CAJ | 학술논문

目的研究电针不同穴位对脊髓损伤(SCI)后尿潴留大鼠逼尿肌细胞凋亡的影响,探讨其可能的机制,并比较针刺不同穴位的效应差异.方法将雌性成年SD大鼠100只随机分为正常组、假手术组、模型对照组、电针治疗组(电针关元穴)和电针对照组(电针水道穴),每组20只.采用重物撞击法建立SCI后尿潴留大鼠模型,电针治疗组和电针对照组造模成功后进行电针治疗,每日1次,连续治疗10 d,其它组仅常规饲养,5组大鼠均于电针治疗组和电针对照组治疗10 d后同时取材,采用透射电镜观察膀胱逼尿肌超微结构,并分别应用末端脱氧核糖核酸转移酶(TUNEL)法及免疫组化方法 .观察5组大鼠膀胱逼尿肌细胞凋亡和凋亡相关基因bcl-2和bax的表达.结果通过电镜观察膀胱逼尿肌超微结构,发现经电针干预后,电针治疗组和电针对照组的逼尿肌电镜表现与模型组相比,粗面内质网扩张程度明显减轻,水肿线粒体的数量有所减少.在细胞凋亡的观察中,正常组和假手术组细胞凋亡呈低表达,2组间差异无统计学意义(P＞0.05).模型对照组细胞凋亡指数(AI)高于正常组(P＜0.05);电针治疗组AI较电针对照组减低(P＜0.05).电针治疗组bax蛋白表达较电针对照组及模型组减少(P＜0.05).电针治疗组bcl-2蛋白表达较电针对照组及模型对照组无明显差异(P＞0.05).结论穴位电针能抑制脊髓损伤后尿潴留大鼠逼尿肌细胞凋亡,其机制可能是穴位电针改善了逼尿肌超微结构,降低bax的表达,使bcl-2/bax的比例发生改变,从而降低细胞凋亡程度,且电针关元穴所产生的效果优于电针水道穴.
목적 연구전침불동혈위대척수손상(SCI)후뇨저류대서핍뇨기세포조망적영향,탐토기가능적궤제,병비교침자불동혈위적효응차이.방법 장자성성년SD대서100지수궤분위정상조、가수술조、모형대조조、전침치료조(전침관원혈)화전침대조조(전침수도혈),매조20지.채용중물당격법건립SCI후뇨저류대서모형,전침치료조화전침대조조조모성공후진행전침치료,매일1차,련속치료10 d,기타조부상규사양,5조대서균우전침치료조화전침대조조치료10 d후동시취재,채용투사전경관찰방광핍뇨기초미결구,병분별응용말단탈양핵당핵산전이매(TUNEL)법급면역조화방법 .관찰5조대서방광핍뇨기세포조망화조망상관기인bcl-2화bax적표체.결과 통과전경관찰방광핍뇨기초미결구,발현경전침간예후,전침치료조화전침대조조적핍뇨기전경표현여모형조상비,조면내질망확장정도명현감경,수종선립체적수량유소감소.재세포조망적관찰중,정상조화가수술조세포조망정저표체,2조간차이무통계학의의(P＞0.05).모형대조조세포조망지수(AI)고우정상조(P＜0.05);전침치료조AI교전침대조조감저(P＜0.05).전침치료조bax단백표체교전침대조조급모형조감소(P＜0.05).전침치료조bcl-2단백표체교전침대조조급모형대조조무명현차이(P＞0.05).결론 혈위전침능억제척수손상후뇨저류대서핍뇨기세포조망,기궤제가능시혈위전침개선료핍뇨기초미결구,강저bax적표체,사bcl-2/bax적비례발생개변,종이강저세포조망정도,차전침관원혈소산생적효과우우전침수도혈.
Objective To study the effect of electro-acupuncture(EA)on bladder detrusor apoptosis in rats with urinary retention after spinal cord injury(SCI),compare the effectiveness of different acupoints and explore possible mechanisms.Methods One hundred female adult Sprague-Dawley rats were randomly divided into 5 groups:a normal group,a sham operation group,a model control group,a Guanyuan acupoint(RN4)EA group and a Shuidao acupoint(ST28)EA group,with 20 rats in each group.A model of urinary retention after SCI was established using the weight drop method.The EA groups were given EA once daily for 10 d.The other groups had no treatment.After 10 d of EA,an electron microscope was used to observe the bladder detrusor ultrastructure,and the terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL) method and immunohistochemistry were used to observe any apoptosis in the detrusor smooth muscle cells and the expression of apoptosis-related genes bcl-2 and bax.Results After EA treatment,expansion of the rough endoplasmic reticulum was reduced significantly,and the number of edemic mitochondria was reduced compared with the model control group.In the normal and sham operation groups,little apoptosis was observed,and there was no significant difference between the two groups.Apoptosis indices(AIs)were higher in the model control group than in the normal group.The average AI in the Guanyuan EA group was lower than that in the Shuidao group.In the Guanyuan group,bax protein expression was less than that in the Shuidao group and the model group.In the Guanyuan group,bcl-2 protein expression was not significantly different from that in the Shuidao group and the model control group.Conclusion EA at the Guanyuan or Shuidao aeupoint can restrain bladder detrusor apoptosis in rats with urinary retention after SCI.EA may improve the ultrastructure of the detrosor urinae, reduce the expression of bax, change the ratio of bcl-2 to bax, and thus decrease apoptosis.The effect of EA at the Guanyuan acupoint is superior to that at the Shuidao acupoint.