Acupuncture point specificity study on the treatment of stress incontinence model rats by electroacupuncture at the cìliáo point#br#
ZHANG Weiwei1 CAI Mingxing1 MO Qian1 YANG Dan2
1.College of Acupuncture and Massage, Guizhou University of Traditional Chinese Medicine, Guizhou Province, Guiyang 550002, China;
2.Department of Acupuncture, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guizhou Province, Guiyang 550001, China
Abstract Objective To investigate the acupuncture point specificity of electroacupuncture at the cìliáo point in rats with stress incontinence. Methods Fifty 8-week-old female SD rats, weighing 180 - 220 g, were divided into normal group, model group, cìliáo point group, sānyīnjiāo group, and non-channel point group according to random number table method, with ten rats in each group. The normal group was only tested, and the other four groups were treated with bilateral ovariectomy first, followed by vaginal dilation to establish the model of stress incontinence. After modeling, urine flow dynamics was detected before and after electroacupuncture intervention, and the changes of abdominal leak point pressure (ALPP) and maximal bladder capacity (MBC) were observed. Immunohistochemistry was used to detect the expression levels of type Ⅰ collagen (collagen Ⅰ) and connective tissue growth factor (CTGF) in the tissues of caudal gluteus muscle and bladder cervical urethral sphincter. Results The results of urine flow dynamics showed that MBC and ALPP values of model group were significantly decreased after intervention compared with normal group (P ＜ 0.05). Compared with model group, MBC and ALPP values of cìliáo point group, sānyīnjiāo group, and non-channel point group were increased after intervention (P ＜ 0.05). Compared with cìliáo point group, MBC and ALPP values of sānyīnjiāo group and non-channel point group were decreased (P ＜ 0.05). Immunohistochemical results showed that compared with normal group, the expression levels of collagen Ⅰ and CTGF in model group were significantly decreased (P ＜ 0.01). Compared with model group, the expression levels of collagen Ⅰ and CTGF in cìliáo point group, sānyīnjiāo group, and non-channel point group were significantly increased (P ＜ 0.05). Compared with the cìliáo point group, the expression levels of collagen Ⅰ and CTGF in sānyīnjiāo group and non-channel point group were decreased (P ＜ 0.05). Conclusion Electroacupuncture on cìliáo point can effectively improve the symptoms of stress urinary incontinence and repair the pelvic floor tissue damage, and the bladder regulation effect has acupoint specificity.
ZHANG Weiwei1 CAI Mingxing1 MO Qian1 YANG Dan2. Acupuncture point specificity study on the treatment of stress incontinence model rats by electroacupuncture at the cìliáo point#br#[J]. 中国医药导报, 2022, 19(10): 5-8,13.
[1] Bettez M，Tu le M，Carlson K，et al. 2012 update：guidelines for adult urinary incontinence collaborative consensus document for the canadian urological association [J]. Can Urol Assoc J，2012，6（5）：354-363.
[2] 李志毅，朱兰.女性压力性尿失禁流行病学现状[J].实用妇产科杂志，2018，34（3）：161-162.
[3] Smith A，Bevan D，Douglas HR，et al. Management of urinary incontinence in women： summary of updated NICE guidance [J]. BMJ，2013，347：f5170.
[4] 王孟琦，王峰.近20年来针灸治疗压力性尿失禁的临床研究进展[J].中医药学报，2019，47（6）：73-78.
[5] 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， 27（24）：2493-2501.
[6] 章薇，谭志高，曹卷舒，等.基于数据挖掘技术探析古代针灸治疗尿失禁的用穴规律[J].中国针灸，2015，35（12）：1299-1303.
[7] Qiang F，Guo-long L. Comparative study of three rat models of stress urinary incontinence [J]. Bosn J Basic Med Sci，2011，11（2）：87-90.
[8] 杨智明.压力性尿失禁大鼠动物模型的建立及NOS、COX-2、P38的检测[D].昆明：昆明医科大学，2015.
[9] 王天行，陈跃来，尹平，等.压力性尿失禁动物模型：正确选择与研究目的相关实验动物模型的构建方法[J].中国组织工程研究，2018，22（28）：4557-4561.
[10] 李忠仁.实验针灸学[M].北京：中国中医药出版社，2007：314-329.
[11] 刘笑萌，许明，邓石峰，等.大鼠“次髎”穴的取穴方法研究[J].湖南中医药大学学报，2019，39（11）：1373-1376.
[12] 王婕.产伤、绝经对大鼠压力性尿失禁模型建立的意义[D].太原：山西医科大学，2010.
[13] Damaser MS，Kim FJ，Minetti GM. Methods of testing urethral resistance in the female rat [J]. Adv Exp Med Biol，2003，539（Pt B）：831-839.
[14] 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.
[15] 李倩男，李秉枢，刘成，等.机械力对小鼠成纤维细胞Ⅰ、Ⅲ型胶原蛋白表达的影响研究[J].实用妇产科杂志，2017，33（8）：590-595.
[16] Anitua E，Tejero R，Zalduendo MM，et al. Plasma rich in growth factors promotes bone tissue regeneration by stimulating proliferation，migration，and autocrine secretion in primary human osteoblasts [J]. J Periodontol，2013， 84（8）：1180-1190.
[17] 汤康敏，明树人，刘建党，等.电针对压力性尿失禁大鼠盆底MMPs和TIMPs表达的影响[J].上海中医药大学学报，2019，33（1）：81-86.
[18] 王元毅，轩留明，王勤章.中国女性压力性尿失禁危险因素的Meta分析[J].中国临床研究，2021，34（7）：865-871.
[19] 于沁，薛小军，王福好，等.硫酸阿托品穴位注射联合盆底康复治疗仪治疗女性压力性尿失禁的疗效与安全性[J].中国医药科学，2021，11（2）：91-94.
[20] 刘林梅，王丽萍，王大雪，等.中医辨证施护联合电针治疗对围绝经期妇女压力性尿失禁疗效及TGF-β1与CTGF表达影响[J].四川中医，2020，38（11）：203-206.
[21] 崔灿，王志莲，郝敏，等.压力性尿失禁大鼠模型阴道前壁组织中结缔组织生长因子和整合素β1的表达[J].中国现代医生，2015，53（11）：25-28.
[22] 陈元霄，马睿杰.电针会阳、中髎穴结合头针治疗女性压力性尿失禁临床观察[J].上海针灸杂志，2015，34（12）：1159-1161.
[23] 洪领俊，赵晋.电针阴部神经刺激疗法治疗压力性尿失禁的临床观察[J].中华中医药杂志，2016，31（7）：2857-2860.
[24] 王琳琳，任志欣，朱敬云，等.电针联合透灸治疗产后压力性尿失禁疗效观察[J].中国针灸，2019，39（6）：599-603.
[25] 宛远君，张玉婵，张娟，等.电针治疗女性压力性尿失禁合并盆腔器官脱垂的效果[J].中国医药科学，2021，11（18）：80-83，150.
[26] Sun J，Zhang X，Cao T，et al. Treatment of urinary incontinence after total hysterectomy with acupuncture：A case report [J]. Medicine，2019，98（20）：e15687.
[27] 莫倩，杨硕，伍先明.电针对膀胱过度活动症大鼠膀胱功能的影响[J].时珍国医国药，2019，30（5）：1244-1246.
[28] 刘丛丛，王扬，莫倩，等.电针次髎/中髎穴抑制膀胱过度活动的穴位特异性研究[J].环球中医药，2013，6（12）：885-890.
