电针对骶上脊髓损伤后神经源性膀胱大鼠膀胱功能及髓内NGF和NT-3的影响

目的观察电针对完全性骶上脊髓损伤后神经源性膀胱大鼠尿流动力学及髓内神经生长因子(NGF)和神经营养素3(NT-3)表达水平的影响。方法选取60只雌性SD大鼠,随机抽取24只分为空白组和假手术组(各12只),其余36只大鼠采用脊髓横断法进行手术造模,再选取经评价符合模型标准的24只大鼠随机分为模型组和电针组(各12只),模型成功后各组予以相应干预,连续7 d。各组动物行尿流动力学评估后处死,取膀胱组织切片观察逼尿肌功能,取脊髓组织用Western blot法和RT-PCR法测定髓内NGF和NT-3的表达。结果HE染色结果提示,与空白组、假手术组比较,模型组膀胱上皮细胞结构破坏,逼尿肌肌纤维增生,有严重出血改变;与模型组比较,电针组完整膀胱上皮细胞增多,逼尿肌肌纤维增生程度减轻,出血改变减少。尿流动力学结果提示,与空白组、假手术组比较,模型组膀胱最大容量及顺应性均明显降低(P<0.01),膀胱漏尿点压增加(P<0.01);与模型组比较,电针组膀胱最大容量及顺应性均明显增加(P<0.01),膀胱漏尿点压降低(P<0.01)。Western blot结果和RT-PCR结果提示,与空白组、假手术组比较,模型组髓内NGF蛋白及其mRNA含量明显降低(P<0.01),NT-3蛋白及其mRNA含量明显增加(P<0.01);与模型组比较,电针组髓内NGF、NT-3蛋白及其mRNA含量均升高(P<0.05)。结论电针次髎、中极、三阴交、大椎可升高骶上脊髓损伤后神经源性膀胱大鼠脊髓组织中NGF和NT-3蛋白及其mRNA含量,改善膀胱神经支配,提高受累膀胱储尿控尿的能力。

Effects of Electroacupuncture on Bladder Function and Intramedullary NGF and NT-3 in Neurogenic Bladder Rats After Sacral Spinal Cord Injury

Objective To observe the effect of electroacupuncture on urodynamics and expression of intramedullary nerve growth factor(NGF)and neurotrophin 3(NT-3)in neurogenic bladder rats after complete sacral spinal cord injury.Methods 60 female SD rats were selected,24 rats were randomly divided into the blank group and the sham operation group(12 rats in each group),the remaining 36 rats were operated by transection of spinal cord,then 24 rats that met the model criteria were randomly divided into the model group and the electroacupuncture group(12 rats in each group),after the model was successful,each group intervened for 7 consecutive days.The animals were killed after urodynamic evaluation,bladder tissue sections were taken to observe detrusor function,the expressions of intramedullary NGF and NT-3 were determined by Western blot method and RT-PCR method.Results HE staining results indicated,compared with the blank group and the sham operation group,there were structural disruption of bladder epithelial cells in the model group,with fibre proliferation of the detrusor and severe bleeding changes;compared with the model group,the number of intact bladder epithelial cells in the electroacupuncture group increased,the degree of myofibrillar hyperplasia of the detrusor was reduced,and bleeding changes decreased.Urodynamic results suggested,compared with the blank group and the sham operation group,both bladder maximum capacity and compliance were significantly decreased in the model group(P<0.01),with the bladder leak point pressure increased(P<0.01);compared with the model group,both bladder maximum capacity and compliance increased significantly in the electroacupuncture group(P<0.01),with the bladder leakage point pressure decreased(P<0.01).Western blot and RT-PCR results indicated that the content of intramedullary NGF protein and its mRNA decreased significantly(P<0.01),and the content of the NT-3 protein and its mRNA increased significantly(P<0.01)in the model group compared with the blank group and the sham operation group.Compared with the model group,the contents of NGF,NT-3 protein and its mRNA in the electroacupuncture group increased(P<0.05).Conclusion Electroacupuncture of"Ciliao"(BL32),"Zhongji"(RN3),"Sanyinjiao"(SP6)and"Dazhui"(DU14)can increase the contents of NGF and NT-3 protein and its mRNA in spinal cord of neurogenic bladder rats after sacral spinal cord injury,improve bladder innervation and improve the ability of urine storage and control in affected bladder.