[1]杨 明,朱旭东,马 波,等.电针气海、中极、关元穴改善压力性尿失禁尿道括约肌线粒体损伤机制研究[J].陕西中医杂志,2024,(4):440-445.[doi:DOI:10.3969/j.issn.1000-7369.2024.04.002]
 YANG Ming,ZHU Xudong,MA Bo,et al.Effect of electroacupuncture at Qihai,Zhongji and Guanyuan points on mitochondrial damage of urethral sphincters in stress urinary incontinence[J].,2024,(4):440-445.[doi:DOI:10.3969/j.issn.1000-7369.2024.04.002]
点击复制

电针气海、中极、关元穴改善压力性尿失禁尿道括约肌线粒体损伤机制研究
分享到:

《陕西中医》杂志[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年4期
页码:
440-445
栏目:
基础研究
出版日期:
2024-04-05

文章信息/Info

Title:
Effect of electroacupuncture at Qihai,Zhongji and Guanyuan points on mitochondrial damage of urethral sphincters in stress urinary incontinence
作者:
杨 明1朱旭东1马 波1盛梦钰1蔡晓清1李海涛2邵轶群3叶和松1
(1.南京中医药大学第二附属医院,江苏 南京 210017; 2.沭阳县中医院,江苏 宿迁 223600; 3.上海中医药大学附属岳阳中西医结合医院,上海 200437)
Author(s):
YANG MingZHU XudongMA BoSHENG MengyuCAI XiaoqingLI HaitaoSHAO YiqunYE Hesong
(The Second Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210017,China)
关键词:
压力性尿失禁 电针 尿控 尿道括约肌 线粒体动力学 大鼠
Keywords:
Stress urinary incontinence Electroacupuncture Urinary control Urethral sphincters Mitochondrial dynamics Rat
分类号:
R 695
DOI:
DOI:10.3969/j.issn.1000-7369.2024.04.002
文献标志码:
A
摘要:
目的:观察电针对压力性尿失禁(SUI)环境下尿控的影响,并基于线粒体动力学探讨相关作用机制。方法:对SD大鼠进行随机分组,空白组未采取任何处理,假手术组完成手术解剖未干预,模型组行双侧卵巢切除+阴道扩张,假针组予非穴位电针,电针组进行穴位电针。尿动力学仪测量各组大鼠的最大膀胱容量(MBC)和腹腔漏尿点压力(ALPP)和漏尿点压力(LPP); HE染色观察尿道括约肌肌纤维形态改变; ELISA试剂盒检测线粒体膜电位、ATP和氧化应激相关指标; 电镜观察尿道括约肌线粒体形态; Western blot检测尿道括约肌线粒体动力学相关因子线粒体融合素1(Mfn1)、Mfn2、线粒体动力相关蛋白1(Drp1)、线粒体分裂因子(MFF)、沉默信息调节因子1(SIRT1)和过氧化物酶体增殖物激活受体γ共激活因子-1α(PGC-1α)蛋白表达。结果:与假手术组比较,模型组大鼠尿控指标MBC、ALPP和LPP显著降低(均P<0.05),尿道括约肌纤维断裂、排列紊乱,线粒体明显肿胀,嵴增宽; 线粒体膜电位、ATP、琥珀酸脱氢酶(SDH)和超氧化物歧化酶(SOD)水平显著降低(均P<0.05),丙二醛(MDA)水平显著升高(P<0.05); SIRT1、PGC-1α、Mfn1和Mfn2蛋白表达显著降低(均P<0.05),Drp1和MFF蛋白表达显著升高(均P<0.05)。与假针组比较,电针组大鼠的MBC、ALPP和LPP显著升高(均P<0.05),尿道括约肌纤维断裂、排列紊乱及线粒体的肿胀、嵴增宽情况显著改善; 线粒体膜电位和ATP水平以及SDH和SOD活性显著升高(均P<0.05),MDA水平显著降低(P<0.05); SIRT1、PGC-1α、Mfn1、Mfn2蛋白表达显著升高(均P<0.05),Drp1和MFF蛋白表达显著降低(均P<0.05)。结论:电针可通过调控线粒体动力学改善SUI环境下尿道括约肌肌纤维形态和线粒体形态及功能障碍。
Abstract:
Objective:To observe the effect of electroacupuncture in urinary control and further explore the relevant mechanism based on mitochondrial dynamics.Methods:SD rats were randomly divided into groups.The control group did not take any treatment,the sham surgery group completed the surgical anatomy without intervention,the model group received bilateral ovariectomy+vaginal dilatation,the sham acupuncture group received non acupoint electroacupuncture,and electroacupuncture group receives acupoint electroacupuncture.The maximum bladder capacity(MBC),abdominal leak point pressure(ALPP)and leak point pressure(LPP)of rats in each group were measured by urodynamic testing.HE staining was used to observe the morphological changes of urethral sphincters muscle fibers.ELISA kit was used to detect mitochondrial membrane potential,ATP and oxidative stress related indicators.The morphology of mitochondria in urethral sphincters was observed by electron microscope.Western blot method was used to detect mitochondrial fusion protein 1(Mfn1),Mfn2,mitochondrial dynamics related protein 1(Drp1),mitochondrial fission factor(MFF),silent information regulator 1(SIRT1)and peroxisome proliferators-activated receptor γ coactivator-1α(PGC-1α)protein expression.Results:Compared with the sham surgery group,the urinary control indexes(MBC,ALPP and LPP)in the model group were significantly lower(all P<0.05),the urethral sphincters fibers were broken and disordered,the mitochondria were swollen and cristae widened,the mitochondrial membrane potential,ATP,succinate dehydrogenase(SDH)and superoxide dismutase(SOD)levels were significantly lower(all P<0.05),and the level of malondialdehyde(MDA)was significantly higher(P<0.05),the expression of SIRT1,PGC-1α,Mfn1 and Mfn2 proteins was significantly reduced(all P<0.05),while the expression of Drp1 and MFF proteins was significantly increased(all P<0.05).Compared with the sham acupuncture group,the MBC,ALPP and LPP of rats in the electroacupuncture group were significantly increased(all P<0.05),the fibers of the urethral sphincters were broken and disordered,and the swelling of mitochondria and the widening of crista were significantly improved; Mitochondrial membrane potential and ATP levels,SDH and SOD activities were significantly increased(all P<0.05),while MDA levels were significantly decreased(P<0.05),the expression of SIRT1,PGC-1α,Mfn1 and Mfn2 proteins significantly increased(all P<0.05),while the expression of Drp1 and MFF proteins significantly decreased(all P<0.05).Conclusion:Electroacupuncture can improve the fiber morphology and mitochondrial morphology and dysfunction of urethral sphincters under the SUI environment by regulating mitochondrial dynamics related factors.

参考文献/References:

[1] LIN J S,SKOKAN A J,WESSELLS H,et al.Management of male stress urinary incontinence in high-risk patients:A narrative review[J].Transl Androl Urol,2023,12(5):898-917.
[2] LANGFORD B T,JOHNSON B E,MOREY A.A narrative review of the role of the male stress incontinence grading scale in the surgical management of male stress urinary incontinence[J].Transl Androl Urol,2023,12(5):926-931.
[3] DONG B,SHI Y,CHEN Y,et al.Perineal ultrasound to assess the urethral spatial movement in stress urinary incontinence in women[J].BMC Urol,2023,23(1):44.
[4] 陈庆,张欣,谢秀英.女性盆底功能障碍康复训练研究进展[J].陕西医学杂志,2020,49(11):1531-1533.
[5] 郭玉琳,王榆平,思美丽,等.初产妇压力性尿失禁患病率及产后干预研究[J].陕西医学杂志,2023,52(1):83-85.
[6] BRAGA A,CACCIA G,PAPADIA A,et al.Urethral bulking agents for the treatment of recurrent stress urinary incontinence:A systematic review and meta-analysis[J].Maturitas,2022,163:28-37.
[7] RUFFOLO A F,BRAGA A,TORELLA M,et al.Vaginal laser therapy for female stress urinary incontinence:New solutions for a well-known issue-A concise review[J].Medicina(Kaunas),2022,58(4):512.
[8] KIBSCHULL M,NGUYEN T T N,CHOW T,et al.Differentiation of patient-specific void urine-derived human induced pluripotent stem cells to fibroblasts and skeletal muscle myocytes[J].Sci Rep,2023,13(1):4746.
[9] HAN L,WANG L,WANG Q,et al.Association between pelvic organ prolapse and stress urinary incontinence with collagen[J].Exp Ther Med,2014,7(5):1337-1341.
[10] ALWAY S E,PAEZ H G,PITZER C R,et al.Mitochondria transplant therapy improves regeneration and restoration of injured skeletal muscle[J].J Cachexia Sarcopenia Muscle,2023,14(1):493-507.
[11] QUADRILATERO J.Mitochondria:Key modulators of skeletal muscle remodeling[J].Semin Cell Dev Biol,2023,143:1-2.
[12] LI Q,LI B,LIU C,et al.Protective role of Nrf2 against mechanical-stretch-induced apoptosis in mouse fibroblasts:A potential therapeutic target of mechanical-trauma-induced stress urinary incontinence[J].Int Urogynecol J,2018,29(10):1469-1477.
[13] LIU Z,LIU Y,XU H,et al.Effect of electroacupuncture on urinary leakage among women with stress urinary incontinence:A randomized clinical trial[J].JAMA,2017,317(24):2493-2501.
[14] TANG K,SU T,FU L,et al.Effect of electroacupuncture added to pelvic floor muscle training in women with stress urinary incontinence:A randomized clinical trial[J].Eur Urol Focus,2023,9(2):352-360.
[15] ZHANG X,ZHONG W,YAN W,et al.Long-term efficacy of the pelvic floor muscle rehabilitation for women with stress urinary incontinence[J].Zhong Nan Da Xue Xue Bao Yi Xue Ban,2023,48(3):414-421.
[16] 叶和松,陈佳佳,朱红,等.针灸联合生物反馈对压力性尿失禁患者尿流动力学的影响的观察[J].中国中西医结合外科杂志,2020,26(1):89-93.
[17] 杨明,叶和松,秦远,等.针灸联合生物反馈治疗女性轻中度压力性尿失禁[J].中国中西医结合外科杂志,2018,24(3):290-293.
[18] ZHANG Z H,YANG M,YIN A L,et al.Serum metabolomics reveals the effect of electroacupuncture on urinary leakage in women with stress urinary incontinence[J].J Pharm Biomed Anal,2020,190:113513.
[19] LIN A S,CARRIER S,MORGAN D M,et al.Effect of simulated birth trauma on the urinary continence mechanism in the rat [J].Urology,1998,52(1):143-151.
[20] 李忠仁.实验针灸学[M].北京:中国中医药出版社,2007:157.
[21] 魏俊英,郑志攀,张彪,等.女性压力性尿失禁中医渊源探微[J].中医研究,2009,2(12):14-15.
[22] 张林.针刺治疗脑卒中后排尿障碍随机平行对照研究[J].实用中医内科杂志,2017,31(8):55-57.
[23] 孟兆祥,王彤,尹正录,等.电针结合经会阴BTX-A注射治疗脊髓损伤后神经源性膀胱的临床研究[J].中国针灸,2015,35(1):17-20.
[24] LEDUC-GAUDET J P,HUSSAIN S N A,BARREIRO E,et al.Mitochondrial dynamics and mitophagy in skeletal muscle health and aging[J].Int J Mol Sci,2021,22(15):8179.
[25] NOONE J,O'GORMAN D J,KENNY H C.OPA1 regulation of mitochondrial dynamics in skeletal and cardiac muscle[J].Trends Endocrinol Metab,2022,33(10):710-721.
[26] MARCHANT E D,NELSON W B,HYLDAHL R D,et al.Passive heat stress induces mitochondrial adaptations in skeletal muscle[J].Int J Hyperthermia,2023,40(1):2205066.
[27] JIAO H,JIANG D,HU X,et al.Mitocytosis a migrasome-mediated mitochondrial quality-control process[J].Cell,2021,184(11):2896-2910.
[28] 王凯华,杨鑫勇,郑光珊,等.柚皮素对脑缺血损伤小鼠神经细胞线粒体自噬的影响实验研究[J].陕西中医,2022,43(8):997-1002,1008.
[29] BAKER N,WADE S,TRIOLO M,et al.The mitochondrial protein OPA1 regulates the quiescent state of adult muscle stem cells[J].Cell Stem Cell,2022,29(9):1315-1332.

相似文献/References:

[1]贺韵涵,李晓峰,符 涛,等.针刺干预对肌萎缩侧索硬化症模型小鼠脑及脊髓中IBA-1和TNF-α表达的影响*[J].陕西中医杂志,2020,(3):292.
 HE Yunhan,LI Xiaofeng,FU Tao,et al.Effects of acupuncture on the expression of IBA-1 and TNF-α in the brain and spinal cord in mice with smyotrophic lateral sclerosis disease[J].,2020,(4):292.
[2]黄 建,杨丽薇,邓国忠.高频电针结合臭氧对膝骨关节炎患者血清IL-1及TNF-α表达的影响*[J].陕西中医杂志,2020,(7):966.[doi:DOI:10.3969/j.issn.10007369.2020.07.039]
 HUANG Jian,YANG Liwei,DENG Guozhong..Effect of high frequency electroacupuncture combined with ozone on serum IL-1 and TNF-α expression in patients with knee osteoarthritis[J].,2020,(4):966.[doi:DOI:10.3969/j.issn.10007369.2020.07.039]
[3]孟晓鹏,杨 欢,王瑞辉△.电针对创伤性颅脑损伤大鼠脑组织细胞凋亡及p-GSK-3β、GLUT1蛋白表达的影响*[J].陕西中医杂志,2020,(8):1032.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.005]
 MENG Xiaopeng,YANG Huan,WANG Ruihui..Effects of electroacupuncture on apoptosis of brain tissue and expression of p-GSK-3β、GLUT1 protein in rats with traumatic brain injury[J].,2020,(4):1032.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.005]
[4]李 丹,罗朝斤,黄 程.火针与电针配合康复训练治疗脑卒中后偏瘫痉挛临床研究*[J].陕西中医杂志,2020,(8):1155.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.038]
 LI Dan,LUO Chaojin,HUANG Cheng..Fire-needle acupuncture or electroacupuncture combined with rehabilitation training on hemiplegia spasm after stroke[J].,2020,(4):1155.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.038]
[5]肖风娟,姚艳玲,王丽芬.电针联合生化汤加减治疗药物流产不全临床研究[J].陕西中医杂志,2021,(4):520.[doi:DOI:10.3969/j.issn.1000-7369.2020.04.031]
 XIAO Fengjuan,YAO Yanling,WANG Lifen.Clinical efficacy of electroacupuncture combined with Shenghua decoction in the treatment of incomplete abortion[J].,2021,(4):520.[doi:DOI:10.3969/j.issn.1000-7369.2020.04.031]
[6]张良兵,操礼琼,董 巍.电针联合有氧运动对脑梗死后缺血半暗带cAMP/PKA通路的影响[J].陕西中医杂志,2021,(7):827.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.003]
 ZHANG Liangbing,CAO Liqiong,DONG Wei.Effect of electroacupuncture combined with aerobic exercise on cAMP/PKA pathway in ischemic penumbra after cerebral infarction[J].,2021,(4):827.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.003]
[7]徐进友,罗 玺.轻中度腕管综合征中医治疗及相关电生理学研究进展[J].陕西中医杂志,2021,(7):980.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.045]
[8]李 娜,王瑞辉,郭 婕,等.电针对创伤性颅脑损伤大鼠炎症因子表达及神经功能的影响[J].陕西中医杂志,2021,(10):1358.[doi:DOI:10.3969/j.issn.1000-7369.2020.10.008]
[9]耿久军,高杨阳,曹 斌,等.电针治疗卒中后吞咽障碍疗效Meta分析[J].陕西中医杂志,2021,(12):1814.[doi:DOI:10.3969/j.issn.1000-7369.2020.12.042]
[10]张容超,吴 涛,刘 奇,等.电针对颅脑损伤大鼠脑组织中PI3K/AKT通路关键蛋白的影响[J].陕西中医杂志,2022,(3):279.[doi:DOI:10.3969/j.issn.1000-7369.2022.03.002]
 ZHANG Rongchao,WU Tao,LIU Qi,et al.Effect of electroacupuncture on key proteins of PI3K/AKT signaling pathway in brain tissue of rats with traumatic brain injury[J].,2022,(4):279.[doi:DOI:10.3969/j.issn.1000-7369.2022.03.002]

备注/Memo

备注/Memo:
基金项目:国家自然科学基金青年基金资助项目(82104720); 江苏省中医药科技发展计划项目(MS2021031,YB2020026); 江苏省研究生培养创新工程研究生科研与实践创新计划项目(SJCX21_0790)
更新日期/Last Update: 2024-04-10