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Based on the tutor clinical experience in medical treatment of chronic kidney disease proteinuria

Author: WangYunLiang
Tutor: ZhangZuo
School: Beijing University of Traditional Chinese Medicine
Course: Chinese medical science
Keywords: Jiaweihuangqichifeng decoction Adriamycin nephropathy Proteinuria Radical damage Glomerulosclerosis Renal fibrosis
CLC: R277.5
Type: Master's thesis
Year: 2011
Downloads: 6
Quote: 0
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Abstract

Proteinuria is not only a sign of chronic renal disease(CKD), but also a factor that aggravates the progress of kidney diseases. Long term proteinuria, especially when there were a long term heavy and nonselective proteinuria, the toxicity/inflammatory system it contains would increase the ECM as a result of some different activate ways, which leads to renal fibrosis and finally results in renal failure. This progress brings a heavy burden on both the patient and the society, hence, finding an effective way to reduce the proteinuria and block the way the renal diseases evolve is with great significant. With the experience of my supervisor in clinic treating proteinuria and the progress of curing proteinuria all of the world, systematic studies on the prevention and treatment for proteinuria had been performed in this essay from the three following aspects:1 Reference reviewThis essay reviewed from the advances of such fields as follwed:the mechanism of renal toxicity of proteinuria; the mechanism of podocyte damage on proteinuria and the intervention of traditional Chinese medicine.2 Experience study from my supervisor To study the experience in treating proteinuria in chronic nephritis and nephropathy syndrome, and count the most daily used herbals.3 Experimental researchObjective To investigate the effect of Jiaweihuangqichifeng decoction on proteinuria, radical damage, serum NO, serum ET-1 and serum TGF-β1 in nephrotic rats.Methods The rat-models were induced by adriamycin which was injected by caudal vein to cause nephritic syndrome. They were then divided into four groups randomly. The first group was the model group without any treatment. The second and third group were treated with Jiaweihuangqichifeng decoction by moderate dose and double dose separately. The forth group was treated with Benazepril. The amount of 24-hour urinary protein was tested at 14th,28th,42nd and 56th day respectively. Blood and kidneys were harvested by the 56th day, after which biochemical tests were done.Results Model induced by adriamycin showed an increasing proteinuria after 14 days which lasts to the end. The proteinuria decreased after the treatment of drugs:The group treated with double dose had significant differences (P<0.05) compared with the model group at the 28th,42nd and 56th day separately. The group treated with moderate dose had significant differences (P<0.05) at the 28th day and treated with Benazepril (P<0.05) at the 56th day compared with the model group. Meanwhile, compared with the model group, the double dose group had significant differences in renal cortex SOD (P<0.01), renal cortex MDA (P<0.05), serum NO (P<0.01) and serum TGF-β1 (P<0.01), while the renal cortex SOD (P<0.01) and the serum TGF-β1 (P<0.01) in the group treated with moderate dose. As to serum ET-1, the groups had significant differences (P<0.01) compared with the model group treated with moderate dose and Benazepril separately. meanwhile, the serum NO in Benazepril group increased (P<0.05).Conclusion The experiment suggested that Jiaweihuangqichifeng decoction can decrease the proteinuria with the effect of reduce radical damage and can modify the serum NO, serum ET-1 and serum TGF-β1, which give a positive contribution to delaying glomerulosclerosis and renal fibrosis.

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