Observation On The Efficacy Of Yiqi Huayu Qingre Prescription In Therapy Of Efractory Nephritic Syndrome And The Expression Of TRPC6 And Podocalyxin In The Podocyte

This paper contains two parts including clinical observation and Experimental research.Clinical Observation Objective:To retrospectively analyze the clinical effects of Yiqi Huyu Qingre Fang on treating refractory nephrotic syndrome(RNS).Methods:60 cases with RNS enrolled from July 2013 to July 2014 into this retrospective longitudinal study in the first affiliated hospital of Henan college of traditional Chinese medicine and Children’s hospital of zhengzhou city.To observe the changes of those indicators,such as 24h-UTP,ALB,CHOL,FIB,PT,APTT,Frequency of infection and recurrence, Blood routine examination and Hepatorenal function,on the before and after treatment 2 weeks,4weeks,8weeks,12 weeks,24weeks and 36 weeks,to understand the difference between the two groups by the statistical analysis.Results:The total effective rate of the treatment group was 86.7%,while the control group was 70%,the total effective rate in the two group has statistically significant difference(P<0.05) in the two groups.The recurrence rates of the treatment group is lower than the recurrence rates of the control group(P<0.05). After 36 weeks’treatment,the degree of decline of 24-UTP,CHOL and rise level of ALB and improvement of the high blood coagulation in the treatment group were better than those in the control group(P<0.05).Conclusion:Yiqi Huayu Qingre Fang can reduce 24-UTP,and increased ALB,and also can improve blood hypercoagul ability, while it reduce the recurrence rate of refractory nephrotic syndrome in children,and improve the clinical curative effect.There were no adverse reactions during the clinical observations.Experimental Research Objective:To observe the effect of Yiqi Huayu Qingre prescription and its separations on the expression of mouse podocyte TRPC6 and podocalyxin,and to study the cell and molecular biology mecha-nism of those traditional Chinese medicine in the treatment of podocyte in vitro stimulated by PAN.Methods:To stimulated the mouse podocyte with PAN in vitro to make the model of the damaged podocyte,and the damaged podocyte was divided randomly into eight equal groups:contained-yiqi serum group,contained-huayu serum group,contained-qingre serum group,c-ontained compound serum group,the control group,contained-tripterygium glycosides serum group,the model group,the blank group,and to observe the effect of those serum on the expression of the mRNA and protein of TRPC6 and podocalyxin by using RT-PCR and Western Blot.Results:1 RT-PCR results showed:The difference of expression of TRPC6 mRNA and podocal-yxin mRNA in the blank group and the model group had statistical significance(P<0.05).① After serum with those medicine had worked 2L hours,the work of the contained-tripterygium glycosides serum group and contained-tripterygium glycosides serum group were the best.And the expression of the rest of group were lower than the control group;the contained-tripterygium glycosides serum group decreased expression of TRPC6 significantly.then the contained-huayu serum group,contained-qing-re serum group,contained compound serum group did it work,the work of contained-yiqi serum group was worst.②after serum with contained those medicine had worked 48 hours,all the groups could improve the expression of podocalyxin mRNA,and the work of containing compound serum group and the contained-tripterygium glycosides serum group were the best,then the contained-huayu serum group was better than the contained-yiqi serum group and the contained-qingre serum group;all the groups could decrease the expression of TRPC6 mRNA,and those groups had no significant difference.2.Western Blot results showed:The difference of exprression of the protein of TRPC6 and podocalyxin in the blank group and the model group had statistical significance(P<0.05).③ After serum with contained those medicine had worked 24 hours,the work of the contained-qingre serum group on improving the expression of podocalyxin was better than the contained compound serum group,the contained-qingre serum group and the contained-huayu serum.all the groups could decrease the expression of protein of TRPC6,the work of the contained-yiqi serum group and the contained-huayu serum group were the better than the work of the contained compound serum group and the contained-qingre serum group(P<0.05).② After serum with contained those medicine had worked 48 hours,all the groups could improve the expression of protein of podocalyxin,the containing compound serum group was the best,then the contained-huayu serum group was better than the contained-yiqi serum group and the contained qingre serum group.all the groups could decrease the expression of protein of TRPC6,the contained compound serum group was the better than the contained-yiqi serum group、the contained-qingre serum group and the contained-huayu serum group(p<0.05).Conclusion:Yiqi Huayu Qingre prescription and its separations could improve the expression of podocalyxin and decrease the expression of TRPC6.2.The work of the contained qingre serum group on improving the expression of podocalyxin was the best after PAN had worked 24hours.The work of the contained compound serum group in the expression of podocalyxin was the best after PAN had worked 48hours,and the work of the rest of the three groups were weaker than the contained qingre serum group’s.The work of the contained qingre serum group and the contained compound serum group were comparable in the increased podocalyxin mRNA expression to the contained tripterygium glycosides serum group.3.The work of the contained triterygi-um glycosides serum group on decreasing the expression of TRPC6 mRNA was the best after PAN had worked 24hours.the contained qingre serum,the contained huayu serum and the contained compound serum group were weaker than the contained tripterygium glycosides serum group’s.In terms of protein expression,The work of the contained tyiqi serum group and the contained huayu serum group were the best.the contained qingre serumand the contained compound serum group were weaker.All the contained medicine serum group could decrease the expression of TRPC6 after PAN had worked 48hours,and the contained compound serum group was the best in terms of reduced protein.