| ObjectiveObservation of ginseng granules for CTLA-4 blood mononuclear cells of spleen and kidney deficiency syndrome in chronic glomerulonephritis patients,the level of B7-1 and serum IL-2,effects of IFN-γ.The intervention effect of immune inflammatory disorders of ginseng granules induced CTLA-4/B7-1 in patients with chronic nephritis by.Methods:From June 2015-2016 year in December in our department and in accordance with the 60 cases of spleen and kidney deficiency type CGN patients with the inclusion criteria,were randomly divided into 2 groups,30 cases in treatment group and 30 cases in the control group,and the addition of 20 cases of normal group.The treatment group received shendi granules of warm boiling water,three times a day,10 g each time;control group was treated with valsartan,80 mg orally,1 times daily for 12 weeks.Observe two groups of patients before and after treatment 24 H urinary protein(24HUPr),serum creatinine(Scr),blood urea nitrogen(BUN),estimated glomerular filtration rate(e GFR)and B7-1 in peripheral blood mononuclear cells(CD80)and the level of serum interleukin-2(IL-2)and interferon gamma(IFN-y),B7-1 urine(urinary CD80 levels).Results1.During treatment,the treatment group was treated with glucocorticoid drugs,2 cases were taken as control group,and the other group was treated with valsartan.The control group was treated with Tripterygium Glycosides tablets in 1 cases,and the other patients were not treated with valsartan in accordance with the requirements of.A total of 3 cases were excluded.The final completion of the number of cases in 55 cases,the treatment group of 28 cases,the control group of 27 cases,the normal group of 20 cases into statistical analysis.2.Comparison of TCM syndrome integral value:After treatment,the TCM syndrome integral were decreased in two groups of patients,compared with before treatment.The difference was not statistically after independent sample t test(P>0.05);the difference was statistically significant compared two groups before and after treatment by paired samples t test(P<0.05);There was no difference that compared with the treatment group and control group after treatment(P<0.05).3.Comparison of TCM syndromes:The TCM syndrome curative effect in the control group was 55.55%,and effective rate in treatment group was higher than control group,the rate was 92.86%.The Ridit test showed significant difference(P<0.05).4.Disease efficacy determination:The total effective rate of the control group and the treatment group were 62.96% and 89.29%,respectively.Compared with the two groups,there was significant difference(P<0.05).5.24 H urine protein quantitation:Compared with the treatment of fourth weeks before treatment,the treatment group compared with control group 24 HUPr had no statistical significance(P>0.05);for 8 weeks and 12 weeks,the treatment group and the control group have a substantial reduction on 24 HUPr,compared with before treatment,there was statistically significant(P<0.05);after treatment all groups have a substantial reduction on 24 HUPr,especially in the 12 week.The treatment group twelfth weeks urinary protein compared with the control group,the urine protein decreased significantly,with statistical significance(P<0.05).6.Comparison of serum cytokines:IL-2 in control group and treatment group was higher than before treatment,and IL-6 and IFN-γ levels were increased.The difference was significant compared with normal group(P<0.05).At the same group IL-2 increased and IL-6、IFN-γ decreased in the other groups compared with before treatment the difference was statistically significant(P<0.05);After treatment IL-2 was increased in treatment group and control group compared with before treatment.Compared with after treatment the IL-6 and IFN-γ decreased,the difference was significant(P<0.05).7.Serum and urine B7-1:The difference was statistically significant,treatment group and control group compared with before treatment(P<0.05).The difference was statistically significant after treatment the serum B7-1 and urine B7-1 was decreased compared with that before treatment in the same groups(P<0.05).After treatment the serum B7-1 and urine B7-1 in treatment group and control group were decreased,there was no statistically significant difference(P>0.05).8.Comparison of renal function before and after treatment:The treatment group before treatment compared with serum creatinine,urea nitrogen,creatinine,glomerular filtration rate in after treatment,the difference was not statistically significant(P>0.05);Compared with before treatment serum creatinine,urea nitrogen,creatinine,glomerular filtration rate in the treatment group and after treatment,blood urea nitrogen,glomerular filtration rate compared,there was no difference statistical significance(P>0.05).9.Comparison of blood pressure before and after treatment:The treatment group have 28 research object,and about 15 people blood pressure exceed 140/90 mm Hg.The control group have 27 research object and 13 have Hypertension.All of the patients were normal after treatment(below 140/90 mm Hg).Conclusion1.Patients with chronic nephritis have CTLA-4/B7-1 signal system disorder,cause Th1/Th2 cell imbalance,causing the secretion of inflammatory factors,immune complex deposition,the final mesangial proliferation,mesangial matrix increased,glomerular damage increased.2.Th1/Th2 can regulate the costimulatory signal system in patients with CGN,and down regulate IFN-gamma,cytokines and other cytokines,promote the recovery of balance,inhibit the immune disorder,and reduce the renal pathological damage.3.Shendi granules can significantly improve the clinical symptoms of CGN patients with deficiency of spleen and kidney,reduce patient symptom scores,reduce 24 H urinary protein.4.In the course of nephritis,the adverse reactions of the patients after taking the ground particles have not been found.It shows that the patients have a high safety and is beneficial to the clinical application.ObjectiveTo establish a model of mesangial proliferative glomerulonephritis rats and observe CTLA-4 rats,the expression of B7-1 on the cell surface,and cytokines(IL-2,IL-6,INF-γ),24 h urinary protein,renal pathology,to explore the protective mechanism of ginseng granules on mesangial proliferative glomerulonephritis in rats.MethodsThe body weight of 180-220 g male SD rats of clean grade 60,are a qualified animal,animal room school for 1 weeks after.1 weeks to simple random sampling,10 rats were randomly selected as the normal group,the remaining 50 rats were made Ms PGN model,according to the method of random sampling and divided into 3 groups: experiment group(ginseng granules group)and control group(valsartan group),model group.The rats in the model after completion of second days to medicine,ginseng ginseng granules granules group will be dissolved in warm water in the aqueous solution,according to 4.0g/kg D Ig;valsartan group also made in the same way to solvent 1.03mg/1 00g-D dose gavage;model group and normal group were injected daily with the same method step temperature boiling water(3ml)by gavage for 12 weeks,the rats after the experiment.The end of anesthesia,blood and kidney tissue,serum creatinine(Scr),blood urea nitrogen(BUN),24 H urinary protein the level of serum IL-2,IFN-γ,CTLA-4,B7-1 gamma,content,and renal histopathological changes.Result1.The general condition of the rats: After the successful establishment of the model,all the rats were depressed,and they were lazy and lazy,and their hair was dark and dull.The rats in the normal group had good mental state,shiny hair,normal diet and weight gain.The rats in the experimental group and the control group were treated with continuous intragastric administration for 12 weeks.The improvement of mental state,hair gloss,activity,diet intake and body weight increased,and the improvement of the experimental group was better than that of the control group.The rats in the model group was curling up lazy,gray hair,eating less food intake.2.24 H urine protein quantitative: The normal group after 12 weeks of urine protein declined with model group,there was no significant difference between(P>0.05).The 24 H urine protein quantitative was increased after modeal succeed in model group,control group and after experimental modeal;compared with normal group there was statistically significant difference compared with(P<0.05);the experimental group compared with the model group 24 HUPr for sixth weeks,there was no statistically significant difference was statistically significant(P>0.05);twelfth weeks after the experimental group compared with model group(P<0.05).3.Serum cytokines: There was statistical significance,the serum IL-2,IL-6,IFN-γ in model group compared with normal group(P<0.05).IL-6,IFN-γ in control group and experimental group was lower than model group,IL-2 was high than the model group,the difference was statistically significant(P<0.05).IL-2 was high in experimental group,IFN-γ was low compared with control group,the difference was statistically significant(P<0.05).The difference was statistical significant,IL-6 in experimental group compared with control group.4.The difference was statistically significant,the model group serum and urine CD80 were higher than the normal group,the serum levels of CD152 were lower than the normal group,(P<0.05);serum CD152 after treatment in the control group and the experimental group increased,CD80 decreased,with statistical significance(P<0.05).The difference was statistically significant,when the the experimental group compared with the control group,(P<0.05).5.Peripheral blood CTLA-4/B7-1: The model group CD3+CTLA-4+%,CD4+CTLA-4+% was lower than that in normal group is higher than the normal group,there were statistical differences in CD19+CD80+%(P<0.05);the control group,the experimental group compared with the model group,the difference was statistically significant(P<0.05);compared with the control group,CD3+CTLA-4+%,CD4+CTLA-4 +% increased,CD19+CD80+% decreased,with significant difference(P<0.05).6.Scr,BUN: BUN and Scr in model group was high than normal group,the comparison have statistically significant(P<0.05).When give the drugs to those two groups,BUN and Scr were decreased,the comparison have statistical significance(P<0.05).BUN and Scr in experimental group and control group were decreased,the difference was not significant when compared with those two group(P>0.05).7.Renal pathology: Glomerular mesangial cells and mesangial matrix diffuse hyperplasia(3-5 / mesangial area),glomerular volume increased,glomerular capillary lumen stenosis,renal interstitial lymphocytic infiltration,some nterstitial fibrosis.The experimental group and the control group: two groups had mild mesangial cells in the glomeruli,ginseng granules group mesangial matrix hyperplasia and basement membrane thickness were compared with valsartan group,that Shendi granule can inhibit Ms PGN renal mesangial cell proliferation in rats.Conclusion1.In Ms PGN rats,the CTLA-4/B7-1 signal system is disordered,which leads to the imbalance of Th1/Th2 cells,the secretion of inflammatory factors,the deposition of immune complexes,the proliferation of mesangial cells,the increase of mesangial matrix and the aggravation of glomerular damage.2.The particles can regulate the costimulatory signal system of MsPGN rats,down regulate IFNgamma,IL-6 and other cytokines,promote the recovery of Th1/Th2 cells balance,inhibit the continuation of immune disorders,reduce renal pathological damage.3.The expression of CTLA-4 was decreased in Ms PGN rats,which led to the abnormal activation of T lymphocytes,and the cellular and humoral immune responses.The expression of CTLA-4 was inhibited by regulating the expression. |
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