| With the development of urbanization,industrialization,high fat,high sugar diet,excessive nutrition,sedentary and less active habit,and the increase of living habits,Metabolic syndrome(MetS)has gradually become a major public health problem in society.It is reported that the incidence of renal insufficiency and proteinuria in patients with MetS were 5.34 times and 2.91 times higher than those in patients without MetS,respectively.The results showed that MetS patients were more likely to develop renal damage than non-MetS patients.Probe into the core pathogenesis and pathogenesis of MetS renal damage.Give the treatment at the early stage of Metabolic syndrome and its induced renal damage.May prevent the occurrence and progress of renal damage.Searching for the related factors and risk factors of MetS and renal damage is beneficial to the combination of prevention and treatment.To prevent or delay the onset and progression of renal damage in MetS.1.Clinical researchTo observe the Clinical features of renal damage in patients with MetS.Objective:By comparing the severity of renal damage,complications,metabolic abnormalities between MetS patients and non-MetS patients.Observe the effect of MetS on renal damage and its complications.Further explore the risk factors that can promote the development of MetS and its renal damage,In order to intervene,treat,prevent or delay the occurrence and progress of renal damage in MetS.Methods:From January 2017 to January 2018,200 cases of Mets complicated with renal damage in our hospital were collected.100 cases of Mets complicated with renal damage,100 patients with chronic renal insufficiency but not yet diagnosed as Mets were collected.Record the general condition of each patient such as age,gender,weight,blood pressure,primary disease,medical history,family history,eating habits,etc.And serum markers TG,CHO,fasting blood glucose,HDL-C,LDL-C,HGB,ALB,CRP,T3.Renal function index UA,CRE,urea,β2-MG,24 hour urine protein quantitative.Calculate the glomerular filtration rate,BMI,and record the results of renal ultrasonography in each patient.Results:The patients in MetS group had significantly higher UA,Cre,β2-MG and urinary protein levels than those of non-MetS group.The body weight,waist circumference and blood pressure in MetS group were significantly higher than those of non-MetS group.The level of TG,GLU were significantly higher than that of non-Mets group.The level of ALB,HGB,T3 were significantly lower than those of non-MetS group,the level of CRP were significantly higher than that of non-MetS group.Smoking,drinking,diabetes and hyperlipidemia were all risk factors for the development of metabolic syndrome and renal damage.Conclusion:More severe renal structural and functional damage,metabolic disorder occurred in the MetS group than in the non-MetS group.In addition,the common complications of CKD,such as malnutrition,anemia and microinflammation in the MetS group were more serious than those in the non-MetS group under the combined action of renal failure and MetS.The more the number of abnormal metabolic factors,the more serious renal damage.The disorder of glycolipid metabolism,high uric acid,inflammation of the body,smoking and drinking are the high risk factors for MetS and its kidney damage.In the early stage of ckd,liver and spleen lesions are the main lesions,and spleen deficiency syndrome is the core pathogenesis of renal damage in MetS.The research group proposed the method of invigorating spleen and soothing liver to interfere with renal damage of metabolic syndrome.Based on the core pathogenesis of renal damage in MetS,we proposed the method of invigorating spleen and soothing liver to treat renal damage in MetS.To intervene in the absence or early stage of renal damage in MetS.Preventing or delaying the occurrence and progress of renal damage.The effect of strengthening spleen and soothing liver on renal damage of metabolic syndrome was verified by animal experiment,and the curative effect was evaluated.2.Experimental Study2.1 Intervention effect of Chaiqi decoction on glucose and lipid metabolism disorder and renal function in rats with MetS.Objective:To study the effect of Chaiqi decoction on the disorder of glucose and lipid metabolism and renal function in rats with MetS,and to evaluate the effect of Chaiqi decoction on renal damage in rats with MetS.Methods:SD rats were fed with high-fat,high-sugar and high-salt diets to establish a MetS-induced renal injury model.At the same time,Chaiqi Decoction and pioglitazone hydrochloride were used to intervene.At the end of the 16th week of the experiment,blood samples were taken to detect the indexes of glucose and lipid metabolism,such as serum FBG,FINS,TG,TC,HDL-C,LDL-C,and the indexes of renal damage,such as the quantity of urinary protein of 24 hours in rats,Cre,Urea and UA.Results:Body weight,blood pressure,FBG,FINS,TG,TC,and LDL-C in the model group were significantly higher than those of control group.The above indexes in the Chaiqi Decoction and the pioglitazone group were significantly lower than those of model group,but still higher than those of normal group.The difference were statistically significant(P<0.05).The creatinine,Urea,UA and urinary protein were significantly higher in the model group than in the normal group.The above indexes in the Chinese medicine and western medicine groups were significantly lower than those of model group.The difference was statistically significant.Conclusion:Chaiqi decoction can effectively regulate the disorder of glucose and lipid metabolism in MetS rats,alleviate renal damage in Mets rats,thus play a protective role in kidney.2.2 The regulation of p38MAPK-CREB-FN pathway by Chaiqi decoctionObjective:To explore the mechanism of Chaiqi decoction in prevention and treatment of renal damage in MetS.Methods:Observation of renal structure in Mets rats by he staining and masson staining.Detection of the expression of inflammatory factor IL-6 and TNF-α in renal tissue by Elisa.And the level of oxidative stress factor MDA,SOD in the kidney.Detection of protein and gene expression in p38MAPK-CREB-FN signaling pathway by Western-blot and RT-PCR.Results:The model group had more serious renal pathological damage and Fibrin and collagen deposition than the normal group.The content of renal inflammatory factor IL-6,TNF-α,MCP-1 and the level of oxidative stress index MDA in the model group were significantly higher than those in the normal group.The antioxidant stress index SOD was significantly lower than that in the normal group.The protein and gene expression of p38MAPK-CREB-FN in the model group was stronger than that of the normal group,and the protein expression in the western medicine intervention group were weaker than that of the model group.Conclusion:The renal oxidative stress and inflammatory response in the model group were more severe than those in the normal group.Chaiqi decoction alleviates renal inflammatory and oxidative stress by regulating p38mapk-creb-fn oxidative stress and inflammatory response pathway,improves renal pathological injury and plays a protective role in kidney. |
