Zhan Hongyue, Han Pengxun, Wang Menghua, Wang Yao, Weng Wenci, Yu Xuewen, Yuan Changjian, Li Yuyan, Shao Mumin, Sun Huili
Department of Nephrology, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine Shenzhen, Guangdong, China.
Department of Critical Care Medicine, Shantou Hospital of Traditional Chinese Medicine Shantou, Guangdong, China.
Int J Clin Exp Pathol. 2020 May 1;13(5):827-836. eCollection 2020.
Evidences demonstrated that the effect on anti-proteinuria and renal protection of Chinese herbs combination with ACEi or ARB seemed to be better than ACEi or ARB alone. Astragaloside IV could decrease the urinary albumin excretion rate and could protect against renal injuries linking to its anti-oxidation ability. We aimed to investigate the effect of astragaloside IV combined with ACEi on diabetic nephropathy and to explore whether its underlying mechanism is dependent on anti-oxidation. 8-week-old male experiment mice were randomly assigned to five groups: lean wild type (wt) group, db/db group, db/db + astragaloside IV group, db/db + enalapril group, db/db + combination therapy with astragaloside IV and enalapril group. During the experiment, 24 hours urinary albumin, fasting glucose, body weight, and metabolic parameters were monitored in regular intervals. At the end of the study, tail blood pressure, serum HO, lipid, and liver function were measured and kidney histological injuries were evaluated. Results of the study indicated that combination therapy with astragaloside IV and ACEi further reduced 24 hours urinary albumin excretion rate, blood pressure, and body weight. Combination therapy reduced the foot process width, glomerular base membrane thickness, glomerular tuft cell proliferation, tubular cell atrophy, tubular base membrane thickness, and improved tubular cell proliferation. It modulated the body HO metabolism and up-regulated the expression of the catalase in renal cortex. Astragaloside IV combined with ACEi exerted renal protective effects in db/db mice more significantly than their individual used. The mechanism possibly involved their synergistic effects on anti-oxidation.
证据表明，中药与ACEi或ARB联合使用在抗蛋白尿和肾脏保护方面的效果似乎优于单独使用ACEi或ARB。黄芪甲苷IV可降低尿白蛋白排泄率，并因其抗氧化能力而对肾脏损伤具有保护作用。我们旨在研究黄芪甲苷IV与ACEi联合使用对糖尿病肾病的影响，并探讨其潜在机制是否依赖于抗氧化作用。将8周龄雄性实验小鼠随机分为五组：瘦野生型（wt）组、db/db组、db/db +黄芪甲苷IV组、db/db +依那普利组、db/db +黄芪甲苷IV与依那普利联合治疗组。实验期间，定期监测24小时尿白蛋白、空腹血糖、体重和代谢参数。研究结束时，测量尾动脉血压、血清HO、血脂和肝功能，并评估肾脏组织学损伤。研究结果表明，黄芪甲苷IV与ACEi联合治疗进一步降低了24小时尿白蛋白排泄率、血压和体重。联合治疗减少了足突宽度、肾小球基底膜厚度、肾小球毛细血管丛细胞增殖、肾小管细胞萎缩、肾小管基底膜厚度，并改善了肾小管细胞增殖。它调节了机体HO代谢并上调了肾皮质中过氧化氢酶的表达。黄芪甲苷IV与ACEi联合使用对db/db小鼠的肾脏保护作用比单独使用更显著。其机制可能涉及它们在抗氧化方面的协同作用。
