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The Clinical and Experimental Research on Jiaweihuangqichifeng Soup for the Treatment of IgA Nephropathy Proteinuria and the Prevention of Renal Fibrosis

Author: JiaoZhiNa
Tutor: ZhangZuo
School: China Academy of Traditional Chinese Medicine
Course: Chinese medical science
Keywords: Jiaweihuangqichifeng soup IgA nephritic disease single caserandomized controlled lipopolysaccharide glomerular mesangial cell glomerularsclerosis extracellular matrix
CLC: R277.5
Type: Master's thesis
Year: 2013
Downloads: 18
Quote: 0
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Abstract


Part1:Reference review The research progress in the treatment of IgA nephritic disease by using Traditional Chinese Medicine.Part2:Clinical Reseach The single case randomized controlled research in the treatment of proteinuria in IgA nephritic disease by using Jiaweihuangqichifeng soup.Objective:To observe JiaweihuangqichifengSoup’s safety and efficacy of treatment of IgA nephritic disease.Methods:Recruit subjects in strict accordance with the requirements of thestudy. Take single case randomized controlled design, which means every case’s research is divided into three rounds and every round is divided into two periods, treatment period and control period, each of them costs four weeks. Every round is randomized by random number table and then designs the therapeutic schedule. In addition of regular treatments, cases in treatment period are given Jisweihuangqichifeng soup and Telmisartan while cases in control period are only given Telmisartan. Patients’ cardinal symptom integral and24-hour urinary protein quantity are the therapeutic effect indexesand hepatorenal function and blood routine examination are the Security Index. The symptom integral will be recorded every day and the laboratory index will be recorded before and after the study.Result:The five cases’ Chinese medicine’s symptom integral had varying degrees’ improvement in each round. Among them, all patients’ symptom improved completely (P<0.05) in the first round except patient2and patient5’s symptomwhich only improved partly.After combining with Chinese medicine’s symptom integral, the five patients’ control periods’ symptom all improved(P<0.05)compared with treatment periods’. In each round, the five patients’treatment periods’24-hour urine protein quantitation are lesser than the control period(P<0.05). After combining all the three rounds’ data of five patients’ clinical symptom integral and24-hour urine protein quantitation, the differences between treatment period and control period have statistical significance(P<0.05). All data of treatment period are better than that of control period and no adverse event happen. Conclusion:Jiaweihuangqichifeng Soup is safe and effective in treating IgA nephritic disease, Randomized controlled single cases applied to IgA nephropathy disease is feasible.Part3:Experimental Research Effect of Jiaweihuangqichifeng soup on proliferation of Glomerular mesangial cells in mice stimulated by Lipopolysaccharide and the expression of extracellular matrix.Objective:To observe JiaweihuangqichifengSoup’s influence on proliferation of mesangial cells (GMC) stimulated by Lipopolysaccharide (LPS), expression of laminin (LN), IV collagen fibers (Col-IV), and fibronectin (FN)in the cell supernatant, and cell cycle and then discuss JiaweihuangqichifengSoup’s significance in treating IgA nephritic disease and preventing renal fibrosis.Method:Prepare medicated serum by using JiaweihuangqichifengSoup and Telmisartan to give ratintragastric administration. Take DMEM nutrient solution with10%medicated serum to culture GMC and LPS in vitro as stimulating factors, divide cells into blank group, LPS group, Telmisartan group, high dose JiaweihuangqichifengSoup group, mid dose JiaweihuangqichifengSoup group and low dose JiaweihuangqichifengSoup group and then observe the following phenomenon:First, Taking CCK-8and MTT methods to detect medicated serum’s toxic effect on GMC and dynamic observing GMC’s proliferation in various treatment factors. Second, taking Enzyme-linked immunoassay adsorption test (ELISA) to measure vitro cultured GMC’s extracellular matrix (ECM)(LN,Col-IV and FN)’s secretion situation under various treatment factors. Third, detect cells cycle byflow cytometry (FCM).Result:Compared with the normal group, medicated serum have no toxic effect on GMC(P>0.05). LPS can stimulate the proliferation of vitro cultured GCM which have the performance that Compared with the normal group, cell proliferation in0.625-80ug/ml LPS group have statistical significance(P<0.0). Jiaweihuangqichifeng Soup’s groups all have inhibiting effect on GMC’s proliferation stimulated by LPS at24,47and72hour and among them, the inhibition rate was highest at24hour. Compare each TCM group’s inhibition ratio at a fixed point-in-time, mid dose group and high dose group have statistical differences and mid dose group and low dose group have statistical difference(P<0.05). Jiaweihuangqichifeng Soup can block the cell cycle.Compared with the model group, in the mid dose group and high dose group,the percentage of G0/G1phase cells gradually increased,while the percentage of S phase cells reduced(P<0.05); For effects on ECM, compared with72-hour model set, Col-Ⅳ、FN’s content in Jiaweihuangqichifeng soup high-dose group decreased obviously (P<0.01) and LN’s content didn’t change much, Col-Ⅳ、FN、LN’s content in Jiaweihuangqichifeng soup mid-dose groupall decreased obviously (P<0.01) and only FN’s content decreased obviously in Jiaweihuangqichifeng soup low-dose group, the other two didn’t change obviously.Conclusion:LPS can stimulate GMC’s proliferation. Jiaweihuangqichifeng soup can obviously restrain GMC’s proliferation,make it arrest in G0/G1, and it can restrain ECM’s secretion stimulated by LPS which means that GMC is the important target cell for Jiaweihuangqichifeng soup in treating IgA nephritic disease and preventing renal fibrosis. Jiaweihuangqichifeng soup rely on dose or time in certain degree to restrain GMC’s proliferation which means the clinical drug administration time and dosage are rational and long-term using is safety and effective.

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