补肾活血合剂对DM性ED大鼠海绵体神经及血窦作用机制的实验研究
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摘要
目的：探讨补肾活血合剂对DM性ED大鼠海绵体神经及血窦的作用机制。
方法：采用腹腔注射链脲佐菌素(63mg/kg)复制DM大鼠模型，8周后以阿朴吗啡筛选ED大鼠。实验大鼠随机分为5组：正常对照组、模型组、补肾活血合剂(高、低剂量组)、达美康+安雄组。观察4周后各组大鼠血糖、糖化血红蛋白、胰岛素、血流变、海绵体神经(电生理、髓鞘、nNOS)及血窦(VEGF、eNOS、基底膜)的变化。
结果：1、补肾活血合剂能有效的降低实验性DM性ED大鼠异常升高的血糖、HbA_(1c)、改善部分胰岛功能及异常的血流动力学指标。2、补肾活血合剂能缩短大鼠海绵体神经-海绵体平滑肌传导潜伏期，降低肌电位，促进神经髓鞘的再生，增加nNOS蛋白的表达。3、补肾活血合剂能增加实验性DM性ED大鼠的血窦含量，增加血窦内皮eNOS的合成，降低VEGF的表达，抑制血窦基底膜胶原增生，降低基底膜的厚度。
结论：补肾活血合剂能改善DM性ED大鼠的勃起功能，作用机制可能与其改善代谢紊乱、海绵体神经及血窦病变有关。
Objetives: To investigate the mechanism of the formula of tonifying the kidney and circulating blood on cavernosal nerve and sinus.
Methods: Diabetes was established by the administration of streptozotocin (63mg/kg) intraperitoneally. We selected diabetes erectile dysfunction rats after 8 weeks by apomorphine. The rats were randomly divided into 5 groups: normal control group, model group, the formula of tonifying the kidney and circulating blood(high dosage group, low dosage group), gliclazide with Anxiong group. 4 weeks later, We observe the effect on the blood glucose, hemoglobinAic. insulin, blood rheologic index, corpus cavernosal nerve(electrophysiology, myelin sheaths,
nNOS) and sinus (VEGF, eNOSN basement membrane).
Results: 1, The formula of tonifying the kidney and circulating blood can lower blood glucose, hemoglobin A1C, improve the function of islets beta-cells and blood rheologic index. 2, The formula of tonifying the kidney and circulating blood can shorten rats cavernosal nerve-cavernosal smooth muscle reflection latent period, lower myopotential, increase nNOS protein expression, enhance remyelination. 3, The formula of tonifying the kidney and circulating blood can increase the volume of cavernous sinus and synthese of endothelial cell eNOS protein, lowering the expression of VEGF protein, inhibiting the proliferation of collagen, lower the thickness of basement membrane.
Conclusions: The formula of tonifying the kidney and circulating blood can better the function of diabetes erectile dysfunction rats. The mechanism maybe correlate with it correcting metabolic, cavernous sinus and nerves disorder.
方法：采用腹腔注射链脲佐菌素(63mg/kg)复制DM大鼠模型，8周后以阿朴吗啡筛选ED大鼠。实验大鼠随机分为5组：正常对照组、模型组、补肾活血合剂(高、低剂量组)、达美康+安雄组。观察4周后各组大鼠血糖、糖化血红蛋白、胰岛素、血流变、海绵体神经(电生理、髓鞘、nNOS)及血窦(VEGF、eNOS、基底膜)的变化。
结果：1、补肾活血合剂能有效的降低实验性DM性ED大鼠异常升高的血糖、HbA_(1c)、改善部分胰岛功能及异常的血流动力学指标。2、补肾活血合剂能缩短大鼠海绵体神经-海绵体平滑肌传导潜伏期，降低肌电位，促进神经髓鞘的再生，增加nNOS蛋白的表达。3、补肾活血合剂能增加实验性DM性ED大鼠的血窦含量，增加血窦内皮eNOS的合成，降低VEGF的表达，抑制血窦基底膜胶原增生，降低基底膜的厚度。
结论：补肾活血合剂能改善DM性ED大鼠的勃起功能，作用机制可能与其改善代谢紊乱、海绵体神经及血窦病变有关。
Objetives: To investigate the mechanism of the formula of tonifying the kidney and circulating blood on cavernosal nerve and sinus.
Methods: Diabetes was established by the administration of streptozotocin (63mg/kg) intraperitoneally. We selected diabetes erectile dysfunction rats after 8 weeks by apomorphine. The rats were randomly divided into 5 groups: normal control group, model group, the formula of tonifying the kidney and circulating blood(high dosage group, low dosage group), gliclazide with Anxiong group. 4 weeks later, We observe the effect on the blood glucose, hemoglobinAic. insulin, blood rheologic index, corpus cavernosal nerve(electrophysiology, myelin sheaths,
nNOS) and sinus (VEGF, eNOSN basement membrane).
Results: 1, The formula of tonifying the kidney and circulating blood can lower blood glucose, hemoglobin A1C, improve the function of islets beta-cells and blood rheologic index. 2, The formula of tonifying the kidney and circulating blood can shorten rats cavernosal nerve-cavernosal smooth muscle reflection latent period, lower myopotential, increase nNOS protein expression, enhance remyelination. 3, The formula of tonifying the kidney and circulating blood can increase the volume of cavernous sinus and synthese of endothelial cell eNOS protein, lowering the expression of VEGF protein, inhibiting the proliferation of collagen, lower the thickness of basement membrane.
Conclusions: The formula of tonifying the kidney and circulating blood can better the function of diabetes erectile dysfunction rats. The mechanism maybe correlate with it correcting metabolic, cavernous sinus and nerves disorder.
引文
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[4] 王为服，张元芳，丁强等．糖尿病性阳痿动物模型的建立．上海医科大学学报 1998,25(5)：385-387
[5] Basar M, Yildiz F, Basar H, et al. Histopathological changes and nitric oxide synthase activity in corpus eavernosum from rats with neurogenic erectile dysfunction. BJU International 1999,83(2): 101-107
[6] Sagel J, et al. Ineneased platelet aggregation in early diabetes mellitus. Am Intern Med. 1975,(4):233
[7] 贾彦波．活血化瘀治疗阳痿之我见．河北中医 1987，2：30
[8] 冯振兴．中医药研究 1991，3：60
[9] Bariow DH. Causes of sexual dysfunction: the role of anxiety and congnitive interference. J Consult Clim Psychol 1986,4:140
[10] Lingling Yang, Chenyen Xuo, Lingyan Su. Depression in Chinese medical inpatients. Am J Psychiatry 1987,144:226-228
[11] 薛志敏，刘哲宁，姚干等．阳痿患者心理状况初步调查．中国心理卫生杂志 2000，14(4)：236-238
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[16] 洪寅．益肾活血汤治疗糖尿病性阳瘘16例．浙江中医学院学报 1997，21(5)：16
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[23] B. Alice MK. Apoptosis in the erectile tissue of diabetic and healthy rats. BJU International 2000,85:326-329
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