文章摘要
李炀,张润宁,张保平,丁天红.基于Cajal间质细胞探讨电针对逼尿肌反射亢进型神经源性膀胱大鼠的作用机制[J].中国康复,2019,34(4):171-174
基于Cajal间质细胞探讨电针对逼尿肌反射亢进型神经源性膀胱大鼠的作用机制
Action mechanism of electroacupuncture on detrusor hyperreflexive neurogenic bladder in rats
  
DOI:
中文关键词: 脊髓损伤  神经源性膀胱  电针  ICC  C-kit
英文关键词: spinal cord injury  neurogenic bladder  electroacupuncture  inferstitial cells of cajal  C-KIT  rats
基金项目:陕西省中医管理局(2017中医管理局JCPT040)
作者单位
李炀 1.陕西中医药大学陕西咸阳 7120002.陕西中医药大学第二附属医院针灸康复科陕西咸阳 712000 
张润宁 1.陕西中医药大学陕西咸阳 7120002.陕西中医药大学第二附属医院针灸康复科陕西咸阳 712000 
张保平 陕西中医药大学第二附属医院针灸康复科陕西咸阳 712000 
丁天红 陕西中医药大学第二附属医院针灸康复科陕西咸阳 712000 
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中文摘要:
  目的:观察经电针治疗后的逼尿肌反射亢进型神经源性膀胱大鼠的膀胱功能变化,并基于Cajal间质细胞(ICC)探索该治疗方法的作用机制。方法:健康成年雌性SD大鼠40只,按照随机数字表法分为对照组、假手术组、模型组、电针组每组各10只。假手术组在T10水平只暴露脊髓,不离断;模型组、电针组大鼠在T10水平完全横断脊髓制作神经源性膀胱大鼠模型。待大鼠渡过脊休克期后,电针组给予电针次髎穴治疗,1次/d,连续14天。电针14天后测尿流动力学,观察各组大鼠膀胱功能的变化;然后处死大鼠,蛋白质印迹法检测膀胱组织C-kit蛋白的表达;免疫荧光分析ICC数量变化。结果:模型组和电针组膀胱最大容量及膀胱顺应性较对照组和假手术组降低(P<0.05),膀胱基础压力和漏尿点压力较之增加(P<0.05);电针组的膀胱最大容量、膀胱顺应性较模型组增加(P<0.05),膀胱基础压与漏点压较之降低(P<0.05);模型组和电针组膀胱C-kit蛋白表达较对照组和假手术组升高(P<0.01),ICC数量增加(P<0.01);与模型组比较,电针组膀胱C kit蛋白表达降低(P<0.01),ICC数量减少(P<0.01)。结论:电针次髎穴对逼尿肌反射亢进型神经源性膀胱有显著疗效,其机制之一可能为通过抑制C-kit表达,减少ICC数量,从而减少膀胱逼尿肌无抑制收缩。
英文摘要:
  Objective: To observe the changes of bladder function in rats with neurogenic bladder with detrusor hyperreflexia after electroacupuncture treatment, and to explore the mechanism of this treatment based on intertitial cells of cajal(ICC). Methods: Forty healthy adult female SD rats were randomly divided into control group, sham operation group, model group, and electroacupuncture group with 10 rats in each group. The sham operation group exposed only the spinal cord at the T10 level which was not disconnected. The spinal cord at the T10 level in the model group and the electroacupuncture group was completely transected to make a rat model of neurogenic bladder. After the rats passed through the spinal shock phase, the electroacupuncture group was electroacupunctured on Ciliao, once a day for 14 consecutive days. Urinary flow dynamic parameters were measured 14 days after electroacupuncture and the changes of bladder function were observed. Rats were then sacrificed, and the expression of C-kit protein in bladder tissue was detected by Western blotting. The number of ICC was analyzed by immunofluorescence. Results: The maximum bladder capacity and bladder compliance in the model group and the electroacupuncture group were significantly reduced (P<0.05), and the bladder base pressure and the leakage point pressure were increased as compared with those in the control group and the sham operation group (all P<0.05). The maximum bladder capacity and bladder compliance in the electroacupuncture group increased (P<0.05), and the bladder basal pressure and leakage point pressure decreased (P<0.05) as compared with the model group. The expression of bladder C-kit protein and the number of ICC in the model group and electroacupuncture group were significantly increased as compared wiht those in the control group and sham operation (P<0.01). As compared with the model group, the expression of C-kit protein in the bladder and the number of ICC were significantly reduced in the electroacupuncture group (P<0.01). Conclusion: Electroacupuncture at the time of acupoints has a significant effect on detrusor hyperreflexia neurogenic bladder, probably by inhibiting the expression of C-KIT and reducing the number of ICC, thereby decreasing the contractile contraction of the bladder detrusor.
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