1.上海中医药大学附属岳阳中西医结合医院针灸科(上海 200437)
2.上海中医药大学针灸推拿学院(上海 201203)
杨梦伊,女,硕士研究生,主要从事针灸治疗泌尿生殖疾病临床和机制研究工作
侯文光,主任医师,硕士研究生导师; E-mail:houwenguang@126.com
扫 描 看 全 文
杨梦伊,屈之榆,李超楠等.电针对压力性尿失禁大鼠阴道前壁胶原分解与合成的影响[J].上海中医药杂志,2022,56(06):63-72.
YANG Mengyi,QU Zhiyu,LI Chaonan,et al.Effect of electroacupuncture on collagen decomposition and synthesis of anterior vaginal wall in rats with stress urinary incontinence[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(06):63-72.
杨梦伊,屈之榆,李超楠等.电针对压力性尿失禁大鼠阴道前壁胶原分解与合成的影响[J].上海中医药杂志,2022,56(06):63-72. DOI: 10.16305/j.1007-1334.2022.2111085.
YANG Mengyi,QU Zhiyu,LI Chaonan,et al.Effect of electroacupuncture on collagen decomposition and synthesis of anterior vaginal wall in rats with stress urinary incontinence[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(06):63-72. DOI: 10.16305/j.1007-1334.2022.2111085.
目的,2,观察电针对压力性尿失禁(SUI)大鼠阴道前壁胶原分解与合成的影响。,方法,2,60只SD大鼠随机分为假手术组10只、造模组50只。假手术组予开腹处理,找到卵巢组织后直接缝合,不予卵巢切除及阴道扩张;造模组采用阴道扩张后双侧卵巢切除法建立SUI大鼠模型,采用喷嚏试验检验模型是否成功。将造模成功大鼠随机分为模型组、电针非穴位组(简称“针非组”)、电针组、阻断剂组。模型组不予任何处理;电针组大鼠分别在双侧“肾俞”穴和“会阳”穴给予电针治疗,每次20 min,连续3 d;针非组针刺“肾俞”对照点、“会阳”对照点(两穴旁开1 cm)并予电针治疗,每次20 min,连续3 d;阻断剂组予盐酸多西环素灌胃给药,连续3 d。治疗结束后,评价尿动力学指标,取各组大鼠尿道下阴道前壁组织,采用PCR、Western blot、免疫组化的方法检测阴道前壁胶原总含量(Col-Ⅰ、Col-,Ⅲ,)、降解环节相关因子(MMP-1、MMP-2、MMP-9、TIMP-1)、胶原合成环节相关因子(DCN、TGF-β)的mRNA及蛋白表达。,结果,2,①造模后,喷嚏试验阳性提示SUI模型造模成功,与假手术组比较,造模大鼠的最大膀胱容量和腹压漏尿点压明显降低(,P,<,0.05)。②治疗后,与假手术组比较,模型组大鼠,Col,-,I、Col,-,Ⅲ, mRNA及蛋白表达水平升高,,MMP,-,1,、,MMP,-,2,、,MMP,-,9, mRNA及蛋白表达水平降低,,TIMP,-,1, mRNA及蛋白表达水平升高,,DCN ,mRNA及蛋白表达水平降低,,TGF,-,β ,mRNA表达水平升高(,P,<,0.05)。③与模型组比较,电针组及阻断剂组大鼠漏尿点压及膀胱最大容量均升高(,P,<,0.05);电针组阴道前壁,Col,-,I,、,Col,-,Ⅲ, mRNA及蛋白表达水平升高(,P,<,0.05),,MMP,-,1,、,MMP,-,2 ,mRNA及蛋白表达水平降低(,P,<,0.05),,MMP,-,9, mRNA表达水平降低(,P,<,0.05)。,TIMP,-,1, mRNA表达水平升高(,P,<,0.05),,DCN ,mRNA及蛋白表达水平降低(,P,<,0.05),,TGF,-,β, mRNA表达水平升高(,P,<,0.05)。与针非组比较,电针组,Col,-,Ⅲ ,mRNA及蛋白表达水平升高(,P,<,0.05),,MMP,-,1,、,MMP,-,2, mRNA及蛋白表达水平降低(,P,<,0.05),,MMP,-,9, mRNA表达水平降低(,P,<,0.05)。,TIMP,-,1, mRNA表达水平升高(,P,<,0.05),,DCN, mRNA及蛋白表达水平均降低(,P,<,0.05)。,结论,2,SUI大鼠阴道前壁胶原蛋白流失,胶原降解增加,胶原合成减少。电针可通过抑制胶原蛋白异常降解,促进胶原蛋白合成,提高SUI大鼠阴道前壁胶原蛋白的总含量,进而达到治疗SUI的目的,且电针穴位疗效优于非穴位。
Objective,2,To observe the effect of electroacupuncture on the decomposition and synthesis of collagen in anterior vagina wall of rats with stress urinary incontinence (SUI).,Methods,2,Totally 60 SD rats were randomly divided into sham operation group (,n,=10) and model group (,n,=50). The sham operation group was treated by laparotomy, and the ovarian tissue was found and sutured directly without ovariectomy and vaginal dilatation; the model group was established by bilateral ovariectomy after vaginal dilatation, and the sneeze test was used to test the success of the model. The successful model rats were randomly divided into the model group, the electroacupuncture non-acupoint group (“acupuncture non-acupoint group”), the electroacupuncture group and the blocker group, and the model group did not receive any treatment. The rats in the electroacupuncture group were treated with electroacupuncture at bilateral “Shenshu(BL23)” and “Huiyang(BL35)” points for 20 min each time for 3 days. The rats in the acupuncture non-acupoint group were treated with acupuncture at the control points of “Shenshu(BL23)” and “Huiyang(BL35)” (1 cm beside the two acupoints) and electroacupunctured for 20 min each time for 3 days, while those in the blocker group were given doxycycline hydrochloride intragastrically for 3 days. After treatment, urodynamic indexes were evaluated, and the mRNA and protein expression of total collagen content (Col-Ⅰ, Col-Ⅲ), degradation link related factors (MMP-1, MMP-2, MMP-9, TIMP-1), collagen synthesis link related factors (DCN, TGF-β) in anterior vagina wall were detected by PCR, Western blot and immunohistochemistry.,Results,2,① After modeling, the positive sneezing test indicated that the SUI model was successful. Compared with the sham operation group, the maximum bladder capacity and abdominal pressure leakage point pressure of the model rats were significantly lower (,P,<,0.05). ② After treatment, compared with the sham operation group, the expression levels of ,Col,-,I,, ,Col,-,Ⅲ, mRNAs and proteins, ,TGF,-,β, mRNA, and ,TIMP,-,1, mRNA and protein increased(,P,<,0.05), while the expression levels of ,MMP,-,1, MMP,-,2, MMP,-,9, mRNAs and proteins, and ,DCN, mRNA and protein decreased(,P,<,0.05)in the model group. ③ Compared with the model group, the leak point pressure and the maximum capacity of bladder in the electroacupuncture group and the blocker group were significantly higher than those in the model group (,P,<,0.05). In the electroacupuncture group, the expressions of ,Col,-,I,, ,Col,-,Ⅲ, mRNAs and proteins, ,TIMP,-,1, mRNA and ,TGF,-,β, mRNA increased(,P,<,0.05), while the expressions of ,MMP,-,1,, ,MMP,-,2, mRNAs and proteins, ,MMP,-,9, mRNA, ,DCN, mRNA and protein decreased(,P,<,0.05) in the anterior vaginal wall. Compared with the acupuncture non-acupoint group, the expression,of, Col,-,Ⅲ, mRNA and protein and ,TIMP,-,1, mRNA increased(,P,<,0.05), while the expressions of ,MMP,-,1,, ,MMP,-,2, mRNAs and proteins, ,MMP,-,9, mRNA, and ,DCN, mRNA and protein decreased (,P,<,0.05)in electroacupuncture group.,Conclusion,2,In SUI rats, it is found that the collagen is lost, the collagen degradation is increased, and the collagen synthesis is decreased in the anterior vaginal wall. Electroacupuncture can inhibit the abnormal degradation of collagen, promote collagen synthesis, increase the total content of collagen in the anterior vaginal wall of SUI rats, and then achieve the purpose of treating SUI, and the curative effect of electroacupuncture at acupoints is better than that of electroacupuncture at non-acupoints.
压力性尿失禁电针胶原代谢大鼠模型
stress urinary incontinenceelectroacupuncturecollagen metabolismrats model
朱兰,孙智晶. 女性压力性尿失禁诊断和治疗指南(2017)[J]. 中华妇产科杂志,2017, 52(5): 289-293.
侯文光,明树人,汤康敏,等. 电针对轻、中度女性压力性尿失禁的防治效应研究[J]. 上海针灸杂志,2017, 36(8): 956-959.
陈锐娥,周幸知,丁淼,等. 盆底功能障碍性疾病基础研究进展[J]. 国际妇产科学杂志,2017, 44(5): 589-593.
CHERMANSKY C J, MOALLI P A. Role of pelvic floor in lower urinary tract function[J]. Auton Neurosci, 2016(200): 43-48.
LIU Z, LIU Y, XU H, et al. Effect of electroacupuncture on urinary leakage among women with stress urinary incontinence: a randomized clinical trial[J]. JAMA, 2017, 317(24): 2493-2501.
HU Y, WU R F, LI H, et al. Expression and significance of metalloproteinase and collagen in vaginal wall tissues of patients with pelvic organ prolapse[J]. Ann Clin Lab Sci, 2017, 47(6): 698-705.
张淑静,汪司右,王燕. 电针对压力性尿失禁大鼠盆底组织胶原蛋白表达的影响[J]. 上海针灸杂志,2010, 29(6): 408-410.
RESPLANDE J, GHOLAMI S S, GRAZIOTTIN T M, et al. Long-term effect of ovariectomy and simulated birth trauma on the lower urinary tract of female rats[J]. J Urol, 2002, 168(1): 323-330.
LIN A S, CARRIER S, MORGAN D M, et al. Effect of simulated birth trauma on the urinary continence mechanism in the rat[J]. Urology, 1998, 52(1): 143-151.
郑慧敏,徐世芬,尹平,等. 电针治疗轻中度女性压力性尿失禁的近远期疗效观察[J]. 世界中西医结合杂志,2015, 10(2): 191-193.
哈力甫,陈跃来,梁燕,等. 骶穴电针疗法治疗急迫性尿失禁临床疗效评价[J]. 中西医结合学报,2004, 2(3): 219-221.
汤剑明,洪莉,刘成,等. 压力性尿失禁小鼠模型的建立及效果评价[J]. 中华妇幼临床医学杂志(电子版),2016, 12(5): 540-546.
LIN Y, LIU G , LI M , et al. Recovery of continence function following simulated birth trauma involves repair of muscle and nerves in the urethra in the female mouse[J]. Eur Urol, 2010, 57(3): 506-513.
LARONHA H, CALDEIRA J. Structure and function of human matrix metalloproteinases[J]. Cells, 2020, 9(5): 1076.
CHEN Y, DESAUTEL M, ANDERSON A, et al. Collagen synthesis is not altered in women with stress urinary incontinence[J]. Neurourol Urodyn, 2004, 23(4) : 367-373.
汤康敏,明树人,刘建党,等. 电针对压力性尿失禁大鼠盆底MMPs和TIMPs表达的影响[J]. 上海中医药大学学报,2019, 33(1): 81-86.
DAQUINAG A C, GAO Z, FUSSELL C, et al. Glycosaminoglycan modification of decorin depends on MMP14 activity and regulates collagen assembly[J]. Cells, 2020, 9(12) : 2646.
LI Y, LIU C, LI B, et al. Electrical stimulation activates calpain 2 and subsequently upregulates collagens via the integrin β1/TGF-β1 signaling pathway[J]. Cell Signal, 2019 (59): 141-151.
PANTATOSAKIS E, KARANDREA D, LIAPIS E, et al. Immunohistochemical expression of hormonal receptors, collagen, elastin, and proteoglycans in genuine urinary incontinence[J]. Clin Exp Obstet Gynecol, 2016, 43(6): 849-852.
LI Y, LI B S, LIU C, et al. Effect of integrin β1 in the treatment of stress urinary incontinence by electrical stimulation[J]. Mol Med Rep, 2019, 19(6): 4727-4734.
0
浏览量
303
下载量
0
CSCD
5
CNKI被引量
关联资源
相关文章
相关作者
相关机构