Objective To observe the therapeutic effects and mechanisms of acupuncture at Renying(ST9)on hypertension.Methods Spontaneously hypertensive rats(SHRs)were randomly divided into a model group and a Renying group 6 rats in each group,with six Wistar-Kyoto(WKY)rats serving as the blank control group.The Renying group received bilateral acupuncture at Renying point once daily for 5 consecutive days,followed by a 2-day rest,for a total of 4 weeks.Systolic and diastolic blood pressures were measured via tail-cuff plethysmography before intervention and at weeks 1,2,3,and 4 after intervention.After the intervention,fecal and plasma samples were collected.16S rDNA high-throughput sequencing was used to analyze gut microbiota composition,and 1H NMR spectroscopy was employed to detect plasma metabolite differences.Results(1)Before intervention,systolic and diastolic blood pressures in the model and Renying groups were significantly higher than those in the blank group(P＜0.05).After acupuncture intervention,the Renying group exhibited significantly lower systolic and diastolic blood pressures than the model group at weeks 2,3,and 4(P＜0.05).After 4 weeks,the model group showed significantly increased systolic and diastolic blood pressures compared with baseline(P＜0.05),whereas the Renying group exhibited significantly decreased pressures(P＜0.05).Throughout the intervention,the Renying group demonstrated smaller blood pressure fluctuations and more stable control than the model group.(2)Microbiota analysis:Compared with the blank group,the model group had 39 fewer unique operational taxonomic units(OTUs),whereas the Renying group showed increased unique OTUs,approaching levels observed in the blank group.(3)NMDS analysis of β-diversity revealed that acupuncture significantly altered gut microbial diversity in SHRs.At the phylum level,Firmicutes,Bacteroidetes,Verrucomicrobia,and Patescibacteria dominated gut microbiota composition.Patescibacteria abundance was significantly increased in the model group but decreased in the Renying group(P＜0.05).At the genus level,Bacteroides and Faecalibacterium abundances were reduced in the model group but higher in the Renying group(P＜0.05).(4)LEfSe analysis indicated significant enrichment of Clostridia_vadinBB60_group and Alistipes_sp_CHKCI003 in the Renying group,whereas unclassified_Clostridia_UCG_014 was more prevalent in the model group.(5)OSC-PLS analysis of 1H NMR-detected plasma metabolites revealed significant intergroup differences,with Renying acupuncture altering acetate and trimethylamine N-oxide(TMAO)levels.Conclusion Acupuncture at Renying points significantly reduces systolic and diastolic blood pressures in SHRs,possibly by modulating gut microbiota structure,ameliorating microbial dysbiosis,promoting beneficial bacterial growth,suppressing harmful bacteria,and regulating acetate-and TMAO-related metabolic pathways.

OBJECTIVE:To observe the efficacy and safety of tadalafil combined with tamsulosin in the treatment of erectile dysfunction(ED) patients after four area division plasmakinetic enucleation of prostate (FPKRP). METHODS:Seventy patients with ED after FPKRP were randomly divided into control group and observation group,with 35 cases in each group. Both groups received FPKRP;control group was given Tamsulosin capsule 0.2 mg orally,once a day,1 d after surgery;observation group was additionally given Tadalafil tablet 10 mg,once a day,on the basis of control group. Both groups were treated for 3 months. Clini-cal efficacies of 2 groups were compared;international prostate symptom score,the levels of prostate specific antigen,the maxi-mal urinary flow rate,international erectile function questionnaire-5 score,life quality score and ADR were also compared before and after treatment. RESULTS:The total response rate of short-term therapy in observation group was significantly better than con-trol group,with statistical significance(97.14% vs. 71.43%,P<0.05). Before treatment,there was no significant difference be-tween 2 groups in terms of international prostate symptom score,the maximal urinary flow rate,international erectile function ques-tionnaire-5 score and life quality score(P>0.05). After treatment,international prostate symptom score and life quality score in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group;the maximal urinary flow rate and international erectile function questionnaire-5 score were significantly higher than before treat-ment,and the observation group was significantly higher than the control group,with statistical significance(P<0.05). There was no statistical significance in the levels of prostate specific antigen between 2 groups before and after treatment (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:For patients with ED after FPKRP,tadalafil combined with tamsulosin can effectively improve erectile function,relieve the lower urinary tract symptoms and improve the quality of daily life with good safety.