Effects of Tongmai oral liquid in femoral ateriovenous fistula

BMC Complementary and Alternative Medicine

Xi-Na Jie²  Yi-Qun Lin²  Wen-Jia Geng²  Ni-Zhi Yang²  Guan-Su Wang²  Wei Mao²  Han-Guo Peng³  Kun Bao²  Pei-Ling Su¹ 

[1] Department of Nephrology, The Third Affiliated Hospital, Guangxi University of Chinese Medicine (Liuzhou traditional Chinese Medical Hospital), No.32 of Jiefang Road, Liuzhou 545001, China;Department of Nephrology, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), No.111 of Dade Road, Guangzhou 510120, China;Jiangmen Xinhui District Hospital of Chinese Medicine, No.47 of Huimin Road, Jiangmen 529100, China

关键词: Hemodialysis;    Early fistula maturation;    Tongmai oral liquid;   

Others  :  1224053
DOI  :  10.1186/s12906-015-0844-8

 received in 2015-01-18, accepted in 2015-09-02,  发布年份 2015

【 摘 要 】

Background

This study was conducted to investigate the protective effect of Tongmai oral liquid on arteriovenous fistula function and to provide an effective method to promote fistula maturation.

Methods

Fifteen female and fifteen male SPF New Zealand rabbits were randomly allocated into 3 groups including control, Aspirin and Tongmai oral liquid groups. A side-to-side femoral arteriovenous fistula was established in each rabbit and then animals were treated with Aspirin or Tongmai oral liquid for 2 weeks. The concentrations of circulating ET-1 and NO were determined before and after operation (on preoperative day, operative day, post-D1, post-D3, post-D7 and post-D15), respectively. Blood flow of the fistula stoma and contralateral artery and vein was determined on the 15 ^thpostoperative day. Last, the fistula stoma was dissected to observe patency, thrombosis and adhesion with surrounding tissues.

Results

28 rabbits survived during the surgical process and the following 15-day observational period. Tissue adhesion of arteriovenous fistula with surrounding tissues was improved and fistula thrombosis was reduced by treatment with Tongmai oral liquid. NO concentration decreased to a different extent after vascular surgery. Tongmai oral liquid failed to regulate the equilibrium between NO and ET-1, but it improved blood flow of fistula stoma, as compared to control and Aspirin groups. Blood flow of fistula stoma in the three groups was lower than that of the contralateral femoral artery.

Conclusions

Tongmai oral liquid improved the function of femoral ateriovenous fistula in the rabbit model by increasing blood flow and reducing thrombosis, probably not by regulating the dynamic equilibrium between NO and ET-1.

【 授权许可】

   
2015 Su et al.

【 图 表 】

Fig. 1.

Fig. 2.

【 参考文献 】

• [1]Feldman HI, Kobrin S, Wasserstein A. Hemodialysis vascular access morbidity. J Am Soc Nephrol. 1996; 7(4):523-35.
• [2]Vachharajani TJ. Diagnosis of arteriovenous fistula dysfunction. Semin Dial. 2012; 25(4):445-50.
• [3]Campos RP, Do NM, Chula DC, Do Nascimento DE, Riella MC. Stenosis in hemodialysis arteriovenous fistula: evaluation and treatment. Hemodial Int. 2006; 10(2):152-61.
• [4]Roy-Chaudhury P, Arend L, Zhang J, Krishnamoorthy M, Wang Y, Banerjee R et al.. Neointimal hyperplasia in early arteriovenous fistula failure. Am J Kidney Dis. 2007; 50(5):782-90.
• [5]Allon M, Robbin ML. Increasing arteriovenous fistulas in hemodialysis patients: problems and solutions. Kidney Int. 2002; 62(4):1109-24.
• [6]Nassar GM, Nguyen B, Rhee E, Achkar K. Endovascular treatment of the “failing to mature” arteriovenous fistula. Clin J Am Soc Nephrol. 2006; 1(2):275-80.
• [7]Liu QX. Significance of NO and endothelin interactions in cardiovascular disease [In Chinese]. Chin J Microcirc. 1997; 01:46-9.
• [8]Wang HT, Ji KG, Wang X. Progression of endothelial function in cardiovascular disease [In Chinese]. Guangming J Chin Med. 2009; 06:1193-5.
• [9]Cornwell TL, Arnold E, Boerth NJ, Lincoln TM. Inhibition of smooth muscle cell growth by nitric oxide and activation of cAMP-dependent protein kinase by cGMP. Am J Physiol. 1994; 267:C1405-13.
• [10]Liang A, Wang Y, Han G, Truong L, Cheng J. Chronic kidney disease accelerates endothelial barrier dysfunction in a mouse model of an arteriovenous fistula. Am J Physiol Renal Physiol. 2013; 304(12):1413-20.
• [11]Lin HQ. Studies on the pharmacologic substance basis of Tongmai oral liquid [In Chinese]. MM thesis. Guangzhou: Guangzhou University of Chinese Medicine, Chinese Herbal Medicine Department; 2005.
• [12]Yang NZ, Wang LX, Lin QZ, Mao W, Bao Y. Effect of Tongmai oral liquid in chronic nephritis of Qi-dificiency and blood stasis type: a clinical study of 32 cases [In Chinese]. J New Chinese Med. 2003; 01:19-21.
• [13]Wang J. Effect of Sanqi Oral Liquid on platelet activity of diabetes nephrology [In Chinese]. PhD thesis. Guangzhou: Guangzhou University of Chinese Medicine, Traditional Chinese Internal Medicine Department; 2011.
• [14]Chen Q, Shen Q, Xie XY, Shen JH, Wang LX, Dang H. Effect of Tongmai Oral Liquid on hemodynamics of patients with chronic glomerular nephritis [In Chinese]. J New Chinese Med. 2011; 03:42-3.
• [15]Lin QZ, Fan LM, Huang J, Bao K, Li F, Wu XQ et al.. Effect of Tongmai Oral Liquid in microinflammation status in patients with hemodialysis [In Chinese]. Chin J Integr Tradit West Nephrol. 2010; 05:437-9.
• [16]Wang LX, Yang NZ. Effect of Tongmai Oral Liquid to hemorrheology of patients with chronic glomerular nephritis [In Chinese]. Heilongjiang J Tradit Chin Med. 1997; 04:47-8.
• [17]Shi XY. Methodology of medical animal experiments [In Chinese]. People’s Medical Publishing House, Beijing; 1980.
• [18]Ghanem AA, Elewa AM, Arafa LF. Endothelin-1 and nitric oxide levels in patients with glaucoma. Ophthalmic Res. 2011; 46(2):98-102.
• [19]Gokce N, Keaney JJ, Hunter LM, Watkins MT, Menzoian JO, Vita JA. Risk stratification for postoperative cardiovascular events via noninvasive assessment of endothelial function:a prospective study. Circulation. 2002; 105(13):1567-72.
• [20]Hu PP, Yang F, Wang YZ. Dynamic study progress of neointimal hyperplasia mechanisms in AVF [In Chinese]. Chin Jf Blood Purif. 2011; 10(10):564-6.
• [21]Stracke S, Konner K, Kostlin I, Friedl R, Jehle PM, Hombach V et al.. Increased expression of TGF-beta1 and IGF-1 in inflammatory stenotic lesions of hemodialysis fistulas. Kidney Int. 2002; 61:1011-9.
• [22]Jiang D, Jiang Z, Han F, Zhang Y, Li Z. HGF suppresses the production of collagen type III and alpha-SMA induced by TGF-beta1 in healing fibroblasts. Eur J Appl Physiol. 2008; 103:489-93.
• [23]Subramanian SV, Polikandriotis JA, Kelm RJ, David JJ, Orosz CG, Strauch AR. Introduction of vascular smooth muscle alpha-actin gene transcription in transforming growth factor beta1 activated myofibroblasts mediated by dynamic interplay between the Pur repressor proteins and Sp1/Smad coactivators. Mol Biol Cell. 2004; 15:4532-43.
• [24]Yang B, Janardhanan R, Vohra P, Greene EL, Bhattacharya S, Withers S et al.. Adventitial transduction of lentivirus-shRNAVEGF-A in arteriovenous fistula reduces venous stenosis formation. Kidney Int. 2014; 85(2):289-306.
• [25]Fan P, Yang NZ. Effect of Tongmai oral liquid to real pathology and TGF-beta1 in a diabetic nephropathy murine model [In Chinese]. J Guangzhou Univ Tradit Chin Med. 2008; 06:514-8.
• [26]Wang LX, Duan XJ, Yang NZ, Yang HF, Ou RM, Han L et al.. Effects of Tongmai oral liquid to tubulointerstitial lesion in primary nephritis [In Chinese]. Liaoning J Tradit Chin Med. 2011; 04:764-7.
• [27]Wang LX. Chronic renal failure syndromes distribution and discussion on the mechanism of Yiqi Huoxue Juandu therapy [In Chinese]. PhD thesis. Guangzhou: Guangzhou University of Chinese Medicine, Traditional Chinese Internal Medicine Department; 2006.
• [28]Li JD. The connotation of modern pathology of blood stasis [In Chinese]. Chin J Basic Med Chin Med. 1998; 4:21.
• [29]Li X, Jiang P. Endothelial cell injury and blood stasis [In Chinese]. Chin J Integr Med. 2000; 02:75-7.
• [30]Wang J, Yao KW. Research progression and reflection of essence of blood stasis syndrome [In Chinese]. China J Tradit Chin Med Pharm. 2003; 08:490-3.
• [31]Chen KJ, Li LD, Weng WL. Research of blood stasis syndrome and activating blood to remove blood stasis [In Chinese]. Chin J Integr Med Cardio-Cerebrovascular Dis. 2005; 01:1-2.
• [32]Yang JQ, He HB. Pharmacological research progression of Astragalus [In Chinese]. J Med Theory Pract. 2010; 02:148-50.
• [33]Li JH. Pharmacological research of Astragalus [In Chinese]. J Liaoning Univ Tradit Chin Med. 2009; 04:188-9.
• [34]He K. Pharmacological research progression of radix notoginseng [In Chinese]. Chin J Ethnomed Ethnopharmacy. 2011; 06:21-3.
• [35]He J. Pharmacological effect and research progression of radix notoginseng [In Chinese]. Tianjin Pharmacy. 2004; 05:58-60.
• [36]Li ZX, Li J. Aspirin reduces fistula thrombosis in patients with uremia [In Chinese]. J Modern Med Health. 2012; 16:2479-80.
• [37]Hasegawa T, Elder SJ, Bragg-Gresham JL, Pisoni RL, Yamazaki S, Akizawa T et al.. Consistent aspirin use associated with improved arteriovenous fistula survival among incident hemodialysis patients in the dialysis outcomes and practice patterns study. Clin J Am Soc Nephrol. 2008; 3(5):1373-8.
• [38]Kang L, Yamada S, Hernandez MC, Croatt AJ, Grande JP, Juncos JP et al.. Regional and systemic hemodynamic responses following the creation of a murine arteriovenous fistula. Am J Physiol Renal Physiol. 2011; 301(4):F845-51.
• [39]Manning E, Skartsis N, Orta AM, Velazquez OC, Liu ZJ, Asif A et al.. A new arteriovenous fistula model to study the development of neointimal hyperplasia. J Vasc Res. 2012; 49(2):123-31.
• [40]Langer S, Heiss C, Paulus N, Bektas N, Mommertz G, Rowinska Z et al.. Functional and structural response of arterialized femoral veins in a rodent AV fistula model. Nephrol Dial Transplant. 2009; 24(7):2201-6.
• [41]Li J, Liu H, Zhu XP, Peng YM, Liu FY. Dynamic observation of Hemodynamics to patients treated with hemodialysis suffered with arteriovenous fistula [In Chinese]. J Mod Med. 2003; 15:32-3.
• [42]Zheng DW, Liu GH, Ye RG, Xie YH. Effect of AVF blood flow on cardiac function of hemodialysis patients [In Chinese]. Chin J Integr Tradit Western Nephrology. 2004; 06:328-9.
• [43]Saad TF. Management of the immature autogenous arteriovenous fistula. Vascular. 2010; 18(6):316-24.
• [44]Hua S, Ye CY, Dong ZY, Gao X, Ji CC, Fu LL et al.. A rat model of autogenous internal arteriovenous fistula and the experimental study on internal fistula stenosis [In Chinese]. Chin J Blood Purif. 2009; 6:322-5.