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胫骨神经刺激可增加去卵巢大鼠绝经模型的阴道血流灌注、骨密度和载荷。

Tibial nerve stimulation increases vaginal blood perfusion and bone mineral density and yield load in ovariectomized rat menopause model.

机构信息

Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, MI, USA.

Biointerfaces Institute, University of Michigan, MI, Ann Arbor, USA.

出版信息

Int Urogynecol J. 2022 Dec;33(12):3543-3553. doi: 10.1007/s00192-022-05125-5. Epub 2022 Mar 7.

Abstract

INTRODUCTION AND HYPOTHESIS

Human menopause transition and post-menopausal syndrome, driven by reduced ovarian activity and estrogen levels, are associated with an increased risk for symptoms including but not limited to sexual dysfunction, metabolic disease, and osteoporosis. Current treatments are limited in efficacy and may have adverse consequences, so investigation for additional treatment options is necessary. Previous studies have demonstrated that percutaneous tibial nerve stimulation (PTNS) and electro-acupuncture near the tibial nerve are minimally invasive treatments that increase vaginal blood perfusion or serum estrogen in the rat model. We hypothesized that PTNS would protect against harmful reproductive and systemic changes associated with menopause.

METHODS

We examined the effects of twice-weekly PTNS (0.2 ms pulse width, 20 Hz, 2× motor threshold) under ketamine-xylazine anesthesia in ovariectomized (OVX) female Sprague-Dawley rats on menopause-associated physiological parameters including serum estradiol, body weight, blood glucose, bone health, and vaginal blood perfusion. Rats were split into three groups (n = 10 per group): (1) intact control (no stimulation), (2) OVX control (no stimulation), and (3) OVX stimulation (treatment group).

RESULTS

PTNS did not affect serum estradiol levels, body weight, or blood glucose. PTNS transiently increased vaginal blood perfusion during stimulation for up to 5 weeks after OVX and increased areal bone mineral density and yield load of the right femur (side of stimulation) compared to the unstimulated OVX control.

CONCLUSIONS

PTNS may ameliorate some symptoms associated with menopause. Additional studies to elucidate the full potential of PTNS on menopause-associated symptoms under different experimental conditions are warranted.

摘要

简介与假说

人类绝经过渡和绝经后综合征,由卵巢活动和雌激素水平降低引起,与多种症状相关,包括但不限于性功能障碍、代谢疾病和骨质疏松症,其风险增加。目前的治疗方法在疗效上有限,并且可能有不良后果,因此需要研究其他治疗选择。先前的研究表明,经皮胫骨神经刺激(PTNS)和胫骨神经附近的电针刺激是微创治疗方法,可增加大鼠模型阴道血流灌注或血清雌激素。我们假设 PTNS 将预防与绝经相关的有害生殖和全身变化。

方法

我们在卵巢切除(OVX)雌性 Sprague-Dawley 大鼠中检查了每周两次的 PTNS(0.2ms 脉冲宽度,20Hz,2×运动阈值)在绝经相关生理参数中的作用,包括血清雌二醇、体重、血糖、骨健康和阴道血流灌注。大鼠分为三组(每组 10 只):(1)完整对照组(无刺激)、(2)OVX 对照组(无刺激)和(3)OVX 刺激组(治疗组)。

结果

PTNS 不影响血清雌二醇水平、体重或血糖。PTNS 在 OVX 后长达 5 周的刺激期间短暂增加阴道血流灌注,并增加右侧股骨(刺激侧)的面积骨密度和屈服负荷。

结论

PTNS 可能改善与绝经相关的一些症状。需要进行更多的研究,以阐明不同实验条件下 PTNS 对绝经相关症状的全部潜力。

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