通腑茯苓饮联合电针穴位刺激对骶上脊髓损伤大鼠脊髓S-100β表达及膀胱功能的影响研究

Effect of Tongfu Fuling Decoction(通腑茯苓饮)Combined with Electro-Acupuncture on S-100βExpression in Spinal Cord and Bladder Function in Rats with Suprasacral Spinal Cord Injury

目的观察和研究通腑茯苓饮联合电针穴位刺激对骶上脊髓损伤大鼠脊髓损伤区域星形胶质源性蛋白(S-100β)表达及膀胱功能的影响,旨在明确中医综合疗法作用优势及作用机制,为其临床使用提供可循性的实验依据及相关理论。方法39只成年健康雌性SD大鼠中随机挑取13只作为空白组、其余26只大鼠予以骶上脊髓损伤手术造模,确定模型成功后,再采用随机数字表法将造模成功大鼠随机分为模型组和治疗组,每组13只。空白组大鼠不予任何干预,模型组大鼠仅予以捆绑及0.9%生理盐水灌胃干预,治疗组采用通腑茯苓饮联合电针穴位刺激。观察和比较3组大鼠治疗前后膀胱功能及治疗后脊髓S-100β表达。结果3组大鼠脊髓S-100β表达比较,差异有统计学意义(P<0.05);治疗组与空白组比较,差异无统计学意义(P>0.05);治疗组与模型组比较,差异有统计学意义(P<0.05)。治疗前,模型组、治疗组膀胱最大容量和膀胱顺应性均低于空白组,膀胱基础压和漏尿点压高于空白组,差异有统计学意义(P<0.05);治疗后较治疗前,空白组、模型组膀胱最大容量、膀胱顺应性、膀胱基础压、漏尿点压水平比较,差异无统计学意义(P>0.05),但治疗组膀胱最大容量、膀胱顺应性升高且膀胱基础压、漏尿点压下降,差异有统计学意义(P<0.05);治疗后,空白组、治疗组膀胱最大容量和膀胱顺应性均高于模型组,膀胱基础压和漏尿点压均低于模型组,差异均有统计学意义(P<0.05)。结论通腑茯苓饮联合电针穴位刺激方案能有效降低骶上脊髓损伤大鼠S-100β表达,利于重建受损脊髓功能,因此对促进骶上脊髓损伤大鼠膀胱功能恢复具有一定治疗价值,丰富了中医综合疗法治疗脊髓损伤理论,并为临床干预骶上脊髓损伤后的膀胱功能异常提供了新思路。

Objective To observe and study the effect of Tongfu Fuling Decoction(通腑茯苓饮)combined with electro-acupuncture(EA)on the expression of astrocyte-derived protein(S-100β)and the function of bladder in the area of spinal cord injury in rats with suprasacral spinal cord injury.To clarify the advantage and mechanism of TCM comprehensive therapy and provide the evidence-based experimental basis and relevant theory for its clinical application.Methods Thirteen adult healthy male SD rats were randomly selected as the blank group and the other 26 rats were operated on to establish the model of suprasacral spinal cord injury,and then the rats were randomly divided into model group and treatment group with 13 rats in each group.The rats in the model group were only given binding and 0.9%saline intragastric administration.The rats in the treatment group were given Tongfu Fuling Decoction combined with EA.The bladder function and the expression of S-100βwere observed and compared before and after treatment in three groups.Results The expression of S-100βin the spinal cord of the three groups was significantly different(P<0.05).There was no significant difference between the treatment group and the blank group(P>0.05).There was significant difference between the treatment group and the model group(P<0.05).Before treatment,the maximal bladder capacity and compliance of the model group and the treatment group were lower than those of the blank group,the basic bladder pressure and leak point pressure of the bladder were higher than those of the blank group.The difference was statistically significant(P<0.05).There was no significant difference in bladder capacity,bladder compliance,basal bladder pressure or leak point pressure between the model group and the blank group(P>0.05).However,there were significant differences in the maximum bladder capacity,bladder compliance,basal bladder pressure and leak point pressure in the treatment group(P<0.05).The maximal bladder capacity and bladder compliance of the blank group and the treatment group were higher than those of the model group,and the basal bladder pressure and leak point pressure of the bladder were lower than those of the model group(P<0.05).Conclusion Tongfu Fuling Decoction combined with EA can effectively reduce the expression of S-100βin rats with suprasacral spinal cord injury,and is beneficial to the reconstruction of the function of the injured spinal cord.Therefore,it has therapeutic value in promoting the recovery of bladder function in rats with suprasacral spinal cord injury,enriches the theory of traditional Chinese medicine comprehensive therapy for the treatment of spinal cord injury and provides a new idea for clinical intervention of bladder dysfunction after suprasacral spinal cord injury.