| Objective:The formula of Suoquanwan(SQW) is recorded in a Chinese medicine book named Furenliangfang, which collected hundreds of formulas of Chinese medicine combinations.SQW consists of three herb medicines, Radix Linderae, Radix dioscoreae, and alplnia oxyphylla Miq. The function of SQW is to warm kidney, stop polyuric and hold excessive urination. In clinical practice, it is used in elder patients with diseases of lower urinary tract symptoms(LTUS),such as nocturnal enuresis, enuresis, frequent Urination, urgent urination, uroclepsia.Based on Chinese medical science, occurrence of LTUS has close relationship with wen function of kidney-qi and controlling function of bladder, This subject base on the. urodynamics and bladder diastolic related receptor to investigate the researched mechanism of SQW "kidney shrink urine".Methods:For SQW have efficacy of wen kidney and shrink urine through wenbu kidney-yang,wenhua kidney-qi, which is corresponding with theory of modern medical science to regulate dysfunction of detrusor and futher to treat the LTUS in elders,based on which, this reaserch focused on SQW and primarily detected its mechanism of effect on rats with diuresis through urodynamics test as evaluation measure which is a objective and widely accepted way to evaluate the function of lower urinary tract,and on the basis of SQW’regulating the detrusor function of contraction and relaxation,the detection using related indexes of urodynamics test to rats with LTUS had been done. Through investigating the related indexes of urinary storage and discharge functions of bladder and ufethra,such as leak point pressure (LPP)(including bladder leak point; abdominal leak point pressure), maximum bladder capacity(MBC), bladder compliance(BC),maximum voiding pressure(MVP) during urination, residual urine volume(RUV),EV,functional urethral length(FUL),maximum urethral pressure(MUP) and maximum urethral closure pressure(MUCP) to explore changes in lower urinary tract of aging rats.And we investigated effects of SQW on adrenergic nerve receptors regulating the relaxing function of bladder detrusor,and futher studied its effects on contracting and relaxing function of bladder,and the regulation to nerve receptors function of isolated detrusor to explore deeply its mechanism of action and target of action,which was to reveal the mechanism of wen kidney and shrinking urine which is one of classical theories of Chinese medical’ science,and further to objectively accurately evaluate occurrence of animal LTUS and the efficacy of SQW on it.Results:The study on models of natural aging rats demonstrated:The mechanism of LTUS occurrence in natural aging rats include:firstly, the bladder function of urinary control decreased,and the closing function of sphincter declined too. Urodynamics test showed BLPP and ALPP of aging rats decreased,and also,FUL, MUP, MUCP descended. Secondly, voiding dysfunction had been also observed in natural aging rats,and the models’MBC,Vv and PVR increased after urine voiding, which finally led to the descending of EV. The lower sensitivity of aging baldder to pressure and its flabby bladder wall caused the capacity enlargement of bladder and underactivity of bladder detrusor when urinating,which made PVR increase,and finally led to increase of BC,and decline in MVP and EV.Thirdly, enhancement of BC and descended elasticity had been observed through in vitro experiment. Both agonists of β-AR and β3-AR could relax the bladder detrusor,but Emax and IA of agonist of β3-AR were lower than those of agonist of β-AR,but PD2of the two agonists had no difference,and β3-AR could significantly depress the relaxing effect of non selective agonist,which indicated β-AR is main active substance in β3-AR.And through the study, declining relaxing response of bladder detrusor to agonists of β-AR and β3-AR had been observed,which indicated content and function of β-AR had changed.The descended effect of SR59230A (antagonist of β3-AR)on bladder detrusor of aging rats illustrated the decrease of β-AR is mainly through decreasing β3-AR.The study on SQW to shrinking urine of revealed:The mechanism of SQW to improve LTUS were:firstly,SQW could improve the urinary controlling function during bladder period of storing urine,and enhance contraction function of animals’ urethral sphincter and relaxation function of bladder smooth muscle, urodynamics test demonstrated SQW had the effect on boosting rats BLPP and ALPP,and increasing FUL, MUP, and MUCP to enhance ability of urinary control.And SQW could also relax bladder to increase MBC of bladder,which possibly be made by boosting closing function of bladder sphincter to make detrusor smoothly relax to enhance bladder the ability of urinary control.Secondly, the urinary function could be boosted by SQW through increasing aging rats the MVP, Vv to increase EV.And after finishing urination,SQW could also decrease the PVR of bladder, which possibly worked through boosting bladder the contraction function during period of urination,so,it indicated SQW could increase aging rats the contraction function of bladder. Thirdly,SQW had effects on decreasing detrusor the BC,increasing its elasticity by boosting the sensitivity of detrusor to agonist of β-AR and β3-AR to enhance depressing effect of SR59230A on ISO,which indicated SQW enhanced bladder the relaxing function by increasing animal models the function of adrenergic receptors,especially by increasing sensitivity of β3-AR to neurotransmitter,so,the aging bladder could smoothly relax during period of storing urine to increase its available capacity and finally to make times of urination decrease.Conclusion:This study investigated the function of bladder detrusor by in situ experiment of urodynamic and by detection to isolated detrusor to illustrate that SQW could make relaxing function of aging detrusor recover to normal situation,which revealed from overall and micro aspects the mechanism of efficacy of wen kidney and shrink urine of SQW to regulate bladder the contracting and relaxing function.The enlargement of bladder capacity and increasing PVR had been found in aging rats through urodynamic test,which was possibly related to descending sensitivity of afferent nerve of pelvic nerve to bladder capacity and the decreased bladder pressure during contraction of bladder smooth muscle. The leakage of urine and uroclepsia tended to exist in aging rats, and decreased ALPP, MUCP and FUL had been found through urodynamic test,which illustrated dysfunction of urinary control brought about by aging-caused decreased closing function of urethral smooth muscle. The increased bladder capacity, decreased PVR, and increased BLPP, urethral pressure and FUL after giving orally SQW revealed the improving efficacy of SQW on LTUS. Experiment in vitro showed BC and elasticity declined in aging bladder,and the sensitivity of detrusor to agonists of β-AR and β3-AR descended,and the needed concentration of antiagonist of β3-AR to inhibit aging detrusor of bladder decreased,which demonstrated the decline in function of β-AR was mainly caused by decline in function of β3-AR.After giving SQW,functions of β-AR and β3-AR in aging bladder had been improved,the sensitivities to agonist was also boosted,and BC and elasticity of bladder had been imoroved too,which revealed that SQW regulated water metabolism through improving sensitivity of detrusor of aging rats to neurotransmitter. |
PDF Full Text Request