Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan.
Low Urin Tract Symptoms. 2020 Sep;12(3):198-205. doi: 10.1111/luts.12302. Epub 2020 Feb 3.
Choreito (CRT), a traditional Japanese (Kampo) medicine, is widely used for the treatment of overactive bladder (OAB) and other lower urinary tract symptoms in Japan. This study aimed to identify the effects and therapeutic mechanism of CRT on the improvement of detrusor overactivity (DO) using an experimental rat model. Forty-five female Sprague-Dawley rats were equally divided into three groups: intravesical saline instillation with normal food (normal group), intravesical acetic acid (AA) instillation with normal food (AA group), and intravesical AA instillation with CRT (AA with CRT group). To induce a decrease in bladder capacity, instillation of 0.2% AA was used based on prior studies. Cystometric investigation was employed to clarify the effects of AA and CRT. Microcirculation was performed using a laser blood flowmeter, and the localization of hypoxia-inducible factor 1α (HIF1α) was assessed by immunohistochemistry. The bladder capacities of the normal, AA, and AA with CRT groups were 1.2 ± 0.3 mL, 0.4 ± 0.1 mL, and 0.8 ± 0.1 mL, respectively. CRT significantly attenuated AA irritation of the urinary bladder and exerted protective effects on basal pressure, micturition pressure, micturition interval, and micturition volume. Furthermore, CRT could prevent the excess blood flow and edematous change under the urothelium induced by intravesical AA instillation. No obvious changes in immunohistochemical HIF1α staining were observed among the groups. CRT attenuated DO induced by intravesical AA instillation in a rat experimental model. CRT might impart therapeutic effects on OAB via the mitigation of urothelial damage and regulation of excess blood flow.
芍药甘草汤(CRT)是一种传统的日本(汉方)药物,在日本被广泛用于治疗膀胱过度活动症(OAB)和其他下尿路症状。本研究旨在通过实验性大鼠模型确定 CRT 对改善逼尿肌过度活动(DO)的作用和治疗机制。45 只雌性 Sprague-Dawley 大鼠等分为三组:膀胱内生理盐水灌注加普通食物(正常组)、膀胱内乙酸(AA)灌注加普通食物(AA 组)和膀胱内 AA 灌注加 CRT(AA 加 CRT 组)。根据先前的研究,使用 0.2%AA 灌注来诱导膀胱容量下降。采用膀胱测压法阐明 AA 和 CRT 的作用。使用激光血流计进行微循环研究,并通过免疫组织化学评估缺氧诱导因子 1α(HIF1α)的定位。正常、AA 和 AA 加 CRT 组的膀胱容量分别为 1.2±0.3mL、0.4±0.1mL 和 0.8±0.1mL。CRT 显著减轻了 AA 对膀胱的刺激作用,并对基础压、排尿压、排尿间隔和排尿量产生保护作用。此外,CRT 可以防止膀胱内 AA 灌注引起的过度血流和尿路上皮下水肿变化。各组之间 HIF1α 免疫组织化学染色无明显变化。CRT 减轻了膀胱内 AA 灌注诱导的 DO。CRT 可能通过减轻尿路上皮损伤和调节过度血流对 OAB 产生治疗作用。