防己黄芪汤对大鼠膀胱过度活动症的防治作用

目的 观察防己黄芪汤对大鼠膀胱过度活动症的防治作用。方法 ①选取雌性SD大鼠90只，随机取15只为假手术组，其余75只随机均分为模型组（复制逼尿肌不稳定（detrusor instability, DI）模型），托特罗定组（0.5 mg/kg)，防己黄芪汤高、中、低剂量组（分别为10、5、2.5 g/kg），缩窄近端尿道出口，模型复制第3周开始给药，连续4周。末次给药后测定尿动力学参数，计算膀胱指数，并观察膀胱组织形态学变化。②复制体外膀胱逼尿肌过度活动模型，观察防己黄芪汤对其收缩活动的影响。结果 DI模型大鼠的排尿间隔时间显著缩短（P<0.01），排尿点压、排尿压峰值、膀胱指数显著升高（P<0.01），残余尿量明显增多（P<0.01）；膀胱发生明显的病理性改变。防己黄芪汤高、中剂量组和托特罗定组大鼠排尿间隔时间显著延长（P<0.05，或P<0.01），排尿点压和排尿压峰值降低（P<0.01），膀胱的残余尿量显著减少（P<0.01）；防己黄芪汤高剂量组和托特罗定组膀胱指数显著降低（P<0.05），膀胱病变程度减轻。0.2 mol/L KCl溶液能显著增加正常大鼠逼尿肌的收缩频率和张力（P<0.01），托特罗定(10-8 mmol/L)、防己黄芪汤（10、20、40 g/L）对KCl引起的逼尿肌收缩频率和张力的增加均有明显抑制作用。结论 防己黄芪汤可以改善DI大鼠的下尿路症状，可能是通过调节膀胱逼尿肌和尿道平滑肌的舒缩而发挥作用。

Therapeutic Effect of Fangji Huangqi Decoction on Overactivity Bladder in Rats

Objective To investigate the therapeutic effect of Fangji Huangqi Decoction (containing Menispermaceae and Astragalus) on overactivity bladder (OAB) in rats. Methods Ninety female Sprague-Dawley rats were included in the study. Among these rats, 15 were randomly selected as sham operation group, and the other 75 were randomly and equally divided into detrusor instability (DI) model group, tolterodine group (0.5 mg/kg), and high-, middle-, and low-dose Fangji Huangqi Decoction groups (10, 5, and 2.5 g/kg). A rat DI model was induced by partially ligating the bladder outlet in all groups but sham operation group. All rats were administered respective drugs for 4 weeks from the third week after the ID model was established. Urodynamic parameters were measured in rats under anesthesia. The bladder index (BI) was calculated, and the pathological changes in the bladder were observed. An isolated bladder model of detrusor overactivity was induced, and the effect of Fangji Huangqi Decoction on its contractile activity was observed. Results The DI model group had significantly shortened micturition interval (MI) (P<0.01), significantly increased threshold micturition pressure (TMP), peak micturition pressure (PMP), and BI (P<0.01), significantly increased residual urine volume (P<0.01), and marked pathological changes in the bladder. The high- and middle-dose Fangji Huangqi Decoction groups and tolterodine group had significantly prolonged MI (P<0.05 or P<0.01), significantly decreased TMP and PMP (P<0.01), and significantly decreased residual urine volume (P<0.01). The high-dose Fangji Huangqi Decoction group and tolterodine group had significantly decreased BI (P<0.05) and alleviated pathological changes in the bladder. The contraction frequency and tension of normal rat detrusor were significantly increased in the presence of 0.2 mol/L KCl solution (P<0.01), and tolterodine (10-8 mmol/L) and Fangji Huangqi Decoction (10, 20, and 40 g/L) showed significant inhibitory effects on the increases in contraction frequency and tension of detrusor. Conclusion Fangji Huangqi Decoction can relieve the lower urinary tract symptoms in rats with OAB. It may take effect by inhibiting excessive contraction of bladder detrusor and urethral smooth muscle.