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胡碧浓,刘琼,瞿启睿,张雨辰,吴霞,吕山河,黄梓铭,张泓,艾坤,许明.电针对骶上脊髓损伤大鼠尿流动力学和近端尿道组织结构的影响[J].湖南中医药大学学报英文版,2023,43(7):1308-1314.[Click to copy
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| 电针对骶上脊髓损伤大鼠尿流动力学和近端尿道组织结构的影响 |
| 胡碧浓,刘琼,瞿启睿,张雨辰,吴霞,吕山河,黄梓铭,张泓,艾坤,许明 |
| (长沙卫生职业学院, 湖南 长沙 420199;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 观察电针治疗后骶上脊髓损伤（suprasacral cord injury，SSCI）大鼠的膀胱最大容量（maximum cystometric capacity，MCC）、逼尿肌漏尿点压力（leakage point pressure，DLPP）和近端尿道组织形态学的变化，通过分析近端尿道组织结构形态和细胞成分变化具体引起的功能改变，探讨电针治疗在改善SSCI大鼠下尿路功能的过程中对近端尿道结构和功能的影响。方法 将36只SD雌性大鼠按随机数字表法抽取12只成为空白组；剩余大鼠采用改良的Hassan Shaker法在T10脊髓节段全横断制作SSCI大鼠模型，脊髓休克期后将成模大鼠随机分为模型组和电针组，12只/组。电针组取“次髎”“中极”“三阴交”穴予持续电针刺激40 min，空白组与模型组捆绑固定40 min，1次/d，连续7 d。治疗结束后麻醉大鼠，行尿流动力学检测（MCC和DLPP）；随后处死，剪取大鼠近端尿道组织，HE染色观察组织形态结构。结果 与空白组比，模型组大鼠MCC和DLPP均显著升高（P<0.01）；电针组大鼠MCC和DLPP显著低于模型组（P<0.01），DLPP较空白组差异无统计学意义（P>0.05），MCC仍显著高于空白组（P<0.01）；与模型组相比，电针组大鼠尿路上皮细胞结构损伤减轻，固有层胶原纤维弯曲折叠，平滑肌层胶原纤维浸润减少。结论 电针刺激T10脊髓节段全横断大鼠“中极”“次髎”“三阴交”穴，可能通过减小MCC和DLPP，降低膀胱尿道由于过度充盈所承受的张力，从而保护近端尿道组织结构，提高其顺应性。 |
| 关键词: 神经源性膀胱 膀胱颈 尿道内括约肌 尿路上皮细胞 平滑肌 电针 次髎 中极 三阴交 |
| DOI：10.3969/j.issn.1674-070X.2023.07.025 |
| Received:November 07, 2022 |
| 基金项目:国家自然科学基金项目（81874510，82205255）；湖南省自然科学基金青年项目（2022JJ40301，2022JJ40312）；湖南省教育厅科学研究青年项目（21B0369）；湖南省教育厅科学研究一般项目（20C1432）。 |
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| Effects of electroacupuncture on urodynamics and proximal urethral tissue structure in rats with suprasacral spinal cord injury |
| HU Binong,LIU Qiong,QU Qirui,ZHANG Yuchen,WU Xia,LYU Shanhe,HUANG Ziming,ZHANG Hong,AI Kun,XU Ming |
| (Changsha Health Vocational College, Changsha, Hunan 420199, China;School of Acupuncture-moxibustion, Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China) |
| Abstract: |
| Objective To observe the changes of maximum cystometric capacity (MCC), detrusor leak point pressure (DLPP), and proximal urethral tissue morphology in suprasacral spinal cord injury (SSCI) rats induced by electroacupuncture, to analyze the specific function changes caused by the changes in proximal urethral tissue morphology and cell composition, and to explore the effects of electroacupuncture on the structure and function of proximal urethra in improving lower urinary tract function of rats with SSCI. Methods Twelve rats were randomly selected from 36 SD female rats as blank group, and the SSCI rat models were established in the remaining rats by modified Hassan Shaker spinal cord transection at T10. After spinal shock, the model rats were randomly subdivided into model group (n=12) and electroacupuncture group (n=12). In electroacupuncture group, points of "Ciliao" (BL32), "Zhongji" (CV3), and "Sanyinjiao" (SP6) were subjected to continuous electroacupuncture stimulation for 40 min, while the rats in blank and model groups were bound and fixed for 40 min, once a day for consecutive 7 d. After the treatment, the rats were anesthetized for urodynamic tests (MCC, DLPP). Then they were sacrificed, and the proximal urethral tissue was excised and the morphological structure was observed by HE staining. Results Compared with blank group, MCC and DLPP in model group were significantly higher (P<0.01), while MCC and DLPP in electroacupuncture group were significantly lower than those in model group (P<0.01), and there was no significant difference in DLPP between electroacupuncture group and blank group (P>0.05), but MCC in electroacupuncture group was still significantly higher than that in blank group (P<0.01). Compared with model group, the rats in electroacupuncture group showed less structural damage of urothelial cells, bent and folded collagen fibers in lamina propria, and lower infiltration of collagen fibers in smooth muscle layer. Conclusion Electroacupuncture stimulation at "Ciliao" (BL32), "Zhongji" (CV3), and "Sanyinjiao" (SP6) points in rats after T10 spinal segment transection may reduce MCC and DLPP and lower the tension of bladder and urethra due to overfilling, thus protecting the proximal urethral tissue structure and improving its compliance. |
| Key words: neurogenic bladder bladder neck internal urethral sphincter urothelial cells smooth muscle electroacupuncture "Ciliao" (BL32) "Zhongji" (CV3) "Sanyinjiao" (SP6) |
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