The Research On The Therapeutic Mechanism Of Tianmaxionglingzhixuan Tablet On Hypertensive Nephropathy And Its Renal Protective Effect

Objective:1?Observing and objectively evaluating the therapeutic effect of Tianmayuzhixuan Tablet on patients with hypertensive nephropathy,such as liver-fired phlegm and phlegm-heating,and exploring its possible mechanism of action;2?To observe the effect of Tianmayuzhixuan Tablet on oxidative stress in renal tissue of rats with hypertensive nephropathy,and to explore its possible therapeutic mechanism;3?To observe the protective effect of Tianmayuzhixuan Tablet on renal damage of hypertensive nephropathy,and provide scientific experimental basis for the prevention and treatment of hypertensive nephropathy.Methods:1.Observing the clinical efficacy of Tianmayuzhixuan Tablet in the treatment of patients with hypertensive nephropathy and the changes of indicators related to hypertensive nephropathy;2,Tianma Quzhi glare tablets for blood and weight monitoring of SHR rats after 24 hours of urine collection,urine protein detection;SHR rats after the intervention of abdominal aorta blood detection of oxidative stress related indicators,Angll,serum BUN,SCr and ? 2-microglobulin and other indicators;after intervention,rat kidney tissue,by immunohistochemistry and Western blot and other methods,the renal kidney tissue of rats after intervention TGF-p 1,NF-? B,Smad4,Smad7,MMP-9,TIMP-1 protein expression and p-Smad2/3,Smad2/3 phosphorylation level,TGF-? 1,NF-? B and other indicators were detected,and the morphology of kidney tissue was observed.Results:The first part:Clinical Study on Tianma Xiongling Zhixuan Tablet against Hypertension and Nephropathy of Ganhuokangsheng Syndromes.1.Patients with hypertensive nephropathy who were treated with Tianma Qushuo Tablets,Luoting New Tablets,and Combination Therapy(Tianma Zhishuo Tablets and Luoting New Tablets)significantly reduced blood pressure and significantly improved renal function.However,the improvement of the above indicators after treatment in patients with hypertensive nephropathy in the combined treatment group is more significant,and the synergistic effect of the combination therapy of the two drugs needs further experimental proof.2.Blood creatinine,serum urea nitrogen level,?2-in patients with hypertensive nephropathy after treatment with Tianma Qushuo Tablet,Luoting New Tablet,and Combination Therapy(Tianma Zhishuo Tablet and Luoting New Tablet)Microglobulin,serum cystatin C.plasma endothelin-1.angiotensin-?,plasma NADPH oxidase activity and ROS levels were significantly higher than healthy controls,but after treatment,all three groups were significant.Improvement,in which the improvement of the above indicators was more significant in patients with hypertensive nephropathy in the combined treatment group.3.The treatment and protective mechanism of Tianmayuzhixuan Tablet on hypertensive nephropathy may be related to the protection of renal vascular endothelial cells by reducing the level of oxidative stress in the body.The second part:Therapeutic Mechanism and Kidney Protection Effect of Tianma Xiongling Zhixuan Tablet on Hypertension Nephropathy of Liver and Kidney Yin Deficiency1,Tianma Quzhi glare tablets can reduce SHR blood pressure,and has a certain diuretic effect,and can significantly reduce the proteinuria level of animal models.2,Tianma Quzhi glare tablets can significantly reduce the level of oxidative stress factors,serum and renal Ang II levels,inflammatory factors,renal tissue TGF-?1 positive expression levels,Samds factor expression levels,etc.To improve the kidney function of animal models;in terms of morphology,Tianma Zhishuo Tablet can significantly improve renal tissue fibrosis,interstitial cell infiltration,basement membrane glycoprotein deposition,podocyte phagocytosis and fusion.3.The treatment and protection mechanism of Tianmayuzhixuan Tablet on animal model hypertensive nephropathy may be through reducing oxidative stress and inflammatory infiltration in SHR,and then improving renal tissue fibrosis caused by hypertensive nephropathy;oxidative stress and Ang? level was positively correlated.Tianmazhizhixuan tablets may also reduce the level of Angll in SHR plasma and kidney by improving oxidative stress in SHR,which in turn affects TGF-?1 and its downstream signaling pathways to exert anti-renal fibrosis.To improve the pathological changes of renal tissue in SHR rats.Conclusion:Tianma Qutan Tablets can effectively improve the TCM syndrome manifestations and clinical symptoms of patients with hypertensive nephropathy,and can improve the degree of renal fibrosis,oxidative stress as renal inflammatory infiltration The initiating factors of renal fibrosis are involved in kidney damage of hypertensive nephropathy.The anti-inflammatory infiltration and anti-renal fibrosis effects of Tianmazhizhixuan tablets may be due to its strong antioxidant capacity.