姜 敏,徐福利,兰叶平

目的：基于转化生长因子-β1(TGF-β1)/结缔组织生长因子(CTGF)通路，探究益气固肾汤对压力性尿失禁（SUI）大鼠盆底损伤及排尿功能的影响。方法：以SD雌性未育大鼠为研究载体，通过模拟产伤联合双侧卵巢切除法建立SUI大鼠模型。随机分为空白对照组、模型组、益气固肾汤低剂量、益气固肾汤中剂量、益气固肾汤高剂量及阳性对照组。各组大鼠给予不同给药处理，给药（28天）结束后进行喷嚏实验及尿流动力学指标检测。采用HE染色和Masson染色观察大鼠阴道组织形态学变化。ELISA检测大鼠阴道组织MDA、总SOD、GSH-Px和CAT水平。TUNEL染色检测盆底肌细胞凋亡水平。PCR检测阴道组织MMPs、TIMPs、TGF-β1及CTGF mRNA表达水平。结果：经益气固肾汤治疗后，SUI大鼠的漏尿点压力（LPP）及腹压漏尿点压力（ALPP）水平增加。HE染色及Masson染色结果显示，益气固肾汤减轻了SUI大鼠阴道组织固有层胶原纤维及肌层平滑肌变细断裂的现象。益气固肾汤提高了SUI大鼠阴道组织SOD、GSH-Px及CAT水平，降低了SUI大鼠阴道组织MDA水平。Tunel染色结果显示，益气固肾汤显著降低SUI大鼠盆底肌细胞凋亡水平。PCR结果中，益气固肾汤组降低SUI大鼠的MMP-2 mRNA表达水平，增加TIMP-2、TGF--β1及CTGF mRNA表达水平。中剂量及高剂量益气固肾汤组相比低剂量组作用效果更好，呈剂量依赖性。结论：益气固肾汤通过调节TGF-β1/CTGF通路抑制ECM降解，同时降低阴道组织氧化应激及凋亡水平，从而改善SUI大鼠的阴道损伤及排尿功能障碍。

压力性尿失禁；益气固肾汤；TGF-β1/CTGF通路；氧化应激

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