiasis in rats.Methods Fifty grams of shade-dried coarsely powdered Aerva lanata(L.) root was successively extracted with organic solvents in increasing order of polarity [petroleum ether(60-80 ℃), chloroform, and ethanol] using a Soxhlet apparatus, and then concentrated. Physical tests including nature, color, odor, and texture were performed on the herbal suspension. In vitro nephrolithiasis assessment was performed by nucleation assay, aggregation assay, and crystal growth assay. Thirty adult male Wistar albino rats were randomly divided into five groups(six rats in each group). Group 1: negative control group without induction or treatment till day 28. Group 2: positive control group receiving a daily oral solution of 0.75% ethylene glycol till day 14, and mixed with distilled water till day 28. Group 3: standard group receiving a daily oral solution of 0.75% ethylene glycol till day 14 and Cystone(750 mg/kg) from day 15 to day 28. Group 4: low dose HAEAL group receiving a daily oral solution of 0.75%ethylene glycol till day 14, and 400 mg/kg HAEAL from day 15 to day 28(1 mL per day). Group 5: high dose HAEAL group receiving a daily oral solution of 0.75% ethylene glycol till day 14,and 800 mg/kg HAEAL from day 15 to day 28(1 mL per day). Urine(urine volume, pH value,appearance, odor, and turbidity) examination and serum test were performed. On day 29, the kidneys were dissected, and histopathology examination was performed to determine the degree of tubular injury.Results The suspension showed stability and aroma with no turbidity at room temperature.The suspension did not show changes in color and odor until day 3, indicating that the preparation was stable for 72 h. Body weight decreased in the positive control group indicating stone formation and changes in water intake. Both standard and HAEAL treatments restored the body weight to normal levels after treatment, indicating the beneficial effects of the treatment. Histopathological examination revealed no significant findings in the negative control group, whereas the positive control group showed inflammation in the kidney parenchyma.Compared with positive control group, there was increase in urine volume and excretion of urinary constituents such as calcium and oxalate(P < 0.01) as well as improved clearance rate(P < 0.05) in HAEAL treatment groups, in addition, the urine pH value of HAEAL groups was increased.Conclusion HAEAL reduced nephrolithiasis formation and had a diuretic effect, which could be used to promote the expulsion of stones. Further studies are needed to enhance the stability of the suspension for the production of better pharmaceutical formulations. 展开更多
关键词 Aerva lanata(L.) NEPHROLITHIASIS Ethylene glycol ANTIOXIDANT Tubular injury DIURESIS Suspension
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