目的 基于“金水相生”探讨补肺活血胶囊对慢性阻塞性肺疾病（COPD）相关性肾损伤的小鼠模型的治疗作用。方法 32只C57BL/6小鼠随机分为对照组、模型组和补肺活血胶囊低、高剂量（0.32、0.64 g·kg^-1）组，除对照组外，通过香烟烟熏联合气管内滴注脂多糖诱导COPD，同时用腺嘌呤ig诱导肾损伤来建立COPD相关性肾损伤模型，造模成功后，ig给予补肺活血胶囊4周；评估小鼠一般行为学变化、抓力、体质量；酶联免疫吸附测定（ELISA）法检测血清中白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、半胱氨酸蛋白酶抑制剂-C（Cys-C）水平；苏木精-伊红（HE）染色观察肺、肾组织病理变化； Western blotting法检测肾组织中肾损伤分子-1（Kim-1）、中性粒细胞明胶酶相关脂蛋白（NGAL）的蛋白表达。结果 与模型组相比，补肺活血胶囊组小鼠的精神状况、咳喘好转，体质量、抓力均显著增加（P＜0.05）；血清中炎症因子IL-6、TNF-α和Cys-C水平均显著降低（P＜0.05），肺组织炎症细胞浸润减少、肺泡结构恢复，肾组织表现为肾小球和肾小管结构的改善；小鼠肾组织中Kim-1、NGAL蛋白表达水平显著降低（P＜0.05）。结论 补肺活血胶囊能改善COPD相关性肾损伤模型小鼠肺、肾组织病理损伤，其机制与Kim-1/NGAL相关信号通路表达降低及炎症因子的减少有关。

Objective To investigate the therapeutic effects of Bufei Huoxue Capsule on chronic obstructive pulmonary disease (COPD)-associated kidney injury in mice based on the "Metal-Water Mutual Generation" theory in traditional Chinese medicine. Methods Thirty-two C57BL/6 mice were randomly divided into four groups: control, model, low-dose Bufei Huoxue Capsule (0.32 g·kg^-1), and high-dose Bufei Huoxue Capsule (0.64 g·kg^-1). The COPD-associated kidney injury model was established by cigarette smoke exposure combined with intratracheal lipopolysaccharide (LPS) instillation to induce COPD, along with adenine by gavage to induce kidney injury. Treatments were administered for four weeks. General behavior, grip strength, and body weight were assessed. Serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and cystatin C (Cys-C) were measured using ELISA. Pathological changes in lung and kidney tissues were observed via hematoxylin-eosin (HE) staining. Protein expression of kidney injury molecule-1 (Kim-1), neutrophil gelatinase-associated lipocalin (NGAL)in renal tissues was detected by Western blotting. Results Compared with the model group, mice treated with Bufei Huoxue Capsule showed improved mental status, reduced coughing/wheezing, and significantly increased body weight and grip strength (P<0.05). Serum levels of IL-6, TNF-α, and Cys-C were significantly decreased (P<0.05). Lung tissues exhibited reduced inflammatory cell infiltration and restored alveolar structure, while kidney tissues showed improved glomerular and tubular structures. Expression levels of Kim-1 and NGAL in renal tissues were significantly downregulated (P<0.05). Conclusion Bufei Huoxue Capsule ameliorates pathological damage in lung and kidney tissues in COPD-associated kidney injury mice, potentially mediated by suppressing the Kim-1/NGAL signaling pathway and reducing inflammatory factors.

R285.5

湖北省自然科学基金-中医药创新发展联合基金项目（2024AFD280）