目的：本研究目的在探討中藥複方加味建瓴湯與加味金匱腎氣丸對糖尿病腎病的療效和作用機制。材料與方法：本研究採用實驗研究，將雄性小鼠45隻分為五組，一組為正常對照組，另外四組分別為diabetic control（以下簡稱為DC組）作為糖尿病對照組；Chinese medicine 1（以下簡稱為CM1組）為加味建瓴湯治療組；Chinese medicine 2（以下簡稱為CM2組）為加味金匱腎氣丸治療組；angiotensin-converting enzyme inhibitors（以下簡稱為ACEI組）為西藥captopril治療組。在誘導糖尿病小鼠模型前後分別測量小鼠的體重、血糖。成功誘導糖尿病小鼠模型後的第4週加測尿總蛋白、肌酐等生化數值。在犧牲小鼠後，測量其腎重，計算腎臟肥大指數並腎臟組織切片做免疫組織化學染色。 結果：和DC組小鼠相比，CM2組對於小鼠的血糖值的影響不顯著，但可以明顯減少尿總蛋白排泄量以及尿總蛋白/肌酐比值(urinary protein/creatinine ratio, UPCR)，亦可以改善小鼠的腎臟肥大指數。CM1組治療可以降低小鼠的血糖值、減少尿總蛋白排泄量以及改善腎臟肥大指數，但在尿總蛋白/肌酐比值則沒有顯著差異。腎臟重量和腎臟肥大指數上，中藥兩組間及與ACEI組間無明顯差異。相較於DC組，CM1組、CM2組及ACEI組腎組織TGF-β1蛋白表達下降，uPA蛋白表達增強，但在腎組織IL-6蛋白表達及PTEN蛋白表達，各組之間則沒有顯著差異。 結論：加味建瓴湯、加味金匱腎氣丸和西藥captopril三組藥物，都可以改善糖尿病腎病小鼠之尿總蛋白排泄量和腎臟肥大指數，其機轉是通過降低腎組織TGF-β1表達、增強uPA信號轉導通路達成。 |
Huang Chin-Hung1 Lee Chen-Yu2,* 1Shilin Jinhe Traditional Chinese Medicine Clinic, Taipei, Taiwan 2Yu Sheng Traditional Chinese Medicine Clinic, Taipei, Taiwan |
Purpose: The study aims to clarify the traditional Chinese medicine composed of modified prescription of Jian Ling Decoction and modified prescription of Jin Gui Shen Qi Wan for the improvement and molecular mechanisms of diabetic nephropathy.Material and method: This research was conducted in laboratory. The 45, male, 5 weeks old, mice were fed for 3 weeks. 8 weeks old mice were used and randomly divided into 5 groups with group 1 as normal control group consisted of 9 mice. Other groups were designed to produce mouse models of diabetes. Each group consisted of 9 mice after successful modeling. Group 2 was DC group, as diabetic control group, did not reviewed any treatment. CM1 group, as traditional Chinese medicine experimental group 1, were given modified prescription of Jian Ling Decoction. CM2 group, as traditional Chinese medicine experimental group 2, were given modified prescription of Jin Gui Shen Qi Wan. ACEI group, as Western medicine control group, were given captopril.The body weight and blood glucose of the mice were measured at week 0, the second week and the fourth week after modeled. In addition, experiment was designed to evaluate the effect of TCM on urinary total protein, creatinine and other biochemical indexes of STZ-induced diabetic mice at fourth week after modeled. Results: The effect of modified prescription of Jin Gui Shen Qi wan on blood sugar is not significant by comparing with untreated diabetic control mice. But the urinary total protein excretion and the urinary total protein / creatinine ratio (UPCR) were significantly reduced in CM2 group. Besides, the renal hypertrophy index of mice had been improved as well. These results were similar to the results of ACEI group. The modified prescription of JianLing Decoction could lower blood glucose levels, reduce urinary total protein excretion, and improve renal hypertrophy index in mice, but there is no significant difference in urinary total protein / creatinine ratio. There was no significant difference between the CM1 group, CM2 group and ACEI group for the renal weight and renal hypertrophy index.Compared with DC group, CM1 group, CM2 group and ACEI group could reduce the expression of TGF-β1 protein and increase the expression of uPA protein, but there was no significant difference in IL-6 protein and PTEN protein between all groups. Conclusion: All of three treatment groups including the modified prescription of JianLing Decoction, the modified prescription of Jin Gui Shen Qi wan and captopril could significantly improve urinary total protein excretion and renal hypertrophy index and relieved renal pathological damage in STZ-induced diabetic mice. The mechanism was related to the decrease of TGF-β1 and uPA protein in renal tissue, but not related to the expression of IL-6 and PTEN protein in renal tissue. |
27-2.1 中藥複方對DN 小鼠腎組織TGF-β1、PTEN 蛋白表達的影響
