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OBJECTIVE To study the effects of Phellodendron amurense polysaccharides （PAP） on improving gouty nephropathy （GN） in rats， and to investigate its mechanism primarily by interfering the p38 mitogen-activated protein kinase （p38 MAPK）/nuclear factor-κB（NF-κB）/tumor necrosis factor-α（TNF-α）. METHODS Sixty rats were randomly divided into normal group （water）， model group （water）， allopurinol group （positive control， 20 mg/kg）， PAP high-dose， medium-dose and low-dose groups （100， 50， 25 mg/kg， by raw material） after being stratified by body weight， with 10 rats in each group. Except for the normal group， the other groups were induced to construct GN model by giving 1 500 mg/kg potassium oxazinate and 100 mg/kg adenine intragastrically for 14 days. After modeling， the rats in each group were given relevant medicine/water intragastrically， once a day， for consecutive 28 days. After the last medication， the levels of biochemical parameters related to renal function [uric acid， creatinine （Cr）， blood urea nitrogen （BUN）， xanthine oxidase （XOD）] were detected in rats， and the histopathological changes in the rat kidney were observed. The protein expressions of monocyte chemoattractant protein-1（MCP-1），TNF-α and interleukin-6（IL-6） as well as the phosphorylation levels of p38 MAPK and NF-κB p65 protein were determined in renal tissue of rats. RESULTS Compared with the normal group， the model group suffered from the dilatation of renal tubules， structural damage to glomeruli， accompanied by inflammatory infiltration and fibrosis； the contents of uric acid， Cr， BUN and XOD， the protein expressions of MCP-1，TNF-α and IL-6 and the phosphorylation levels of p38 MAPK and NF-κB p65 protein were all increased significantly （P＜0.05 or P＜0.01）. Compared with the model group， the pathological symptoms of renal tissue in rats had been improved to varying degrees in different dose groups of PAP； the contents of uric acid， Cr， BUN and XOD， protein expressions of MCP-1， TNF-α and IL-6， the phosphorylation levels of p38 MAPK and NF-κB p65 protein in PAP high-dose and PAP medium-dose groups were all decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS PAP exhibits an anti-GN effect， the mechanism of which may be associated with inhibiting the p38 MAPK/NF-κB/TNF-α signaling pathway.
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ObjectiveTo explore the possible mechanism of total flavonoids of peony flower （TFPF） in protecting rats from gouty nephropathy and provide data support for the pharmaceutical research on the treatment of gouty nephropathy. MethodGouty nephropathy rat model was established by adenine combined with ethambutol. Rats were randomly assigned into blank control group， model group， allopurinol （42 mg·kg-1） group， Tongfengshu tablets （600 mg·kg-1， positive control） group， and TFPF （260， 130， and 65 mg·kg-1） groups. Enzyme-linked immunosorbent assay （ELISA） was employed to measure the levels of tumor necrosis factor-α （TNF-α）， monocyte chemoattractant protein-1 （MCP-1）， interleukin-1β （IL-1β）， and interleukin-18 （IL-18） in rat serum and those of transforming growth factor-β1 （TGF-β1） and IL-1β in renal homogenate. Hematoxylin-eosin（HE） staining was carried out for observation of the morphological changes of renal cells. Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling （TUNEL） was conducted for observation of the DNA damage in renal cells. The expression of NOD-like receptor protein 3 （NLRP3）， cysteine aspartic acid protease（Caspase）-1 and IL-1β were observed by immunohistochemistry. The expression levels of NLRP3， Caspase-1 and nuclear transcription factor -κB （NF-κB） in renal tissues were detected by Western blot. ResultCompared with blank group， the contents of TNF-α， MCP-1， IL-1β， IL-18， and TGF-β1 in serum of model group were significantly increased （P<0.01）， and the expressions of NLRP3， Caspase-1， NF-κB and IL-1β in kidney of model group were significantly increased （P<0.01）. The renal tissue cells showed cytoplasmic swelling， cell membrane rupture， and the number of nuclear pyknotic fracture increased. The positive rate of TUNEL staining was significantly increased in model group （P<0.01）， and the contents of IL-1β and TGF-β1 in renal tissue homogenate were significantly increased （P<0.01）. Compared with model group， the contents of inflammatory factors TNF-α， IL-1β and IL-18 in serum of rats in TFPF high- and medium-dose groups could be decreased to different degrees （P<0.05， P<0.01）， while the content of MCP-1 in TFPF high-dose group was significantly decreased （P<0.01）. The content of TGF-β1 in renal tissue homogenate in TFPF high- and medium-dose groups was significantly decreased （P<0.05， P<0.01）， and the content of IL-1β in renal tissue homogenate in TFPF medium-dose group was significantly decreased （P<0.01）. HE staining showed that each dose group of TFPF could improve the status of renal tubular epithelial cells， reduce cytoplasmic swelling and the number of nuclear pyknosis to varying degrees. The positive rate of TUNEL staining was decreased （P<0.01） and DNA damage was decreased. The expression of NLRP3， Caspase-1， IL-1β and NF-κB protein in renal tissue cells was inhibited （P<0.05， P<0.01）. ConclusionTFPF protects rats from gouty nephropathy by inhibiting the secretion of inflammatory cytokines. Specifically， it may inhibit the activation of NF-κB and NLRP3/Caspase-1 pathways to reduce the expression， maturation， and release of inflammatory cytokines such as IL-1β and IL-18 and further inhibit pyroptosis， thereby reversing the inflammatory injury of kidney in gouty nephropathy.
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Objective: To analyze the therapeutic effect and mechanism of Yishen Simiaotang on gouty nephropathy (GN) complicated with renal failure (RF). Method: Totally 96 cases of GN with RF treated at our hospital from March 2015 to December 2017 were divided into the control group (48 cases) and the observation group (48 cases) according to the random control principle. In addition to the basic therapy, allopurinol was added to the control group, and Yishen Simiaotang was added to observation group. After 2 months of treatment, the clinical efficacy and safety of two groups were compared. The urinary levels of β2-microglobulin (β2-MG), α1-microglobulin (α1-MG), 24 h urine protein (24 hUpro) and glomerular filtration rate (eGFR) were compared between two groups before and after treatment, and the levels of serum albumin (ALB), urea nitrogen (BUN), serum creatinine (SCr) and uric acid (UA) were detected and compared before and after the treatment. The serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and hypersensitivity C reactive protein (hs-CRP) were compared before and after treatment between two groups. Result: The total effective rate of observation group was 89.58%, which was significantly higher than 72.92%of control group (χ2=4.376,PPβ2-MG, α1-MG, 24 hUpro in both groups decreased significantly (PPα, hs-CRP and IL-6 in both groups were significantly lower than those before treatment, and the decrease in observation group was more obvious than that in control group (PConclusion: Yishen Simiaotang is effective in the treatment of GN combined with RF, and can reduce renal tubule injury, improve renal function, regulate the state of micro-inflammation, with a high safety.
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Objective To observe the application of allopurinol in the treatment of gouty nephropathy, and evaluate its clinical effect on the level of serum creatinine and urea nitrogen. Methods Patients with gouty nephropathy from April 2015 to May 2017 in Xining first people's hospital 126 patients as the research object, divided into observation group and control group of 63 cases with double blind random method, given the reference group of patients basic treatment, the observation group treated with allopurinol in the reference group on the basis, effects were compared between the two groups the clinical therapeutic effect and serum creatinine and blood urea nitrogen, blood pressure level. Results After 12 months of therapy, compared two groups of patients before treatment, serum uric acid, creatinine, blood urea nitrogen, blood pressure (systolic blood pressure, diastolic blood pressure) were improved, and the observation group was obviously better than that of control group (P<0.05); the observation group total efficiency of treatment group was 88.89％ (56/63), the reference group was 74.60％ (47/63), with significant difference between two groups (P<0.05). Conclusion Allopurinol can be used in the treatment of gouty nephropathy. It can help to improve the clinical effect and improve the clinical symptoms of the patients. It is of practical value.
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Objective To analyse clinical effects and influence on serum creatinine and blood urea nitrogen of Danggui Niantong pill in treatment of gouty nephropathy. Methods 80 patients with gouty nephropathy were divided into two groups and each with 40 cases.The control group were treated with general therapy,and observation group was treated another with Danggui Niantong pill. Results After treatment,effective rate of observation group was 92.50％,higher than that of control group 72.50％(P<0.05).After treatment,renal function serum markers and urine related factors level of observation group were lower than control group(P<0.05).ESR,WBC and N level of observation group were lower than that of control group(P<0.05).The proportion of adverse reactions of observation group was 15.00％ and control group was 12.50％.Conclusion Danggui Niantong pill can improve clinical effects of gouty nephropathy,reduce renal damage amd does not increase adverse reactions.
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Objective To explore the value of virtual touch tissue quantification(VTQ) on the early diagnosis of gouty nephropathy.Methods 180 healthy controls and 109 gout patients including 57 cases with normal renal function,and 52 cases with gouty nephropathy were measured by VTQ in this study.The shear wave velocity (SWV) of renal cortex,renal medulla and renal sinus were measured using virtual touch tissue quantification(VTQ).The recorded SWV value was compared.Results In all groups,the SWV of renal cortex was the highest with significant difference (P ＜0.01).The SWV of renal cortex in gouty nephropathy group was higher than those in control group (t =0.342,P =0.026).The SWV of renal medulla and sinus in gout with normal renal function group and gouty nephropathy group were higher than those in control group,respectively (gout with normal renal function group:t =-0.311,-0.628; P =0.012,0.000;gouty nephropathy group:t =-0.369,-0.701 ; P =0.000,0.000).The SWV of renal cortex,medulla and sinus had no significant difference between gout patients with normal renal function and gouty nephropathy patients(t =0.117,-0.059,-0.073; P =0.232,0.575,0.523).Conclusions The VTQ technology could quantitatively evaluate tissue elasticity of the gout patients and provide evidence for the early diagnosis of gouty nephropathy.
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Objective To investigate the effect of integrative Chinese and western treatment in gouty nephropathy.Methods 200 cases of gouty nephropathy were divided into Integrative Medicine group( treatment group,n =100)and allopurinol treatment group( control group,n =100),The symptom scores,blood urea nitrogen(BUN),creatinine(CR),serum uric acid(UA),24h urinary protein excretion were observed.Results After treatment symptom scores were significantly lower than before treatment ( P ＜ 0.05 ～ 0.01 ) ; treatment group were lower than the control group( P ＜0.05 );Total effective rate of the treatment group( 86.0％ ) was significantly higher than that of the control group(75.0％ ) (P ＜ 0.05 ) ;After treatment,the renal function was significantly improved,but that of the treatment group was better than the control group( P ＜ 0.05 ).Conclusion Integrative Medicine in the treatment of gouty nephropathy had a good effect.
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The incidence of hyperuricemia and relevant diseases has been increasing recently since the living improvement and dietary changing. Both patients and doctors do not pay enough attention to this disease, due to the lack of obvious clinical presentations in early stage. This paper comments on the relationship between hyperuricemia and gout, gouty nephropathy, impaired glucose metabolism,and atherosclerotic diseases in order to arouse enough attention to this disease.
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Objective To observe the clinical effect of Qilingjiangsuan granules treatment on gouty nephropathy﹙GN﹚Methods83 patients with Gouty nephropathy were divided randomly into two groups: treatment group(42 cases) and the contrast group(41 cases).The patients in treatment group were given Qilingjiangsuan granules and tablet Allopurinol.The patients in contrast group were given tablet Allopurinol.ResultsThe total effective rate of treatment group was 90.84%,and the comparison group's was 63.41%.There were significant differences between two groups(P
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@#ObjectiveTo investigate the effect of Jiawei Glutinous decoction on gouty nephropathy. Methods54 patients with gouty nephropathy were randomized into two groups, 31 patients in the treated group were treated with Jiawei Glutinous decoction, and 23 patients in the control group were treated with allopurinol. Blood uricacid (BUA), renal function, β2-microglobulin (β2-MG) and 24 h urine protein of patiens in two groups were measured before and after treatment.ResultsImprovements of symptoms and renal function as well as decreasing of BUA, β2-MG and 24h PRO in the treated group was superior to those in the control(P<0.05).ConclusionJiawei Glutinous decoction present good effect in treating gouty nephropathy.
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Gout produces not only an arthritis but also a form of kidney disease. Studies by Thannhauser show that the defect lies in the metabolic transport of uric acid in the kidneys, in which there is increased reabsorption of uric acid leading to hyperuricemia and deposition of urates.(Summary)