肾衰胶囊治疗慢性肾功能衰竭及对细胞凋亡影响的研究

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1、黑龙江中医药大学博士学位论文肾衰胶囊治疗慢性肾功能衰竭及对细胞凋亡影响的研究姓名：符强申请学位级别：博士专业：中医内科学指导教师：张琪2003.4.1中文摘要0≮研究鼬评价肾衰胶囊对慢性肾功能衰竭的治疗作用，并通过动物实验阐明其作用机理。实验研究：Wistar大鼠60只，随机分为五组，按250mg／Kg／d予腺嘌呤连续灌胃21天诱导CRF模型。造模成功后，用肾衰胶囊治疗31天(预防组在造模同时给药)。实验结束后，称取各组大鼠体重、肾重、肾长径，测大鼠血清BUN、Ser、Hb、RBC、NO，用放免法测定大鼠TNF．a、EPO、ET，免疫

2、组化测大鼠肾组织TGF．13、Bcl．2、Fas表达水平，原位末端标记法检测大鼠肾组织细胞凋亡，并取肾组织作光镜、电镜检查。f实验结果显示，肾衰胶囊可以明显降低腺嘌呤诱导肾衰大鼠血BUN、Scr和TNF．a、ET水平，提高Hb、RBC和NO、EPO，并降低TGF．13肾内表达，抑制肾小球系膜细胞及其基质增生，改善其病理状态，减轻其肾小管一间质损害。通过抑制诱发细胞凋亡的Fas基因和提高抑制细胞凋亡Bcl．2基因表达水平抑制肾小管上皮细胞凋亡。临床研究：将90例慢性肾功能衰竭患者随机分为两组，治疗组50例用肾衰胶囊治疗，对照组40例用尿

3、毒清治疗。疗程2—6个月。于治疗前后分别测定患者血BUN、Scr、Hb、RBC、Ca、P、TC、TG、HDL、LDL。结果显示，肾衰胶囊可以明显改善CRF患者临床症状，降低BUN、Scr，升高Hb、RBC，调节Ca／P比，调节脂质代谢紊乱，效果优于对照药尿毒清。^一，关键词：慢性肾功能衰竭吹、蕻、肾衰膣囊⋯细．胞凋亡TNF．Q、ET、EPOTGF．13、Bel一2、FasIIABSTRACTObiective：ToevaluatetherapecticofShenshuaicapculeinthetreatmentofCRFandst

4、udyitsmechanism．Experimentstudy：thefatswerefedwithadninetoestablishthechronicrenalinsurfficiencyanemiamodel．thentheyweredividedintofivegropes；separatlyfedwithshenshuaicapsuleorNiaoduqingfor31days．Theresultsshowedthatshenshuaicapsulecouldimprovethepathologicstatus．Lightm

5、icroscopic，electronicmicroscopicandimmunohistochemicalstainrevealedthatthemesangialcellindexandmetrixindexwerereduced．ThetubularepicyteapoptosisweresignificantlyretrainedthroughthepromotionofBcl一2geneexpressionanddecreasingofFasgeneexpression，reducedtheplasmaofTumorNecr

6、osisFator．QexpressionandthekidneyofTransformatingGrowthFactor—Bexpression．Clinicalstudy：90casesweredividedintotwogropes．50casesinthetreatmentgrope．treatedwithShenshuaicapsule．40casesinthecontrolgrope，treatedwithNiaoduqing．Thesamecourses(2-6months)andcommontreament．There

7、sultsshowedthatShenshuaicapsulenotonlycoulddecreasetheScr．BUNandtheurinaryproteinwithin24hours，lowertheseruminorganicphosphorusandtheEndothenelin，butalsocouldimprovetheclinicalsymptoms，enhancethebloodcalcium，hemoglobin，urinecreatinine，Nitric0xide．ThereiSaremarkblediffer

8、encebetweenthetreatmentgropeandthecontrolgrope．Conclusion：Shenshuaicapsulehavethefunctionofinvigoratingthesple