The Study Of Interventional Effect Of Jiaweitianmagou-tengyin Decoction On The Early Hypertensive Renal Damage And Vascular Endothelial Dysfunction Of Shr

Objective:To observe the relationship between the vascular endothelial dysfunction and early kidney damage by using the model of spontaneously hypertensive rat (SHR); meanwhile, the SHR were fed with the decoction of Jiaweitianmagoutengyin in the early renal damage(16 weeks), to observe its effects on vascular endothelial function and early kidney damage, explore the channels and mechanisms simultaneously.Methods:40 homogenous 15-week-old male SHR were purchased, adaptive feeding for one week, then weigh, tag the life number and randomly divided into 4 groups, namely, model control group, Jiaweitianmagoutengyin group, Fosinopril group and the joint intervention group. The correlation between 24-hour urine protein excretion and serum NO, plasma ET-1 and circulating NO/ET-1 were observed through the model control group; Meanwhile, the experimental groups, were given corresponding drug-interventions in the early stage of hypertensive renal injury (16 weeks), the changes of blood pressure, 24-hour urine protein quantitative, creatinine clearance rate, serum NO, plasma ET-1 and circulating NO/ET-1 of SHR were observed after using Jiaweitianmagoutengyin decoction, Fosinopril and the combining use of both drugs.Results:1.In model control group,24-hour urine protein excretion was negatively correlated with plasma ET-1, Pearson coefficient was -0.818, P=0.047, P<0.01; and had a negative correlation with circulating NO/ET-1, too, Pearson coefficient was -0.835, P= 0.039, P<0.05; significant relationship between 24-hour urine protein excretion and serum NO was not found.2.Jiaweitianmagoutengyin decoction can significantly reduce the pulse pressure of SHR, P<0.01, play a synergistic effect of depressurization after combining use of Fosinopril.3.Jiaweitianmagoutengyin decoction can significantly reduce the plasma ET-1 level, P<0.01; no significant effect on serum NO level, P> 0.05.4. After combining use of Jiaweitianmagoutengyin decoction and Fosinopril, the 24-hour urinary protein quantitative decreased significantly, compared with the model control group, P <0.01; circulating NO/ET-1 increased compared with model control group, P<0.05.Conclusion:1.SHR's 24 hours urinary protein excretion and serum nitric oxide concentration was negatively correlated, there was also a negative correlation between 24 hours urinary protein excretion and the level of circulating NO/ET-1, speculating that there was a certain degree of relevance between the early stage of hypertensive renal damage and vascular endothelial dysfunction.,especially the diastolic dysfunction.2.Independent use of Jiaweitianmagoutengyin decoction can significantly reduce the pulse pressure, has the equal efficacy compared with Fosinopril(ACEI).3. Jiaweitianmagoutengyin decoction has a good protective effect on vascular endothelium, particularly in reducing plasma ET-1 level, mainly to ameliorate the endothelium-dependent contraction.4.Combining use of Jiaweitianmagoutengyin decoction and Fosinopril(ACEI) showed a synergistic effect of depressurization, further ease early kidney damage, speculating its mechanism may be related to the role of vascular endothelial protection of Jiaweitianmagoutengyin decoction. 5.After combining use of Jiaweitianmagoutengyin decoction and Fosinopril(ACEI), vascular endothelial function and renal damage have improved to some extent,considering the first result of this experiment, speculating that improving vascular endothelial function is a new and effective way to intervene early hypertensive renal damage.6.For prevention and treatment of early hypertensive renal damage, we emphasize the early detection of sensitive indicators;combined with syndrome differentiation, joint use of Chinese medicine compound and antihypertensive drugs, multi-target interference,can play a synergistic role for protection of target organs.