中医"温阳生肌"治则用药对压力性尿失禁的干预作用机制OA

Objective To investigate the mechanism of the traditional Chinese medicine(TCM)principle of"Warming Yang and Promoting Muscle Regeneration"(WYPMR)in the intervention of stress urinary incontinence(SUI),and to provide a new strategy and scientific basis for clinical treatment of SUI.Methods Eight-week-old female healthy SD rats served as the normal control group.SUI model rats were randomly divided into model control,WY(warming yang)group,MR(muscle regeneration)group,and WYPMR group.The WY,MR,and WYPMR groups received intravaginal administration of gels H-1(main components:Cnidium monnieri oil,cinnamon oil),H-2(main components:Bletilla striata polysaccharide,Centella asiatica total glycosides),and H-3(main components:Cnidium monnieri oil,cinnamon oil,Bletilla striata polysaccharide,Centella asiatica total glycosides),respectively,which possess the respective efficacies of"warming yang","promoting muscle regeneration",and their combination.The model control group received a blank gel.After 14 consecutive days of administration,serum levels of neuro-signaling molecules involved in urinary control,including triiodothyronine(T3),free thyroxine(T4),cortisol(CORT),corticotropin-releasing hormone(CRH),adrenocorticotropic hormone(ACTH),and cyclic adenosine monophosphate(cAMP),were measured by ELISA.Masson staining and RT-PCR were used to detect the content and mRNA expression levels of collagen(Collagen Ⅰ and Collagen Ⅲ)in urinary control muscle groups(urethral sphincter,bladder detrusor,and pelvic floor muscles)in each group.Results After 14 days of administration,compared with the model control group,serum levels of neuro-signaling molecules were significantly increased in the WY,MR,and WYPMR groups(P<0.05,P<0.01),with the most pronounced increase observed in the WYPMR group(P<0.05,P<0.01).Masson staining showed that the positive area ratio of collagen in the urinary control muscle groups was significantly higher in all treatment groups than in the model control group(P<0.01),with the WYPMR group showing the greatest increase(P<0.05,P<0.01).RT-PCR analysis revealed that,compared with the model control group,the mRNA expression levels of Collagen Ⅰ and Collagen Ⅲ in the urethra,bladder,and pelvic floor tissues were significantly upregulated in all treatment groups(P<0.01).The magnitude of upregulation in the WYPMR group was significantly greater than that in the WY and MR groups(P<0.05,P<0.01).These results indicate that the regulatory effects of"warming yang"or"promoting muscle regeneration"alone on urinary control neuro-signaling molecules and collagen expression are inferior to those of the combined WYPMR principle,which aligns with the pathogenesis of SUI.Conclusions The TCM principle of"Warming Yang and Promoting Muscle Regeneration"may exert therapeutic effects on stress urinary incontinence by upregulating the levels of urinary control neuro-signaling molecules and promoting the expression of Collagen Ⅰ and Collagen Ⅲ in urinary control muscle groups,thereby repairing both the nerves and muscles involved in urinary control.Therefore,this principle can be recommended as a novel clinical strategy for the treatment of SUI.