1.贵州中医药大学针灸推拿学院,贵州省贵阳市花溪区花溪大学城栋青路4号,550025
2.贵州中医药大学第一附属医院
cuijin@gzy.edu.cn
收稿:2024-12-17,
修回:2025-05-13,
纸质出版:2025-06-17
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晏明熙,李梦泽,葛平玉等.电针“补肾祛瘀”穴位处方对糖尿病勃起功能障碍模型大鼠性功能和阴茎血管内皮功能的影响[J].中医杂志,2025,66(12):1265-1272.
YAN Mingxi,LI Mengze,GE Pingyu,et al.Effects of Electroacupuncture with "Tonifying the Kidney and Dispelling Stasis" Acupoint Prescription on Sexual Function and Penile Vascular Endothelial Function in Diabetic Erectile Dysfunction Model Rats[J].Journal of Traditional Chinese Medicine,2025,66(12):1265-1272.
晏明熙,李梦泽,葛平玉等.电针“补肾祛瘀”穴位处方对糖尿病勃起功能障碍模型大鼠性功能和阴茎血管内皮功能的影响[J].中医杂志,2025,66(12):1265-1272. DOI: 10.13288/j.11-2166/r.2025.12.012.
YAN Mingxi,LI Mengze,GE Pingyu,et al.Effects of Electroacupuncture with "Tonifying the Kidney and Dispelling Stasis" Acupoint Prescription on Sexual Function and Penile Vascular Endothelial Function in Diabetic Erectile Dysfunction Model Rats[J].Journal of Traditional Chinese Medicine,2025,66(12):1265-1272. DOI: 10.13288/j.11-2166/r.2025.12.012.
目的
2
观察电针“补肾祛瘀”穴位处方对糖尿病勃起功能障碍(DMED)模型大鼠性功能的影响,并探讨其可能作用机制。
方法
2
将SPF级雄性SD大鼠随机分为空白组、模型组、他达拉非组、电针组各10只。采用高糖高脂饲料喂养+链脲佐菌素腹腔注射的方法构建DMED大鼠模型。造模成功后,电针组大鼠给予电针“补肾祛瘀”穴位处方干预,隔日1次;他达拉非组给予他达拉非溶液0.5 mg/(kg·d)灌胃,空白组、模型组、电针组给予10 ml/kg纯净水灌胃,均每日1次。各组均干预30天。分别于干预第1、8、15、22天和干预结束后检测大鼠体质量和血糖水平。干预结束后采用阿扑吗啡实验观察大鼠阴茎勃起情况,流式细胞术检测血浆内皮细胞微粒(EMPs)水平,HE染色观察阴茎海绵体组织病理学形态,电镜下观察阴茎血管内皮细胞病理学形态,ELISA法检测血清性激素[包括睾酮(T)、促卵泡激素(FSH)、促黄体生成素(LH)]和血管内皮功能相关因子[包括血管内皮生长因子(VEGF)、内皮素-1(ET-1)、血凝素样氧化低密度脂蛋白受体-1(LOX-1)、可溶性E选择素(sE-selectin)、可溶性细胞间黏附分子-1(sICAM-1)]水平。
结果
2
与空白组同时间比较,模型组、他达拉非组、电针组在各时间检测时体质量均降低,血糖水平均升高(
P
<0.01)。与空白组比较,模型组阴茎勃起次数减少,CD31
+
EMPs水平升高,血清T、FSH、LH、VEGF水平降低,血清ET-1、LOX-1、sE-selectin、sICAM-1水平升高(
P
<0.01)。与模型组比较,他达拉非组和电针组阴茎勃起次数增加,CD31
+
EMPs水平降低,血清T、FSH、LH、VEGF水平升高,血清ET-1、LOX-1、sE-selectin、sICAM-1水平降低(
P
<0.01)。与他达拉非组比较,电针组血清T、FSH、LH、VEGF水平升高,ET-1、LOX-1水平降低(
P
<0.05或
P
<0.01)。HE染色和电镜观察发现,模型组大鼠阴茎海绵体组织和血管内皮细胞均有严重病理损伤,他达拉非组和电针组的病理损伤均得到一定程度改善。
结论
2
电针“补肾祛瘀”穴位处方能够改善DMED模型大鼠勃起功能障碍,与他达拉非效果相当,其作用机制可能与促进血管内皮功能有关。
Objective
2
To observe the effects of electroacupuncture with "tonifying the kidney and dispelling stasis" acupoint prescription on sexual function in diabetic erectile dysfunction (DMED)model rats, and to explore its possible mechanism of action.
Methods
2
SPF male SD rats were randomly divided into 10 each in blank group, model group, Tadalafil group, and electroacupuncture group. DMED rat model was prepared by high glucose and high fat diet combined with intraperitoneal injection of streptozotocin. After successful modelling, rats in the electroacupuncture group were given electroacupuncture intervention of "tonifying the kidney and dispelling stasis" acupoint prescription once every other day; Tadalafil group was given Tadalafil solution 0.5 mg/kg·d by gavage, and the blank group, model group and electroacupuncture group were given 10 ml/kg pure water by gavage once a day. Each group was intervened for 30 days. The body mass and blood glucose level of the rats were detected on the 1st, 8th, 15th, 22nd days and at the end of the intervention, respectively. At the end of the intervention, the penile erection of the rats was observed by using the apomorphine test; the level of plasma endothelial cell microparticles (EMPs)was detected by flow cytometry; the histopathological morphology of the penile cavernous body was observed by HE staining, and the pathological morphology of the endothelial cells of the penile vasculature was observed by electron microscopy. Serum sex hormones including testosterone (T), follicle stimulating hormone (FSH), luteinising hormone (LH) and vascular endothelial function-related factors including vascular endothelial growth factor (VEGF), endothelin-1 (ET-1), lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), soluble E-selectin (sE-selectin), and soluble intercellular adhesion molecule-1 (sICAM-1) were measured by ELISA method.
Results
2
Compared with blank group, the model group, Tadalafil group, and electroacupuncture group all had lower body mass and higher blood glucose levels at each time of testing (
P
<0.01). Compared with the blank group, the number of penile erections reduced in the model group, the level of CD31
+
EMPs increased, the levels of serum T, FSH, LH, and VEGF reduced, and the levels of serum ET-1, LOX-1, sE-selectin, and sICAM-1 increased (
P
<0.01). Compared with the model group, the Tadalafil group and the electroacupuncture group showed an increased number of penile erections decreased level of CD31
+
EMPs, increased levels of serum T, FSH, LH, and VEGF, and decreased levels of serum ET-1, LOX-1, sE-selectin, and sICAM-1 (
P
<0.01). Compared with the Tadalafil group, serum T, FSH, LH, VEGF levels increased and ET-1, LOX-1 levels decreased in the electroacupuncture group (
P
<0
.05 or
P
<0.01). HE staining and electron microscopic observation revealed that there was severe pathological damage to the cavernous tissue of the penis and vascular endothelial cells of the rat in the model group, which was ameliorated to a certain degree in both Tadalafil group and electroacupuncture group.
Conclusion
2
The electroacupuncture prescription of "tonifying the kidney and dispelling stasis" can improve the erectile dysfunction of DMED rats, which is comparable to the effect of Tadalafi. Its mechanism of action may be related to the regulation of vascular endothelial function.
中国中西医结合学会男科专业委员会 . 勃起功能障碍中西医结合诊疗指南(试行版) [J]. 中华男科学杂志 , 2016 , 22 ( 8 ): 751 - 757 .
YUAN P , MA D , ZHANG Y , et al . Analysis of cardiovascular risks for erectile dysfunction in Chinese patients with type 2 diabetes mellitus lacking clinical symptoms of cardiovascular diseases [J]. Transl Androl Urol , 2020 , 9 ( 6 ): 2500 - 2509 .
WU J , HUANG Y , ZHANG J , et al . LncRNA CPhar mediates exercise-induced cardioprotection by promoting eNOS phosphorylation at Ser1177 via DDX17/PI3K/Akt pathway after MI/RI [J]. Int J Cardiol , 2022 , 350 : 16 . doi: 10.1016/j.ijcard.2021.12.040 http://dx.doi.org/10.1016/j.ijcard.2021.12.040 .
李振 , 李向团 , 王昊 , 等 . 针药并用治疗气阴两虚兼瘀型糖尿病性勃起功能障碍的疗效观察及对血管内皮功能及相关生长因子的影响 [J]. 上海针灸杂志 , 2024 , 43 ( 1 ): 24 - 30 .
王昊 , 李振 , 刘媛 , 等 . 芪地通补汤联合针刺治疗气阴两虚兼瘀型糖尿病性勃起功能障碍54例 [J]. 环球中医药 , 2024 , 17 ( 11 ): 2355 - 2359 .
左海燕 , 吴生兵 , 吴欣 , 等 . 电针调控血管内皮生长因子C/血管内皮生长因子受体3信号通路改善急性心肌缺血小鼠炎性反应 [J]. 针刺研究 , 2022 , 47 ( 10 ): 851 - 858 .
全菲 , 肖彩红 , 唐佳璇 , 等 . 基于数据挖掘针灸治疗勃起功能障碍选穴规律分析 [J]. 贵州中医药大学学报 , 2023 , 45 ( 4 ): 62 - 67,77 .
朱敏 , 全菲 , 薛凯阳 , 等 . 针刺治疗勃起功能障碍:随机对照试验 [J]. 中国针灸 , 2024 , 44 ( 4 ): 418 - 422 .
SHEN ZJ , WANG H , LU YL , et al . Gene transfer of vasoactive intestinal polypeptide into the penis improves erectile response in the diabetic rat [J]. BJU Int , 2005 , 95 ( 6 ): 890 - 894 .
HEATON JP , VARRIN SJ , MORALES A . The characterization of a bio-assay of erectile function in a rat model [J]. J Urol , 1991 , 145 ( 5 ): 1099 - 1102 .
中国针灸学会 . 实验动物常用穴位名称与定位第2部分:大鼠 [J]. 针刺研究 , 2021 , 46 ( 4 ): 351 - 352 .
唐勇 . 实验针灸学 [M]. 上海 : 上海科学技术出版社 , 2021 : 146 - 148 .
徐叔云 , 卞如濂 , 陈修 . 药理实验方法学 [M]. 北京 : 人民卫生出版社 , 2002 : 422 .
刘潜 , 张端军 , 周玉良 , 等 . 糖尿病勃起功能障碍中医发病机制研究进展 [J]. 现代诊断与治疗 , 2023 , 34 ( 4 ): 526 - 530 .
蒋海琳 , 徐晓红 , 赵晋莹 , 等 . 腧穴配伍效应:增加“效值”与扩大“效域” [J]. 中国针灸 , 2023 , 43 ( 11 ): 1275 - 1278 .
《糖尿病合并男性性功能障碍多学科中国专家共识》编写专家委员会 . 糖尿病合并男性性功能障碍多学科中国专家共识 [J]. 中国男科学杂志 , 2022 , 36 ( 1 ): 3 - 33 .
CORONA G , ISIDORI AM , AVERSA A , et al . Endocrinologic Control of men's sexual desire and arousal/erection [J]. J Sex Med , 2016 , 13 ( 3 ): 317 - 337 .
赵锐 , 李艳 . 睾酮对血管功能及动脉粥样硬化的影响及其机制的研究进展 [J]. 广西医学 , 2016 , 38 ( 4 ): 533 - 536 .
EI TM , HEGAZY E , IBRAHIM A . Daily oral l-arginine plus tadalafil in diabetic patients with erectile dysfunction: a double-blinded, randomized, controlled clinical trial [J]. J Sex Med , 2019 , 16 ( 9 ): 1390 - 1397 .
马琳 , 李学智 , 姚太万 , 等 . 不同针灸疗法对老年雄性大鼠下丘脑-睾丸中生殖激素调控系统相关基因表达的影响 [J]. 针刺研究 , 2019 , 44 ( 3 ): 200 - 204 .
BLUMENTALS WA , GOMEZ-CAMINERO A , JOO S , et al . Should erectile dysfunction be considered as a marker for acute myocardial infarction? Results from a retrospective cohort study [J]. Int J Impot Res , 2004 , 16 ( 4 ): 350 - 353 .
PÉREZ-GUTIÉRREZ L , FERRARA N . Biology and therapeutic targeting of vascular endothelial growth factor A [J]. Nat Rev Mol Cell Biol , 2023 , 24 ( 11 ): 816 - 834 .
OH YK , BACHAR AR , ZACHARIAS DG , et al . Humanin preserves endothelial function and prevents atherosclerotic plaque progression in hypercholesterolemic ApoE deficient mice [J]. Atherosclerosis , 2011 , 219 ( 1 ): 65 - 73 .
DUAN Q , SI H , TIAN L , et al . LOX-1 attenuates high glucose-induced autophagy via AMPK/HNF4α signaling in HLSECs [J]. Heliyon , 2022 , 8 ( 12 ): e12385 .
AKHMEDOV A , SAWAMURA T , CHEN C , et al . Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1): a crucial driver of atherosclerotic cardiovascular disease [J]. Eur Heart J , 2021 , 42 ( 18 ): 1797 - 1807 .
SIDDIQUI K , GEORGE TP , MUJAMMAMI M , et al . The association of cell adhesion molecules and selectins (VCAM-1, ICAM-1, E-selectin, L-selectin, and P-selectin)with microvascular complications in patients with type 2 diabetes: a follow-up study [J]. Front Endocrinol (Lausanne) , 2023 , 14 : 1072288 . doi: 10.3389/fendo. 2023.1072288 http://dx.doi.org/10.3389/fendo.2023.1072288 .
KURYLISZYN-MOSKAL A , DUBICKI A , ZARZYCKI W , et al . Microvascular abnormalities in capillaroscopy correlate with higher serum IL-18 and sE-selectin levels in patients with type 1 diabetes complicated by microangiopathy [J]. Folia Histochem Cytobiol , 2011 , 49 ( 1 ): 104 - 110 .
MAREI I , CHIDIAC O , THOMAS B , et al . Angiogenic content of microparticles in patients with diabetes and coronary artery disease predicts networks of endothelial dysfunction [J]. Cardiovasc Diabetol , 2022 , 21 ( 1 ): 17 .
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