目的:观察补肾活血方是否对对慢性肾脏病(CKD)血管钙化(VC)大鼠模型B淋巴细胞瘤-2(Bcl-2)、Bcl-2相关X蛋白(Bax)相关凋亡蛋白有调控作用,从而抑制CKD大鼠的血管钙化,并探讨其作用机制。方法:将90只大鼠按体质量随机均分为正常组,模型组、骨化三醇组,中药高、中、低剂量组,每组15只。实验第1-4周,模型组及中药各剂量组大鼠均按250mg/kg剂量给予腺嘌呤混悬液灌胃及含1.2%高磷饲料喂养,第5-8周腺嘌呤改为隔日灌胃,同时中药各剂量组用补肾活血方灌胃治疗,正常组灌胃等量0.9%氯化钠溶液,连续给药8周。给药结束后,检测小鼠体质量及肝肾指数。HE染色观察肾组织变化,茜素红染色观察主动脉钙化结节情况。腹主动脉取血检测血清钙(Ca)、磷(P)、血肌酐(CREA)、尿素氮(UREA)。Western blot法检测主动脉α-平滑肌蛋白(α-SMA)、ALP、Bcl-2、Bax、Caspase-3蛋白的表达。结果:模型组肝肾脏指数显著增加(P<0.01),中药中剂量和高剂量组肾脏指数具有明显差异(P<0.01)。HE染色显示中药组较模型组正常肾小球数目增多,肾小管扩张程度降低,炎性浸润减少,腺嘌呤结晶减少。茜素红染色显示中药各剂量组钙化减轻,中、高剂量减轻较为明显。与正常组同期比较,模型组血P、CREA、UREA水平升高显著,血Ca水平显著下降,主动脉ALP蛋白表达明显升高,α-SMA蛋白表达明显下降,抑凋亡蛋白Bcl-2表达显著下调、凋亡蛋白Bax、Caspase-3表达显著上调(P<0.01);与模型组比较,第4周中药中剂量组血P、CREA、UREA水平显著下降(P<0.05),血Ca水平显著升高(P<0.01),第8周中药各剂量组血P、CREA、UREA水平显著下降(P<0.01),血钙显著上升(P<0.01)。骨化三醇组第8周血P显著降低,血钙显著升高(P<0.05)。Western blot结果显示,中药中、高剂量组主动脉ALP、Bax、Caspase-3蛋白表达降低、α-SMA、Bcl-2蛋白表达升高(P<0.05,P<0.01)。结论:补肾活血方可改善CKD大鼠的肾功能及血管钙化程度,其机制可能与对凋亡相关蛋白Bcl-2/Bax的调控有关。 AIM: To observe whether Bushen Huoxue Recipe regulates the expression of apoptosis-related proteins Bcl-2 and Bcl-2 in rat model of chronic kidney disease (CKD) vascular calcification (VC) Thus inhibiting the vascular calcification of CKD rats and exploring the mechanism of action. Methods: Ninety rats were randomly divided into normal group, model group, calcitriol group and high, medium and low dose groups of Chinese medicine, 15 rats in each group. The rats in the model group and each dose group were given adenine suspension at a dosage of 250 mg / kg and fed with 1.2% At the same time, each dose group of traditional Chinese medicine was treated with Bushen Huoxue prescription. The normal group was given 0.9% sodium chloride solution by gavage for 8 weeks continuously. After administration, the body weight and liver and kidney index of mice were detected. The changes of renal tissues were observed by HE staining and the calcified nodules of aorta were observed by alizarin red staining. Serum calcium (Ca), phosphorus (P), serum creatinine (CREA) and urea nitrogen (UREA) were measured in abdominal aorta. The expressions of α-SMA, ALP, Bcl-2, Bax and Caspase-3 in the aorta were detected by Western blot. Results: The index of liver and kidney in the model group increased significantly (P <0.01). The kidney index of middle dose and high dose group of Chinese medicine had significant difference (P <0.01). HE staining showed that the number of normal glomeruli increased, the degree of renal tubular dilatation decreased, inflammatory infiltration decreased and adenine crystal decreased in the Chinese medicine group compared with the model group. Alizarin red staining showed that each dose of traditional Chinese medicine to reduce the calcification, moderate and high dose to reduce more obvious. Compared with the normal group, the levels of blood P, CREA and UREA in the model group increased significantly, the blood Ca level decreased significantly, the expression of ALP protein in the aorta increased significantly, the expression of α-SMA protein decreased significantly, the expression of Bcl-2 (P <0.01). Compared with the model group, the levels of blood P, CREA and UREA in the middle-dose group decreased significantly (P <0.05), and the level of blood Ca (P <0.01). The levels of blood P, CREA and UREA in each dose group decreased significantly at the 8th week (P <0.01), and the serum calcium significantly increased (P <0.01). In the calcitriol group, serum P was significantly decreased and serum calcium was significantly increased at the 8th week (P <0.05). The results of Western blot showed that the expressions of ALP, Bax and Caspase-3 in the aorta decreased and the expressions of α-SMA and Bcl-2 increased (P <0.05, P <0.01). Conclusion: Bushen Huoxue Fang can improve the renal function and the degree of vascular calcification in CKD rats, and its mechanism may be related to the regulation of apoptosis-related protein Bcl-2 / Bax.