益气散聚方对肥胖相关肾小球病模型小鼠AMPK信号通路影响及机制研究.docx

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1、益气散聚方对肥胖相关肾小球病模型小鼠AMPK信号通路影响及机制研究*方明珠2徐艳秋I顾耀东II上海中医药大学附属岳阳中西医结合医院肾内科（上海200437）2上海市第六人民医院金山分院中医内科（上海201599）方明珠1987.12女籍贯：河南主治医师研究生硕士研究方向：中西医结 合防治肾脏病及心血管疾病 徐艳秋1971男籍贯：上海主任医师博士研 究方向：中西医结合治疗肾脏病，尤其是代谢性疾病引起的肾脏损害基金项目：上海市卫生和计划生育委员会中医药科研项目编号2012JAO（H（摘要）目的：探讨益气散聚方对肥胖相关性肾小球病触发因素AMPK及其诱 发的炎症状态、肾损害的影响，阐明益气散聚方防治

2、肥胖相关性肾小球的作用机 制。方法：随机将6周龄的60只雄性C57BL/6试验小鼠进行分组，可分为正常 组、西药组、中药组、中西医结合组、模型组，给正常组小鼠用生理盐水与普通 饲料进行灌胃、给西药组小鼠用二甲双脏与高脂饲料进行灌胃、给中药组小鼠用 益气散聚方与高脂饲料进行灌胃、给中西医结合组小鼠用二甲双服、益气散聚方 与高脂饲料进行灌胃、给模型组小鼠用生理盐水与高脂饲料进行灌胃。经过1 个月的治疗后对小鼠的肥胖体质进行观察,检查并观测24h尿蛋白定量、尿RBP、 尿NAG的变化情况，利用HE染色、免疫组化于镜下对肾脏组织的病理变化情 况进行观察，同时对肾脏组织内TGF-01、MCP-1 P-A

3、MPKamRNA含量进行检 测。结果：治疗1个月后对比正常组与中药组、模型组、西药组的小鼠体重，发 现后3组的体重均增大（P0.05）；中西医结合组小鼠与其他各组相比体重下 降明显（P0.05）；治疗1个月后对比模型组与中药组、中西医结合组、西药组的24h尿蛋白定量、 尿RBP、尿NAG含量，后3组含量均降低（P0.05)；治 疗1月后对5组小鼠免疫组化的结果进行对比，发现中西医结合组、西药组、中 药组比模型组的PAMPK-含量升高明显(P0.01)；实时定量PCR：中药组、 中西医结合组治疗4周后MCP-ImRNA、TGF-PlmRNA表达下降，两组较模型 组均降低(P0.01)；中药组、西

4、药组、中西医结合治疗4周后PAMPKamRNA 表达升高，三组较模型组均升高(P0.05); mice in the integrated traditional Chinese and western medicine group decreased significantly compared with other groups (P0.05); After 4 weeks of treatment, the urine NAG, urine RBP, urine MA, 24h urine protein quantitative of mice in the traditional C

5、hinese medicine group, western medicine group, and integrated traditional Chinese and western medicine group were lower than those in the model group (P0.05); the immunohistochemical results showed: the traditional Chinese medicine group, the western medicine group, and the integrated traditional Ch

6、inese and western medicine group were treated After 4 weeks, the expression of PAMPK- was significantly higher than that of the model group (P0.01); real-time quantitative PCR: the expression of MCP-1 mRNA and TGF-l mRNA decreased after 4 weeks of treatment in the traditional Chinese medicine group

7、and the integrated traditional Chinese and Western medicine group. The expression of PAMPK-(X mRNA increased after 4 weeks of treatment in the traditional Chinese medicine group, the western medicine group, and the combined traditional Chinese and western medicine, and the expression of PAMPK- mRNA increased in the three groups compared with the model group (P0.05). Conclusion: Yiqi Sanju Recipe can improve the expression of AMPK in obesity-related glomerulopathy model mice, and inhibit the expression of inflammatory factors such as MCP-I and TGF-l, thereby improving