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[不同穴位不同疗程温和灸对局灶节段性肾小球硬化大鼠肾功能及肾脏病理改变的影响]

[Effect of Mild Moxibustion with Different Terms at Different Acupoints on Renal Functions and Renal Pathological Changes in Focal Segmental Glomerulosclerosis Rats].

作者信息

Li Lin, Sun Yu-Xia, Ma Jia-Yi, Zhang Chun-Ling, Li Yi

机构信息

Department of Nephrology, Shugang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200021, China.

出版信息

Zhen Ci Yan Jiu. 2016 Dec 25;41(6):521-7.

Abstract

OBJECTIVE

To observe changes of urinary microprotein, and serum creatinine, urea nitrogen and uric acid levels in focal segmental glomerulosclerosis (FSGS) rats treated by mild moxibustion, so as to explore the mechanism of moxibustion underlying improvement of FSGS.

METHODS

SD rats were randomized into normal control (normal), sham operation (sham), model, medication (Losartan), moxibustion-Shenshu (BL 23) and moxibustion-Geshu (BL 17) groups. The latter two moxibustion groups were further divided into 10 min, 20 min and 30 min subgroups (=6 in each group/subgroups). The FSGS model was established by unilateral nephrectomy combined with injection of Losartan into the tail vein twice. Mild moxibustion was applied to bilateral BL 17 and BL 23 for 10, 20 and 30 min, respectively, once every other day, for 12 weeks. The contents of urinary microglobulin α 1, micro-albumin, transferring and IgG were assayed using enzyme linked immunosorbent assay (ELISA), and serum creatinine, urea nitrogen and uric acid contents (indexes of renal function) determined using an automatic biochemical analyzer. The pathological changes of the kidney tissue was observed by using a microscope after periodic acid schiff (PAS) staining.

RESULTS

No significant differences were found between the normal control and sham groups in the levels of all the urinary and serum indexes (>0.05) and pathological changes of the renal tissues. Compared with the normal control group, the contents of urinary microglobulin α 1, micro-albumin, transferrin and IgG, and serum creatinine, urea nitrogen and uric acid were significantly increased in the model group (<0.01). Following medication and moxibustion, the contents of the aforementioned 7 indexes in the Losartan group, and urinary microglobulin α 1, micro-albumin, transferrin and IgG, and serum creatinine levels in the moxibustion BL 23-20 min and 30 min groups, and the micro-albumin and transferrin contents in the BL-17 10 min group and IgG level in the BL-23 10 min group, the serum creatinine and urea nitrogen levels at the 3 time-points of both moxibustion BL 23 and BL 17 groups, and serum uric acid in the moxibustion BL 23 30 min, and BL17 20 and 30 min groups were all considerably down-regulated (<0.05, <0.01). The therapeutic effects of moxibustion 30 min were notably better than moxibustion 10 min in reducing urinary microglobulin α 1, micro-albumin, transferring and IgG levels (<0.05, <0.01). Results of PAS staining showed that the injury of the renal tissue as the endothelial and mesangial cellular proliferation, collagen proteinosis, interstitial fibrosis, etc were relatively milder in the Losartan and moxibustion 20 and 30 min groups.

CONCLUSIONS

Mild moxibustion may reduce proteinuria, and improve the kidney function and pathological changes in FSGS rats, and longer duration of moxibustion is better in achieving therapeutic effect.

摘要

目的

观察温和灸对局灶节段性肾小球硬化(FSGS)大鼠尿微量蛋白及血清肌酐、尿素氮、尿酸水平的影响,探讨艾灸改善FSGS的作用机制。

方法

将SD大鼠随机分为正常对照组(正常组)、假手术组(假手术组)、模型组、药物组(氯沙坦组)、艾灸肾俞穴(BL 23)组和艾灸膈俞穴(BL 17)组。后两个艾灸组再分为10 min、20 min和30 min亚组(每组/亚组n = 6)。采用单侧肾切除并经尾静脉注射两次氯沙坦的方法建立FSGS模型。分别对双侧BL 17和BL 23进行温和灸10、20和30 min,隔日1次,共12周。采用酶联免疫吸附测定(ELISA)法检测尿微量球蛋白α1、微量白蛋白、转铁蛋白和IgG含量,用自动生化分析仪检测血清肌酐、尿素氮和尿酸含量(肾功能指标)。经高碘酸希夫(PAS)染色后,用显微镜观察肾组织病理变化。

结果

正常对照组和假手术组各项尿、血指标水平及肾组织病理变化差异均无统计学意义(P > 0.05)。与正常对照组比较,模型组尿微量球蛋白α1、微量白蛋白、转铁蛋白和IgG含量及血清肌酐、尿素氮和尿酸水平均显著升高(P < 0.01)。药物及艾灸治疗后,氯沙坦组上述7项指标含量,艾灸BL 23 - 20 min组和30 min组尿微量球蛋白α1、微量白蛋白、转铁蛋白和IgG含量及血清肌酐水平,艾灸BL - 17 10 min组微量白蛋白和转铁蛋白含量及BL - 23 10 min组IgG水平,艾灸BL 23和BL 17组3个时间点的血清肌酐和尿素氮水平,艾灸BL 23 30 min组、BL17 20 min组和30 min组血清尿酸水平均明显下调(P < 0.05,P < 0.01)。艾灸30 min在降低尿微量球蛋白α1、微量白蛋白、转铁蛋白和IgG水平方面的疗效明显优于艾灸10 min(P < 0.05,P < 0.01)。PAS染色结果显示,氯沙坦组及艾灸20 min和30 min组肾组织损伤如内皮细胞和系膜细胞增生、胶原纤维沉积、间质纤维化等相对较轻。

结论

温和灸可降低FSGS大鼠蛋白尿水平,改善肾功能及病理变化,艾灸时间越长疗效越好。

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