李鹏,金文琪,李小嘉,丁旭枫,朱煜璋,杨镛,郭修田

• 1:上海中医药大学附属市中医医院

摘要(Abstract)：

目的观察温和灸联合骨髓间充质干细胞移植对大鼠损伤肛门括约肌的修复效果。方法将120只SD大鼠随机等分为5组。所有大鼠采用Zutshi大鼠肛门括约肌复合体损伤模型,造模成功后均采用温和灸15 min或骨髓间充质干细胞移植进行治疗,连续7 d。分别于术后7、14、28 d进行肛门括约肌功能性检测,于术后第28天进行Masson染色。结果在造模后第28天时,温和灸加干细胞组新生肌纤维含量显著高于其他治疗组(P <0.05);温和灸加干细胞组的收缩压与静息压显著高于干细胞及温和灸组(P <0.001),但仍低于空白对照组。术后14 d,所有治疗组肌电振幅与频率均显著高于假手术组;术后28 d,温和灸加干细胞组肌电振幅与频率均显著高于其他治疗组(P <0.001)。结论温和灸联合干细胞移植可显著促进大鼠括约肌损伤处肌肉新生,并能够促进肛压与肌电的恢复,提示温和灸与干细胞移植联合应用可促进恢复大鼠损伤肛门括约肌的结构和功能的恢复。

关键词(KeyWords)： 温和灸;骨髓间充质干细胞;肛门括约肌;肛压;肌电;大鼠

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金青年科学基金项目（81804110,81904208）;国家自然科学基金面上项目（81573977,81873308)

作者(Author): 李鹏,金文琪,李小嘉,丁旭枫,朱煜璋,杨镛,郭修田

参考文献(References)：

• [1] Sharma A,Yuan L,Marshall RJ,et al. Systematic review of the prevalence of faecal incontinence[J]. Br J Surg,2016,103(12):1589-1597.
• [2] Bharucha AE,Rao SSC,Shin A. Surgical interventions and the use of device-aided therapy for the treatment of fecal incontinence and defecatory disorders[J]. Clin gastroenterol H,2017,15(12):1844-1854.
• [3] Chamberlain G,Fox J,Ashton B,et al. Concise review:Mesenchymal stem cells:Their phenotype,Differentiation capacity,Immunological features,and potential for homing[J].Stem Cells,2007,25(11):2739-2749.
• [4] Gr?s S,Tolstrup CK,Lose G. Regenerative medicine provides alternative strategies for the treatment of anal incontinence[J].Int Urogynecol J,2016,28(3):1-10.
• [5]周细秋，金文琪，郭修田，等.温和灸对大鼠肛门括约肌损伤后间充质干细胞移植归巢的影响[J].上海中医药大学学报，2014,28(3):86-89.
• [6]郭修田，董青军，曹永清.温和灸对大鼠肛瘘术后创面组织修复中血管生成及微循环的影响[J]. J Integr Med,2009,7(12):1154-1158.
• [7] Pittenger MF,Mackay AM,Beck SC,et al. Multilineage potential of adult human mesenchymal stem cells[J]. Science,1999,284(5411):143-147.
• [8] Castromanrreza ME,Montesinos JJ. Immunoregulation by mesenchymal stem cells:biological aspects and clinical applications[J]. J Immunol Res,2015,2015:1-20.
• [9] Wang K,Jiang Z,Webster KA,et al. Enhanced cardioprotection by human endometrium mesenchymal stem cells driven by exosomal MicroRNA-21[J]. Stem Cells Transl Med,2016,6(1):209-222.
• [10] As GR,Van DI,Boersma H,et al. Long-term contribution ofhuman bone marrow mesenchymal stromal cells to skeletal muscle regeneration in mice[J]. Cell Transplant,2011,20(2):217-231.
• [11] Merrit EK,Cannon MV,Hammers DW,et al. Repair oftraumati skeleal muscle injury with Bone-Marrow-Derived mesenchymal stem cells seeded on extracellular matrix[J]. Tissue Eng PartA,2010,16(9).2871-288.
• [12] Xu Y,Li Z,Li X,et al. Regulating myogenic differentiation of mesenchymal stem cells using thermosensitive hydrogels[J].Acta Biomater,2015,26:23-33.
• [13] Ross CL,Siriwardane M,Almeida-Porada G,et al. The effect of low-frequency electromagnetic field on human bone marrow stem/progenitor cell differentiation[J]. Stem Cell Res,2015,134(1):96-108.
• [14] Fasolino I,Guarino V,Cirillo V,et al. 5-Azacytidine-mediated hMSC behavior on electrospun scaffolds for skeletal muscle regeneration[J]. J Biomed Mater Res A,2017,105(9):2551-2561.
• [15] Kheradmandi M,Vasheghani-Farahani E,Ghiaseddin A,et al. Skeletal muscle regeneration via engineered tissue culture over electrospun nanofibrous chitosan/PVA scaffold[J].JBiomed Mater Res A,2016,104(7):1720-1727.
• [16] Haghighipour N,Heidarian S,Shokrgozar MA,et al. Differential effects of cyclic uniaxialstretch on human mesenchymal stem cell into skeletalmusclecell[J]. Cell BiolInt,2012,36(7):669-675.
• [17] Oshima S,Kamei N,Nakasa T,et al. Enhancement of muscle repair using human mesenchymal stem cells with a magnetic targeting system in a subchronic muscle injury model[J]. J Orthop Sci,2014,19(3):478-488.