| 引用本文: |
田楚宁, 罗小精, 彭佳丽, 胡栓, 许明, 邓石峰, 艾坤, 卓越, 张泓.不同时间窗电针干预对脊髓损伤后神经源性膀胱大鼠膀胱纤维化的影响[J].湖南中医药大学学报,2026,46(5):915-924[点击复制] |
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| 不同时间窗电针干预对脊髓损伤后神经源性膀胱大鼠膀胱纤维化的影响 |
| 田楚宁,罗小精,彭佳丽,胡栓,许明,邓石峰,艾坤,卓越,张泓 |
| (湖南中医药大学针灸推拿与康复学院, 湖南 长沙 410208) |
| 摘要: |
| 目的 观察不同时间窗启动电针干预对脊髓损伤（SCI）后神经源性膀胱（NB）大鼠膀胱功能、纤维化进程及相关调控蛋白表达的影响。方法 从42只成年雌性SD大鼠中随机选取8只为假手术组，其余34只大鼠行T8脊髓完全横断手术，以建立NB大鼠模型。将最终造模成功的24只大鼠二次随机分为模型组、电针1组、电针2组，每组8只。电针1组、电针2组分别于术后第19、29天开始，选取次髎、中极、三阴交给予电针干预，20 min/次，1次/d，连续干预10 d。每天观察各组大鼠一般情况。待电针2组干预结束后，采用超声影像学、尿流动力学检测大鼠膀胱壁厚度及膀胱功能；肉眼观察膀胱形态并计算膀胱指数（BI）；采用Masson染色评估膀胱组织纤维化程度并计算胶原容积分数（CVF）；通过离体膀胱逼尿肌收缩试验观察逼尿肌兴奋性及收缩性；采用Western blot检测膀胱组织转化生长因子-β1（TGF-β1）、结缔组织生长因子（CTGF）、Ⅰ型胶原（COLⅠ）及Ⅲ型胶原（COLⅢ）的蛋白相对表达水平。结果 与假手术组相比，模型组大鼠膀胱容积明显增加、膀胱壁明显增厚（P<0.01）；膀胱最大压力、膀胱灌注时间及膀胱最大容量显著增加（P<0.01）；膀胱代偿性增大，BI显著升高（P<0.01）；膀胱组织CVF显著升高（P<0.01），伴胶原纤维沉积增加、平滑肌束排列紊乱；离体逼尿肌收缩幅度显著降低、收缩频率显著增加（P<0.01）；膀胱组织COLⅠ、COLⅢ、TGF-β1及CTGF蛋白相对表达均显著升高（P<0.01）。与模型组相比，电针1组和电针2组膀胱容积明显下降（P<0.01），膀胱壁厚度减少（P<0.05，P<0.01）；膀胱最大压力、膀胱灌注时间及膀胱最大容量均减少（P<0.05，P<0.01）；BI下降（P<0.05，P<0.01）；膀胱组织CVF降低（P<0.05，P<0.01），胶原纤维沉积减少、平滑肌束排列较为规整；离体逼尿肌收缩幅度显著增加（P<0.01），收缩频率降低（P<0.05，P<0.01）；膀胱组织COLⅠ、COLⅢ、TGF-β1及CTGF蛋白相对表达均降低（P<0.05，P<0.01）。与电针2组相比，电针1组膀胱容积下降、膀胱壁厚度减少（P<0.05）；膀胱最大压力、膀胱灌注时间及膀胱最大容量均减少（P<0.05）；BI下降（P<0.05）；膀胱组织CVF降低（P<0.05），胶原纤维分布减少，平滑肌束排列更为规整；离体逼尿肌收缩幅度增加、收缩频率降低（P<0.05）；膀胱组织COLⅠ、COLⅢ、TGF-β1及CTGF蛋白相对表达均降低（P<0.05）。结论 不同时间窗启动电针干预的效应存在差异，较早启动电针干预在改善SCI后NB大鼠的膀胱功能、减轻膀胱纤维化病理改变及下调相关蛋白表达方面，疗效显著优于较晚启动。 |
| 关键词: 脊髓损伤|神经源性膀胱|电针|干预时机|膀胱功能|尿流动力学|胶原沉积|纤维化 |
| DOI：10.3969/j.issn.1674-070X.2026.05.006 |
| 投稿时间：2025-11-06 |
| 基金项目:国家自然科学基金项目（82274666，82505781）；湖南省自然科学基金青年项目（2024JJ6340）；湖南省教育厅科学研究优秀青年项目（23B0350）；湖南中医药大学校级优秀青年科研项目（Z2023XJYQ06）；湖南中医药大学研究生创新项目（2024CX034）。 |
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| Effects of electroacupuncture initiated at different time windows on bladder fibrosis in rats with neurogenic bladder following spinal cord injury |
| TIAN Chuning, LUO Xiaojing, PENG Jiali, HU Shuan, XU Ming, DENG Shifeng, AI Kun, ZHUO Yue, ZHANG Hong |
| (School of Acupuncture-moxibustion, Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China) |
| Abstract: |
| Objective To investigate the effects of electroacupuncture (EA) initiated at different time windows on bladder function, fibrotic progression, and the expression of fibrosis-related regulatory proteins in rats with neurogenic bladder (NB) following spinal cord injury (SCI). Methods Among 42 adult female SD rats, 8 were randomly assigned to the sham operation group, while the remaining 34 rats underwent complete transection of the spinal cord at the T8 level to establish an NB model. Twenty-four successfully modeled rats were further randomly divided into model group, EA1 group, and EA2 group, with 8 rats in each group. EA intervention was initiated on postoperative days 19 and 29 in the EA1 and EA2 groups, respectively. Acupoints Ciliao (BL32), Zhongji (CV3), and Sanyinjiao (SP6) were selected for EA treatment, 20 min each time, once daily, for 10 consecutive days. General conditions of the rats were observed daily. After completion of the intervention in EA2 group, ultrasonography and urodynamic testing were used to assess bladder wall thickness and bladder function. Bladder morphology was examined visually, and the bladder index (BI) was calculated. Masson staining was performed to evaluate the degree of fibrosis in bladder tissues and to calculate the collagen volume fraction (CVF). An isolated bladder detrusor contraction assay was performed to observe detrusor excitability and contractility. Western blot was used to determine the relative protein expression levels of transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), collagen typeⅠ(COLⅠ), and collagen type Ⅲ (COL Ⅲ) in bladder tissues. Results Compared with the sham operation group, rats in the model group exhibited significantly increased bladder volume and bladder wall thickness (P<0.01), along with marked increases in maximum bladder pressure, bladder perfusion time, and maximum cystometric capacity (P<0.01). Compensatory bladder enlargement and a significantly elevated BI were also observed (P<0.01). An increased CVF (P<0.01), accompanied by excessive collagen deposition and disorganized smooth muscle bundles were also observed. In addition, the contraction amplitude of isolated detrusor strips was significantly decreased, while contraction frequency was significantly increased (P<0.01). The relative protein expression levels of COLⅠ, COLⅢ, TGF-β1, and CTGF were significantly elevated (P<0.01). Compared with the model group, both EA1 and EA2 groups showed significant reductions in bladder volume (P<0.01), bladder wall thickness (P<0.05, P<0.01), maximum bladder pressure, bladder perfusion time, and maximum cystometric capacity (P<0.05, P<0.01), as well as decreased BI (P<0.05, P<0.01). The CVF in bladder tissues was significantly reduced (P<0.05, P<0.01), with decreased collagen fiber deposition and more orderly arrangement of smooth muscle bundles. The contraction amplitude of isolated detrusor strips was significantly increased (P<0.01), while contraction frequency was decreased (P<0.05, P<0.01). The relative protein expression levels of COLⅠ, COLⅢ, TGF-β1, and CTGF in bladder tissues were all significantly decreased (P<0.05, P<0.01). Compared with the EA2 group, the EA1 group showed greater reductions in bladder volume, bladder wall thickness (P<0.05), maximum bladder pressure, bladder perfusion time, and maximum cystometric capacity (P<0.05), as well as a lower BI (P<0.05). The CVF was further decreased (P<0.05), with reduced collagen fiber deposition and more organized smooth muscle bundles. The contraction amplitude of isolated detrusor strips was increased, while contraction frequency was decreased (P<0.05). Additionally, the relative expression levels of COLⅠ, COLⅢ, TGF-β1, and CTGF in bladder tissues were further reduced (P<0.05). Conclusion The effects of electroacupuncture vary depending on the time window of initiation. Earlier initiation of electroacupuncture is significantly superior to later initiation in improving bladder function, alleviating pathological changes of bladder fibrosis, and downregulating the expression of related proteins in rats with NB after SCI. |
| Key words: spinal cord injury|neurogenic bladder|electroacupuncture|timing of intervention|bladder function|urodynamics|collagen deposition|fibrosis |
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