电针通过TGF-β1/Smad2信号通路调控神经源性膀胱大鼠膀胱纤维化趋势的研究  

Study on the tendency of bladder fibrosis in neurogenic bladder rats regulated by electroacupuncture through TGF-β1/Smad2 signaling pathway

作　　者：展立芬 曾学究 梁柔筠 丁强盛 胡晓妹[1] 卓越 艾坤[1] 刘琼[1] 张泓[1] ZHAN Lifen;ZENG Xuejiu;LIANG Roujun;DING Qiangsheng;HU Xiaomei;ZHUO Yue;AI Kun;LIU Qiong;ZHANG Hong(College of Acupuncture,Massage and Rehabilitation,Hunan University of Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学针灸推拿与康复学院,长沙410208

出　　处：《中华中医药杂志》2024年第5期2423-2429,共7页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.82274666,No.81874510);湖南中医药大学学科建设揭榜挂帅项目(No.22JBZ013),湖南中医药大学研究生创新项目(No.2023CX13);湖南省教育厅科学研究青年项目(No.21B0369);湖南省自然科学基金青年项目(No.2022JJ40301)。

摘　　要：目的:从转化生长因子β1(TGF-β1)/Smad2信号通路观察电针对骶上脊髓横断损伤后神经源性膀胱(NB)模型大鼠损伤膀胱逼尿肌组织中纤维化的影响趋势,进而探讨电针改善NB大鼠膀胱功能可能的作用机制。方法:选用50只雌性SD大鼠(体质量220~250 g)按随机数表分为空白组(10只)和模型制备组(40只)。模型制备组采用改良模型制备方法制备NB模型,20只模型制备成功的大鼠随机分为模型组和电针治疗组,每组10只。模型制备术后第19天进行电针治疗,干预腧穴为次髎、大椎、中极和三阴交,连续治疗10d。治疗结束后,采用超声影像学技术测量大鼠膀胱壁厚度,比较各组大鼠尿动力学指标,观察大鼠膀胱最大容量、漏尿点压力等膀胱情况;Masson染色观察受损膀胱逼尿肌中细胞纤维化情况;Western Blot法测定膀胱逼尿肌中TGF-β1、Smad2的水平。结果:(1)模型组大鼠膀胱壁厚度较空白组明显增加,电针治疗组大鼠膀胱壁厚度较模型组减少。(2)模型组大鼠膀胱最大容量、膀胱最大压力、漏尿点压力及灌注时间均显著增加(P<0.05);电针治疗后上述指标均有所减轻(P<0.05)。(3)模型组胶原容积分数显著高于空白组(P<0.05),电针治疗组较模型组胶原容积分数存在减少的趋势;(4)模型组TGF-β1、Smad2蛋白较空白组显著增高(P<0.05),电针治疗后上述蛋白的表达含量显著降低(P<0.05)。结论:电针次髎、大椎、中极、三阴交后膀胱组织中纤维化病变改善,TGF-β1、Smad2的表达含量有下降的趋势,可以推测NB大鼠膀胱功能病变与纤维化存在关联,且电针具有改善这一现象的趋势。Objective:To observe the influence of transforming growth factor-β1(TGF-β1)/Smad2 signaling pathway on the fibrosis of injured detrusor muscle in neurogenic bladder(NB)model rats after transverse injury of superior sacral spinal cord,and to explore the possible mechanism of electroacupuncture to improve bladder function in NB rats.Methods:A total of 50 female SD rats(220-250 g)were selected according to random number table blank group(n=10)and model preparation group(n=40).NB model was prepared by improved model preparation method.Twenty rats were randomly divided into model group(n=10)and electroacupuncture treatment group(n=10).Electroacupuncture treatment was performed on the 19th day after the model preparation,and the intervention points were Dazhui,Ciliao,Zhongji,Sanyinjiao for 10 consecutive days.After treatment,the bladder wall thickness of rats was measured by ultrasound imaging technology,and urinary dynamics indexes of rats were compared.The bladder conditions of rats were observed,such as maximum bladder capacity and leakage point pressure.The cell fibrosis in detrusor muscle of injured bladder was observed by Masson staining.The levels of TGF-β1 and Smad2 in detrusor muscle of bladder were determined by Western Blot.Results:(1)The thickness of bladder wall in the model group was significantly increased compared with the blank group,and the thickness of bladder wall in the electroacupuncture group was decreased compared with the model group.(2)The maximum bladder capacity,maximum bladder pressure,leakage point pressure and perfusion time of rats in model group were increased(P<0.05).The above indexes were reduced after electroacupuncture treatment(P<0.05).(3)Collagen volume fraction in the model group was significantly higher than that in the blank group(P<0.05),and there was a trend of decrease in the electroacupuncture group compared with the model group;(4)TGF-β1 and Smad2proteins in model group were significantly higher than those in blank group(P<0.05),and the expression contents of these pro

关 键 词：纤维化 神经源性膀胱 转化生长因子β1 SMAD2 电针 

分 类 号：R245.97[医药卫生—针灸推拿学]