中国医院用药评价与分析
中國醫院用藥評價與分析
중국의원용약평개여분석
Evaluation and Analysis of Drug-Use in Hospitals of China
2015年
10期
1309-1312
,共4页
王梓%张浩%郝迪%李旭%袁玲%王蕾
王梓%張浩%郝迪%李旭%袁玲%王蕾
왕재%장호%학적%리욱%원령%왕뢰
参附强心丸%腺嘌呤%慢性肾衰和肾阳虚大鼠%温阳利水%血管紧张素Ⅱ
參附彊心汍%腺嘌呤%慢性腎衰和腎暘虛大鼠%溫暘利水%血管緊張素Ⅱ
삼부강심환%선표령%만성신쇠화신양허대서%온양이수%혈관긴장소Ⅱ
Shenfuqiangxin pills%Adenine%Chronic renal failure and kidney-yang deficiency rats%Warming yang for diuresis%Angiotensin Ⅱ
目的：通过体征、肾功能、神经内分泌激素、血清电解质、肾脏组织形态等环节，探讨参附强心丸对慢性肾衰竭大鼠温阳利水的作用与机制。方法：采用“单肾切除合并腺嘌呤灌胃法”制备大鼠CRF模型，按随机数字表法分为模型对照组、地塞米松对照组、参附强心丸2.14、1.07、0.54 g生药／kg剂量组，观察各组大鼠神经内分泌激素、肾功能、血电解质、体温、肾脏质量与肾体比、肾脏的组织形态等指标。结果：模型对照组大鼠出现皮毛稀疏，蜷卧少动，消瘦等衰弱体征，参附强心丸3个剂量组大鼠一般状况较模型对照组明显好转；模型对照组大鼠尿素氮（ UREA）、肌酐（ CREA）含量明显升高，参附强心丸3个剂量组和地塞米松对照组UREA、CREA水平均明显低于模型对照组；模型对照组和参附强心组大鼠的血管紧张素Ⅱ（ AngII）显著低于假手术对照组，醛固酮（ ALD）明显高于假手术对照组，参附强心丸2.14 g／kg和地塞米松对照组大鼠的ALD较模型对照组明显降低，差异均有统计学意义（ P＜0.05）。模型对照组大鼠呈高钾、低钙、高磷血症，参附强心丸2.14 g／kg组大鼠可纠正低血钙症，3个剂量组均能纠正高磷血症，地塞米松对照组可纠正大鼠高钾、低钙、高磷血症，差异均有统计学意义（ P＜0.05）。模型对照组大鼠体温明显降低，地塞米松组体温过低；模型对照组肾脏质量明显大于假手术对照组，参附强心丸2.14 g／kg组大鼠肾脏质量较模型对照组降低，且肾体比明显低于模型对照组，差异均有统计学意义（ P ＜0.05）。肉眼观察及肾脏病理学显示，参附强心丸3个剂量组及地塞米松组大鼠肾脏大小及病变有不同程度减轻。结论：参附强心丸对大鼠肾阳虚有改善作用，可保护肾功能、改善水钠潴留状态、纠正电解质紊乱、可使病变的肾脏组织结构得以修复。
目的：通過體徵、腎功能、神經內分泌激素、血清電解質、腎髒組織形態等環節，探討參附彊心汍對慢性腎衰竭大鼠溫暘利水的作用與機製。方法：採用“單腎切除閤併腺嘌呤灌胃法”製備大鼠CRF模型，按隨機數字錶法分為模型對照組、地塞米鬆對照組、參附彊心汍2.14、1.07、0.54 g生藥／kg劑量組，觀察各組大鼠神經內分泌激素、腎功能、血電解質、體溫、腎髒質量與腎體比、腎髒的組織形態等指標。結果：模型對照組大鼠齣現皮毛稀疏，踡臥少動，消瘦等衰弱體徵，參附彊心汍3箇劑量組大鼠一般狀況較模型對照組明顯好轉；模型對照組大鼠尿素氮（ UREA）、肌酐（ CREA）含量明顯升高，參附彊心汍3箇劑量組和地塞米鬆對照組UREA、CREA水平均明顯低于模型對照組；模型對照組和參附彊心組大鼠的血管緊張素Ⅱ（ AngII）顯著低于假手術對照組，醛固酮（ ALD）明顯高于假手術對照組，參附彊心汍2.14 g／kg和地塞米鬆對照組大鼠的ALD較模型對照組明顯降低，差異均有統計學意義（ P＜0.05）。模型對照組大鼠呈高鉀、低鈣、高燐血癥，參附彊心汍2.14 g／kg組大鼠可糾正低血鈣癥，3箇劑量組均能糾正高燐血癥，地塞米鬆對照組可糾正大鼠高鉀、低鈣、高燐血癥，差異均有統計學意義（ P＜0.05）。模型對照組大鼠體溫明顯降低，地塞米鬆組體溫過低；模型對照組腎髒質量明顯大于假手術對照組，參附彊心汍2.14 g／kg組大鼠腎髒質量較模型對照組降低，且腎體比明顯低于模型對照組，差異均有統計學意義（ P ＜0.05）。肉眼觀察及腎髒病理學顯示，參附彊心汍3箇劑量組及地塞米鬆組大鼠腎髒大小及病變有不同程度減輕。結論：參附彊心汍對大鼠腎暘虛有改善作用，可保護腎功能、改善水鈉潴留狀態、糾正電解質紊亂、可使病變的腎髒組織結構得以脩複。
목적：통과체정、신공능、신경내분비격소、혈청전해질、신장조직형태등배절，탐토삼부강심환대만성신쇠갈대서온양이수적작용여궤제。방법：채용“단신절제합병선표령관위법”제비대서CRF모형，안수궤수자표법분위모형대조조、지새미송대조조、삼부강심환2.14、1.07、0.54 g생약／kg제량조，관찰각조대서신경내분비격소、신공능、혈전해질、체온、신장질량여신체비、신장적조직형태등지표。결과：모형대조조대서출현피모희소，권와소동，소수등쇠약체정，삼부강심환3개제량조대서일반상황교모형대조조명현호전；모형대조조대서뇨소담（ UREA）、기항（ CREA）함량명현승고，삼부강심환3개제량조화지새미송대조조UREA、CREA수평균명현저우모형대조조；모형대조조화삼부강심조대서적혈관긴장소Ⅱ（ AngII）현저저우가수술대조조，철고동（ ALD）명현고우가수술대조조，삼부강심환2.14 g／kg화지새미송대조조대서적ALD교모형대조조명현강저，차이균유통계학의의（ P＜0.05）。모형대조조대서정고갑、저개、고린혈증，삼부강심환2.14 g／kg조대서가규정저혈개증，3개제량조균능규정고린혈증，지새미송대조조가규정대서고갑、저개、고린혈증，차이균유통계학의의（ P＜0.05）。모형대조조대서체온명현강저，지새미송조체온과저；모형대조조신장질량명현대우가수술대조조，삼부강심환2.14 g／kg조대서신장질량교모형대조조강저，차신체비명현저우모형대조조，차이균유통계학의의（ P ＜0.05）。육안관찰급신장병이학현시，삼부강심환3개제량조급지새미송조대서신장대소급병변유불동정도감경。결론：삼부강심환대대서신양허유개선작용，가보호신공능、개선수납저류상태、규정전해질문란、가사병변적신장조직결구득이수복。
OBJECTIVE:To probe into the effects and mechanism of Shenfuqiangxin pills on the warming yang for diuresis of chronic renal failure rats via the link of signs, renal function, neuroendocrine hormone, serum electrolytes and renal tissue morphology, etc.METHODS:The CRF model of rat was established by“unilateral nephrectomy combined with gavageing adenine”, the rats were divided into the model control, dexamethasone group and the dosage group with Shenfuqiangxin pills of 2.14 g/kg, 1.07 g/kg, 0.54 g/kg in crude drug via the random number table.The indexes of neuroendocrine hormone, renal function, blood electrolytes, body temperature, ratio of the kidney weight versus kidney volume and the form of organization of kidney in rates were observed.RESULTS: Some asthenia signs like sparse fur, sedentary lying and emaciation were observed in rats in mode group.The general conditions in three dosage groups of Shenfuqiangxin pills had been significantly improved.Level of UREA and CREA contents increased significantly in mode group,which in three dosage groups of Shenfuqiangxin pills were significantly lower than that in mode group.In mode group and three dosage groups of Shenfuqiangxin pills, angiotensinⅡ( AngⅡ) were significantly lower than that of sham-operation group, but aldosterone (ALD) were significantly higher than that of sham-operation group.Compared with the mode group, ALD in dosage group with 2.14 g/kg Shenfuqiangxin pills and dexamethasone group were obviously decreased, the differences were statistically significant ( P <0.05 ).Hyperkalemia, low calcium and hyperphosphatemia of rats were observed in the mode group, dosage group with 2.14 g/kg Shenfuqiangxin pills could correct hypocalcemia, and three dosage groups of Shenfuqiangxin pills all could correct hyperphosphatemia; the dexamethasone group could correct hyperkalemia, low calcium and hyperphosphatemia of rats,the differences were statistically significant(P<0.05).The body temperature of rats in mode group were significantly decreased,but hypothermia were observed in dexamethasone group.The kidney weight in mode group were significantly higher than that in sham-operation group;compared with the mode group, kidney weight in dosage group with 2.14 g/kg Shenfuqiangxin pills decreased, and the kidney volume was smaller, the difference was statistically significant ( P<0.05).From the visual inspection and renal pathology, it indicated that the kidney size and lesions both had various degrees of relief in three dosage groups of Shenfuqiangxin pills and dexamethasone group.CONCLUSIONS:Shenfuqiangxin pills can improve the function of kidney-yang deficiency rats, protect the renal function, improve water and sodium retention, correct the electrolyte imbalance, and repair the renal lesions.
