2023 年第 12 期 第 18 卷

加味四妙散联合阿托伐他汀钙片对肥胖相关性肾病大鼠炎症因子及尿蛋白的影响分析

Effects of modified Simiao powder and atorvastatin calcium tablets on inflammatory factors and urine protein in obesity related nephropathy rats

作者：王东峰1王海波2张丽君2李方凯2许光远3侯丹4陈晨1史术峰1

英文作者：Wang Dongfeng1 Wang Haibo2 Zhang Lijun2 Li Fangkai2 Xu Guangyuan3 Hou Dan4 Chen Chen1 Shi Shufeng1

单位：1北京中医药大学第三附属医院推拿科，北京100029；2北京中医药大学东方医院治未病中心，北京100078；3首都医科大学附属复兴医院中医科，北京100000；4北京中医药大学第三附属医院呼吸科，北京100029

英文单位：1Department of Massage Beijing University of Chinese Medicine Third Affiliated Hospital Beijing 100029 China; 2Preventive Center Dongfang Hospital Beijing University of Chinese Medicine Beijing 100078 China; 3Department of Traditional Chinese Medicine Fuxing Hospital Capital Medical University Beijing 100000 China; 4Department of Respiratory Beijing University of Chinese Medicine Third Affiliated Hospital Beijing 100029 China

关键词：肥胖相关性肾病；加味四妙散；炎症因子；蛋白尿

英文关键词：Obesityrelatedkidneydisease;ModifiedSimiaopowder;Inflammatoryfactors;Proteinuria

• 摘要：

• 目的  观察加味四妙散联合阿托伐他汀钙片对肥胖相关性肾病（ORG）大鼠炎症因子及尿蛋白的影响。方法  雄性Wistar大鼠40只随机分成4组，每组10只，分别为模型组、西药组、中药组、中西药组，分别给予高脂饲料喂养，同时给予生理盐水灌胃进行ORG造模。饲养12周后，模型组喂食正常饲料，中药组给予加味四妙散治疗；西药组给予阿托伐他汀钙片治疗；中西药组采用加味四妙散及阿托伐他汀钙片联合治疗，共干预12周。比较各组大鼠体质量，血清脂联素、瘦素、白细胞介素6（IL-6）、肿瘤坏死因子α(TNF-α)、肌酐、尿素氮、三酰甘油、纤维蛋白原（FIB）水平，24 h尿蛋白定量及尿白蛋白含量以及肾脏组织病理学检查结果。结果  干预12周时，西药组、中药组、中西药组大鼠体质量均低于模型组［（569±47）、（543±46）、（523±42）g比（598±39）g］，且中西药组大鼠体质量低于西药组和中药组（均P＜0.05）。干预12周时，中西药组大鼠脂联素、瘦素、IL-6、TNF-α、三酰甘油、FIB水平均低于西药组（P＜0.01或P＜0.05）。各组大鼠血尿素氮水平比较差异无统计学意义（P＞0.05）。中西药组大鼠血肌酐水平低于模型组（P＜0.01）。西药组、中药组、中西药组大鼠24 h尿蛋白及24 h尿白蛋白水平均低于模型组［（15.5±3.1）、（9.5±2.4）、（6.3±1.2）mg比（45.1±3.5）mg；（8.4±2.3）、（5.6±1.7）、（2.5±0.6）μg比（12.6±1.4）μg］，中西药组大鼠24 h尿蛋白及24 h尿白蛋白水平均低于西药组和中药组（P＜0.01或P＜0.05）。模型组大鼠肾小球体积明显增大，与模型组大鼠比较，中药组、西药组、中西药组大鼠肾小球体积明显缩小。模型组大鼠肾小球基底膜增生不明显，但系膜区增生，细胞核增大，系膜基质明显增厚；与模型组大鼠比较，中药组、西药组、中西药组系膜区及系膜基质的增生明显减低。结论  加味四妙散联合阿托伐他汀钙片对ORG大鼠的炎症因子、肾功能及肾小球系膜增生具有明显改善作用。

• Objective To observe the effect of modified Simiao powder combined with atorvastatin calcium tablets on inflammatory factors and urinary protein in rats with obesityrelated nephropathy (ORG). Methods Forty male Wistar rats were randomly divided into four groups, with 10 rats in each group, namely the model group, western medicine group, traditional Chinese medicine group, and traditional Chinese and western medicine group. They were fed with high-fat feed and given physiological saline by gavage for ORG modeling. After 12 weeks of feeding, the model group was fed with normal feed, while the traditional Chinese medicine group was treated with modified Simiao powder, the western medicine group was treated with atorvastatin calcium tablets, and the traditional Chinese and western medicine group was treated with a combination of modified Simiao powder and atorvastatin calcium tablets for a total of 12 weeks of intervention. The body mass, adiponectin, leptin, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α),serumcreatinine, blood urea nitrogen, triacylglycerol, fibrinogen (FIB) levels, 24 h urine protein quantification and urine albumin results, and renal tissue pathological staining results in each group were compared. Results  At 12 weeks of intervention, the body mass of rats in the western medicine group, traditional Chinese medicine group, and traditional Chinese and western medicine group was lower than that in the model group ［(569±47), (543±46), (523±42)g vs (598±39)g］, and the body mass of rats in the traditional Chinese and western medicine group was lower than that in the western medicine group and traditional Chinese medicine group (all P＜0.05). At 12 weeks of intervention, the levels of adiponectin, leptin, IL-6, TNF-α, triacylglycerol and FIB in the traditional Chinese and western medicine group were lower than those in the western medicine group(P＜0.01 or P＜0.05). There was no statistically significant difference in blood urea nitrogen levels among different groups of rats (P＞0.05). The serumcreatinine level in the traditional Chinese and western medicine group was lower than that in the model group (P＜0.01). The 24 h urinary protein and 24 h urinary albumin levels in the traditional Chinese medicine group, western medicine group, and traditional Chinese and western medicine group were lower than those in the model group ［(15.5±3.1), (9.5±2.4), (6.3±1.2)mg vs (45.1±3.5)mg; (8.4±2.3), (5.6±1.7), (2.5±0.6)μg vs (12.6±1.4)μg］, and the levels of 24 h urine protein and 24 h urine albumin in the traditional Chinese and western medicine group were lower than those in the western medicine group and traditional Chinese medicine group(P＜0.01 or P＜0.05). The glomerular volume of the model group rats significantly increased, and compared with the model group, the glomerular volume of the western medicine group, traditional Chinese medicine group, and traditional Chinese and western medicine group significantly decreased. The proliferation of the glomerular basement membrane was not significant in the model group rats, but in the mesangial area, the nuclei increased, and the mesangial matrix thickened significantly. Compared with the model group, the proliferation of the mesangial area and matrix in the traditional Chinese medicine group, western medicine group, and traditional Chinese and western medicine group was significantly reduced. Conclusion Modified Simiao powder combined with atorvastatin calcium tablets can significantly improve the inflammatory factors, renal function and mesangium proliferation in ORG rats.