中图分类号R965；R285 文献标志码A 文章编号 1001-0408（2025）20-2512-07

DOI10.6039/j.issn.1001-0408.2025.20.05

Study on the regulatory effects of Buqi tongqiao formula on intestinal flora and immune balance in IgA nephropathyrats

XU Jinjiang'， ZHANG Man²，WU Qiuye'，GUI Xiongbin³（1. Graduate School，Guangxi University of Chinese Medicine，Nanning 5302O0，China;2.Dept.of Scientific Research，the First Afliated Hospital of Guangxi University of Chinese Medicine，Nanning 530023，China;3.Dept.of Otorhinolaryngology，the First Afiliated Hospital of Guangxi University of Chinese Medicine，Nanning 530023，China）

ABSTRACTOBJECTIVETo explore theregulatory efectsofBuqi tongqiao formulaonintestinalfloraand immunebalance in immunoglobulinAnephropathy（IgAN）rats basedonthe theoryof“treating different diseases with thesame therapy\".METHODS MaleSDratswererandomlyasigned totheNormal groupandthemodelinggroup.IgANratmodelswereestablishedinthe modelinggroupbyintragastricadministrationofbovineserumalbumin，subcutaneous injectionofcarbontetrachlorideandcastor oilmixture，andtailvein injectionoflipopolysaccharide.Succesfullymodeledratswere thenrandomlydividedintothemodel group（Model group），Buqi tongqiao formula low-dose group（BQTQ-L group），Buqi tongqiao formula high-dose group（BQTQHgroup），and positivecontrol group（BZPgroup），with15rats ineach group.BZPgroupreceived intragastricadministrationof benazepril hydrochloride （ [10mg/kg] ），while BQTQ-L and BQTQ-H groups were given Buqi tongqiao formula at doses of 9.81 and （20 19.62g/kg （calculated as raw herb weight），respectively.The Normal group and the Model group received an equal volume of normalsalineintragastrically，onceaday，for8consecutiveweeks.The24-hoururinarytotalprotein（24hUTP）contentswere

measured at weeks 8，10，12，14 and 16 of the experiment. Afterthe last administration，serumcreatinine（Scr）andblood ureanitrogen（BUN）contentsweredetected. Renal histopathological changes and glomerular IgA immune complex deposition were examined.Additionally，alterations in gut microbiota composition，the proportions of peripheral T helper cell 17（Thl7）and regulatoryTcell（Treg），as well as the

ratioof Th17andTreg（Th17/Treg），were analyzedacrossallgroups.RESULTSCompared withthe Model group，ratsinboth BQTQ-LandBQQ-Hgroupsshowed allviatedmesangialcell hyperplasia，reducedmatrix expansion，anddecreased IgAimmune complex deposition in the glomeruli. The 24h UTP contents （at weeks 14 and 16 in the BQTQ-L group；at weeks 12，14 and 16 intheBQTQ-Hgroup），ScrandBUNcontents，IgA-positiveareafluorescenceintensities，relativeabundancesofFirmicutes， Th17 cell proportions，and Th17/Treg were significantly decreased in both BQTQ-L and BQTQ-H groups （Plt;0.05 ）；while the Chaol，Observedspecies，Shannon，andSimpson（exceptforBQTQ-Hgroup）indexes，therelativeabundancesofBacteroidota， and the proportions of Treg were significantly increased （ ⋅lt;0.05 ）.Differential microbiota included c_Clostridia（BQTQ-L group vs.Model group）and g Ruminococcus （BQTQ-H group vs.Model group），etc.CONCLUSIONS Buqi tongqiao formula may allviaterenalijuryandexertarenalprotectiveeffectinIgANratsbymodulatingintestinalflorahomeostasisandTh7/reg immune balance.

KEYWORDSBuqitongqiao formula；immunoglobulinAnephropathy；intestinalflora；immune balance；treatingdiferent diseases with the same therapy

免疫球蛋白A肾病（immunoglobulinAnephropathy，IgAN）是以肾小球系膜细胞增生、基质增多，伴IgA或以IgA为主的免疫复合物在系膜区沉积为特征的一类肾小球疾病，以反复发作性血尿、不同程度蛋白尿为主要临床表现，是全球范围内常见的原发性肾小球疾病]。IgAN是导致患者终末期肾病的重要原因之一，给其家庭及社会带来沉重的经济负担2。目前，血管紧张素转化酶抑制剂、皮质类固醇和免疫抑制剂等药物常被临床用于缓解IgAN患者的疾病进展，但这类药物长期使用可能增加患者感染、代谢紊乱的发生风险，且部分患者接受治疗后仍会进展为终末期肾病。可见，探寻一种有效、安全的IgAN治疗手段十分必要。

由肠道微生物群改变引起的黏膜免疫障碍已被证实是IgAN发病的关键诱导因素。研究指出，失调的肠道菌群可通过T细胞依赖性途径（细胞因子介导）和T细胞非依赖性途径[Toll样受体（Toll-likereceptor，TLR）连接]来促进初始B细胞向IgA抗体分泌细胞转换，从而介导IgAN的发生发展，故靶向调节肠道菌群可能是缓解IgAN的潜在策略。

补气通窍方是桂雄斌教授治疗变应性鼻炎（allergicrhinitis，AR）的经验方，由黄芪、党参、甘草、苍耳子、辛夷、细辛、荆芥、桔梗、鱼脑石、升麻、柴胡组方而成。本课题组在前期研究中发现，补气通窍方可通过调控辅助性T细胞17（Thelpercell17，Th17）与调节性T细胞（regulatoryTcell，Treg）比值（Th17/Treg）来平衡免疫、改善肠道菌群，从而缓解同为免疫性疾病的AR。“异病同治\"是中医理论辨证施治的重要体现，其核心在于针对不同疾病的相同病机进行治疗。……