【作者】 卢鹏；

【导师】 杨为民；

【作者基本信息】 华中科技大学 ， 外科学， 2013， 硕士

【摘要】 目的建立雌性大鼠压力性尿失禁动物模型，并应用电针刺激治疗，研究治疗前后大鼠尿动力学变化及5-HT及肾上腺素在骶髓核脑干的表达变化，为女性压力性尿失禁针灸治疗提供理论依据。方法将60只大鼠随机分成模型组、治疗组和空白对照组，每组20只。模型组和治疗组大鼠麻醉下进行持续阴道扩张构建大鼠压力性尿失禁模型，之后对治疗组进行周期为15天的针灸电刺激治疗，针灸大鼠腧穴三阴交。治疗后大鼠行尿动力学检查并取大鼠脑干及骶髓标本，比较各组大鼠尿动力学检查结果、脑干及骶髓标本5-HT及肾上腺素免疫组化表达。结果1.尿动力学结果：对照组、模型组和治疗组大鼠膀胱容量分别为（0.98±0.19）ml，（10.6±0.20）ml，（10.5±0.22）ml，模型组及治疗组膀胱容量均显著增加（p＜0.05）；对照组、模型组和治疗组腹腔漏尿点压分别为（23.47±2.94）cmH2O，（17.75±2.63）cmH2O，（22.71±3.05）cmH2O，模型组腹腔漏尿点压力相比对照组显著下降（p＜0.05）；对照组、模型组和治疗组排尿压力分别为（24.6±3.36）cmH2O，（17.55±2.79）cmH2O，（23.82±3.42）cmH2O，模型组排尿压力压力相比对照组显著下降（p＜0.05）。2.免疫组化结果：空白对照组骶髓及脑干标本免疫组化染色5-HT水平及肾上腺素呈弱表达，模型组表达水平同空白对照组相比无显著性差异（P＞0.05），治疗组表达水平明显增加，差异具有统计学意义（P＜0.05）。结论利用阴道扩张方法可成功构建大鼠压力性尿失禁模型，针刺腧穴三阴交可通过调节脑干－骶髓Onuf s核5－HT和NE能神经活性来增强尿道括约肌控尿功能。更多还原

【Abstract】 ObjectiveTo research the changes of rats urodynamics and expression of serotonin andnorepinephrine in the sacral spinal cord onuf’s nuclears and brainstem through theelectro-acupuncture treatment for female SD rats stress urinary incontinence modal.Andprovide a theoretical basis of the electro-acupuncture treatment for female stress urinaryincontinence.MethodA total of60female SD rats weighing220-250g were randomly divided into threegroups(n=20): Control group,Model group and Treatment group. Model group and treatmentgroup rats were anesthetized and conducted ongoing vaginal dilator to build the model ofstress urinary incontinence,and then gave the treatment group electro-acupuncture treatmenton the acupoints Sanyinjiao with an acupuncture cycle of2weeks.Made the urodynamicsof all the rats and the collected the brain stem and the sacral spinal cord specimen.Thenmade a comparasion of the urodynamics results, immunohistochemical results ofserotonin and norepinephrine in the sacral spinal cord onuf’s nuclears and brainstembetween each group. ResultUrodynamic results: The maximum bladder capacity of control group, model groupand treatment group were（0.98±0.19）ml，（10.6±0.20）ml，（10.5±0.22）ml respectively;theabdomen leak point pressure of the control group, model group and treatment group were(23.47±2.94) cm H2O,(17.75±2.63) cm H2O (22.71±3.05) cm H2O respectively, theabdomen leak point pressure of model group decreased significantly compared with thecontrol group(p <0.05);and the voiding pressure of the control group, model group andtreatment group (24.6±3.36) cm H2O (17.55±2.79) cm H2O (23.82±3.42) cm H2Orespectively, the voiding pressure of model group decreased significantly compared withthe control group(p <0.05).Immunohistochemical results: The immunohistochemical staining of serotonin andnorepinephrine was weak expression in the sacral spinal cord onuf’s nuclears andbrainstem,, compared with the control group, there was no significant difference in modelgroup(P>0.05), the expression of treatment group was significantly increased, and thedifference was statistically significant (P <0.05).ConclusionVaginal dilator was a successful method to construct rat stress urinary incontinencemodel, and acupuncture the acupoints Sanyinjiao could enhance the urethral sphincterurinary control function by adjusting the brainstem-the sacral Onuf’s nuclear serotonin andnorepinephrine nerve activity.更多还原