目的：探讨真武汤对糖尿病大鼠肾脏的保护作用及机制。方法：腹腔注射链脲佐菌素（ STZ）建立糖尿病肾病大鼠模型，将成模大鼠随机分为糖尿病肾病（ DN）模型组和真武汤治疗组（真武组），另设正常组。采用生化、HE染色观察真武汤对糖尿病肾病大鼠肾功能、肾组织形态学变化及脂质过氧化相关参数的作用；采用蛋白免疫印迹方法探讨真武汤对肾组织α-平滑肌肌动蛋白（α-SMA）和NF-κB表达的影响。结果：模型组大鼠肾系数、24 h尿蛋白定量、血尿素氮、肌酐、血糖和丙二醛（MDA）均显著升高（P＜0．05），体重、超氧化物歧化酶（SOD）及诱导型一氧化氮合酶（iNOS）显著降低（P＜0．05）；真武组大鼠的肾系数、24 h尿蛋白、尿素氮、肌酐、血糖和MDA明显低于模型组（P＜0．05），iNOS显著高于模型组（P＜0．05）；模型组大鼠肾小球肥大、毛细血管基底膜增厚，系膜基质增生，肾小管上皮细胞空泡样变，可见蛋白管型；真武组病变轻于模型组。模型大鼠肾组织α-SMA及NF-κB蛋白的水平明显高于正常组（P＜0．05），真武组大鼠肾组织α-SMA及NF-κB蛋白水平明显低于模型组（P＜0．05）。结论：真武汤能减轻糖尿病肾病肾脏局部氧化应激反应，改善糖尿病肾病大鼠肾功能，减轻病理损伤，其发挥肾脏保护作用可能与抑制α-SMA及NF-κB蛋白的表达有关。%AIM:To investigate the effects of Zhenwu decoction ( ZWD) on the expression of α-smooth muscle actin (α-SMA) and NF-κB in diabetic nephropathy ( DN) rats.METHODS:Diabetic rat model was induced by intrape-ritoneal injection of streptozotocin ( STZ) , and the animals were randomly divided into STZ group ( n=22) and STZ+ZWD group (n=23).The normal rats served as control (n=16).All rats were sacrificed on 8 weeks after modeling.Biochemical assay and pathological observation ( HE staining and transmission electron microscopy ) were used to evaluate the effects of Zhenwu decoction on the renal function and pathological morphology .The body weight , renal index , blood glucose , total urinary protein in 24 h, and superoxide dismutase ( SOD ) , malondialdehyde ( MDA ) , inducible nitric oxide synthase ( iNOS) were determined as well .Western blotting was used to observe the effects of Zhenwu decoction on the expression ofα-SMA and NF-κB in diabetic nephropathy ( DN) rats.RESULTS:Compared with normal group , the renal index , blood glucose concentration, total urinary protein in 24 h, blood urea nitrogen (BUN), serum creatinine (SCr) and MDA were significantly higher and body weight was lower in DN rats (P<0.05).Pathological examination of the kidneys in DN group showed glomerular hypertrophy , glomerular basement membrane thickening , tubular epithelial cell degeneration , me-sangial matrix proliferation , protein cast formation in some renal tubules .The protein expression levels of α-SMA and NF-κB were markedly increased (P<0.05).After ZWD treatment, the level of renal index, total urinary protein in 24 h, BUN, SCr and the expression of α-SMA and NF-κB at the protein level were significantly decreased (P<0.05).The renal histological injury in ZWD group was significantly ameliorated .CONCLUSION: Zhenwu decoction might protect kidney against STZ-induced injury via decreasing the expression of α-SMA and NF-κB.
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