【作者】 宋燕娟； 刘保延； 梁凤霞；

【Author】 SONG Yan-juan;LIU Bao-yan;LIANG Feng-xia;College of Acupuncture and Orthopedics,Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion;China Academy of Chinese Medical Sciences;

【机构】 湖北中医药大学针灸骨伤学院/针灸治未病湖北省协同创新中心； 中国中医科学院；

【摘要】 压力性尿失禁(Stress Urinary Incontinence,SUI)是最常见的尿失禁类型,是指由于体力消耗、运动、咳嗽或打喷嚏导致膀胱压力超过尿道闭合压力而导致的不自主漏尿,在女性中十分常见,严重影响患者的身心健康,并带来巨大的社会经济压力。SUI保守治疗的疗效有限,且很大程度上取决于患者的坚持和依从性,手术治疗往往会带来相关不良并发症和更高的治疗成本。因此,了解压力性尿失禁的潜在分子机制并开发新的治疗方法至关重要。尽管SUI现代基础研究已取得部分进展,但其具体分子致病机制仍不清楚。外泌体是由各种细胞分泌的囊泡(直径30-150nm),它们在细胞之间运输蛋白质、细胞因子和m RNA,并已被证明可有效防止组织损伤并在组织修复中具有治疗作用。外泌体作为细胞间通讯的一种方式,能够携带多种生物分子和药物,作为运载工具靶向识别和治疗疾病。近期相关研究显示外泌体可通过增强神经元细胞活性、促进血管新生和组织修复改善压力性尿失禁(SUI)。近年来,外泌体逐渐应用于中医学领域,结合国内外目前研究进展,本文旨在研究外泌体作为细胞间通讯介质在SUI进展和治疗中的效应机制,讨论外泌体在针灸干预SUI中可能作为生物诊断标志物和治疗靶点应用于临床的潜在价值。通过综述神经、尿道肌肉、尿道周围结缔组织在SUI发病机制和治疗方法中相关的分子机制研究和最新研究进展,进一步探讨针灸刺激对外泌体的影响及其反向应答机制,促进疾病诊断新型标志物的发掘和靶向疾病治疗技术的发展,为临床针灸治疗SUI提供具有前瞻性的新思路和应用转化的新方向。更多还原

【Abstract】 Stress urinary incontinence(SUI) is the most common type of urinary incontinence.It refers to involuntary urine leakage caused by bladder pressure exceeding urethral closure pressure due to physical exertion,exercise,coughing or sneezing.It is very common in women,seriously affecting the physical and mental health of patients and bringing huge socioeconomic pressure.The efficacy of conservative treatment of SUI is limited and depends largely on the persistence and compliance of patients.Surgical treatment often brings adverse complications related to surgery and higher treatment costs for patients.Therefore,it is crucial to understand the underlying molecular mechanisms of stress urinary incontinence and develop new treatments.Although some progress has been made in modern basic research on SUI,its specific molecular pathogenic mechanism remains unclear.Exosomes are vesicles(30-150nm in diameter) secreted by various cells.They transport proteins,cytokines and m RNA between cells and have been shown to effectively prevent tissue damage and have therapeutic effects in tissue repair.As a way of intercellular communication,exosomes can carry a variety of biomolecules and drugs,and serve as delivery vehicles for targeted identification and treatment of diseases.Recent studies have shown that exosomes can improve stress urinary incontinence(SUI) by enhancing neuronal cell activity,promoting angiogenesis and tissue repair.In recent years,exosomes have gradually been used in the field of traditional Chinese medicine.Combining the current research progress at home and abroad,this article aims to study the effect mechanism of exosomes as intercellular communication media in the progression and treatment of SUI,and discuss the potential value of exosomes in acupuncture intervention for SUI as a biological diagnostic marker and therapeutic target for clinical application.By reviewing the molecular mechanism research and the latest research progress related to nerves,urethral muscles,and periurethral connective tissue in the pathogenesis and treatment of SUI,further explore the effect of acupuncture stimulation on exosomes and its reverse response mechanism,promote the discovery of new markers for disease diagnosis and the development of targeted disease treatment technology,and provide forward-looking new ideas and new directions for application transformation for clinical acupuncture treatment of SUI.更多还原