电针对膀胱过度活动症大鼠膀胱功能的影响
摘要
目的探讨电针对膀胱过度活动症(OAB)大鼠膀胱功能的影响。方法 50只SD雄性大鼠随机分为正常组、模型组、三阴交组、合谷组、中髎/次髎组,各10只。除正常组大鼠外均建立OAB模型。正常组、模型组不予干预,其余三组电针干预后再用0.9%NS进行膀胱灌注,观察干预前后各组大鼠尿动力学指标的变化。结果与正常组比,模型组大鼠基础膀胱内压、收缩后膀胱内压升高,膀胱收缩时间、排尿间隔时间缩短,最大逼尿肌收缩压降低(P<0.01)。电针治疗后,各组大鼠基础膀胱压无明显变化(P>0.05);三阴交组、中髎/次髎组大鼠膀胱收缩时间、排尿间隔时间延长、最大逼尿肌收缩压升高(P<0.05或P<0.01);三阴交组大鼠收缩后膀胱内压无明显变化(P>0.05),中髎/次髎组较治疗前降低(P<0.01);合谷组除最大逼尿肌收缩压降低外(P<0.01),其他指标无明显变化(P>0.05)。治疗后三阴交组、中髎/次髎组大鼠之间各项指标变化无明显差异(P>0.05)。结论电针治疗OAB大鼠主要是通过刺激相关神经节段腧穴延长膀胱收缩时间及排尿间隔时间、升高最大逼尿肌收缩压、降低收缩后膀胱内压,从而改善OAB症状。
引文
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[2] Griebling TL.Worldwide prevalence estimates of lower urinary tract symptoms,overactive bladder,urinary incontinence,and bladder outlet obstruction[J].Bju Int,2011,108(7):1138.
[3] 那彦群.中国泌尿外科疾病诊断治疗指南手册:2014版[M].北京:人民卫生出版社,2014.
[4] 沈华锋,郑祥毅,谢立平.膀胱过度活动症的治疗进展[J].国际泌尿系统杂志,2005,25(1):42.
[5] Buser N,Ivic S,Kessler TM,et al.Efficacy and adverse events of antimuscarinics for treating overactive bladder:network meta-analyses[J].Eur Urol,2012,62(6):1040.
[6] Ellsworth P.Treatment of overactive bladder symptoms beyond antimuscarinics:current and future therapies[J].Postgrad Med,2012,124(3):16.
[7] Ouslander J G.Management of overactive bladder[J].N Engl J Med,2004,350(8):786.
[8] 莫倩.针刺对膀胱的“双向调节”效应及神经机制研究[D].北京中医药大学博士学位论文,2015.
[9] 王亚非,潘振亮,陈建军,等.电针疗法治疗膀胱过度活动症的临床研究[J].实用中西医结合临床,2013,13(3):10.
[10] Saito M,Shimizu S,Kinoshita Y,et al.Bladder dysfunction after acute urinary retention in the rats:a novel over active bladder model[J].Mol Cell Biochem,2010,333(1-2):109.
[11] 刘丛丛,王扬,莫倩,等.电针次髎/中髎穴抑制膀胱过度活动的穴位特异性研究[J].环球中医药,2013,6(12):885.
[12] 郭义,方剑乔.实验针灸学[M].北京:中国中医药出版社,2012.
[13] 于金娜,刘志顺,马晓晶,等.大鼠“次髎”穴的定位和解剖结构[J].针刺研究,2007,32(5):334.
[14] 王金武,侯春林,卢宁,等.骶神经根对膀胱功能的选择性支配[J].中国组织工程研究,2005,9(17):227.
[15] Imamura T,Ishizuka O,Aizawa N,et al.Gosha-jinki-gan reduces transmitter proteins and sensory receptors associated with C fiber activation induced by acetic acid in rat urinary bladder[J].Neurourol Urodyn,2008,27(8):832.
[16] 王扬.电针深刺次髎抑制膀胱过度活动的特异效应及其感觉神经调控机制[D].中国中医科学院博士学位论文,2012.
[17] Draka MJ,Gardner BP,Brading AF.Innervation of the detrusor muscle bundle in neurogenic detrusor overactivity[J].Bju Int,2003,91(7):702.
[18] Shalom DF,Pillalamarri N,Xue X,et al.Sacral nerve stimulation reduces elevated urinary nerve growth factor levels in women with symptomatic detrusor overactivity[J].Am J Obstet Gynecol,2014,211(5):S11-S.
[19] 严振国.人体穴位层次解剖图谱[M].上海:上海中医药大学出版社,2005.
[20] H?bler H J,Janig W,Koltzenburg M.Myelinated primary afferents of the sacral spinal cord responding to slow filling and distension of the cat urinary bladder[J].J Physiol,1993,463(5):449.
[21] 杨静,代秀,吴扬,等.电针“三阴交”对膀胱造瘘术后功能亢进模型大鼠膀胱功能的调节作用[J].中国针灸,2014,34(10):998.
[22] 邓春雷.调整膀胱机能的穴位特异性及其实质的探讨[J].上海针灸杂志,1987,(3):17.