[1]王延雷 齐英娜 董春科 王威 移平 杨峰 唐向盛 郝庆英 谭明生△.脊髓减压联合督脉电针对急性脊髓压迫损伤大鼠疗效影响的实验研究[J].中国中医骨伤科杂志,2018,26(02):3-7.
 WANG Yanlei QI Yingna DONG Chunke WANG Wei YI Ping YANG Feng TANG Xiangsheng HAO Qingying TAN Mingsheng.Effects of Spinal Cord Decompression Surgery Combined with Du Meridian Electro-acupuncture for Treating Rats with Acute Spinal Cord Compression Injury[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2018,26(02):3-7.
点击复制

脊髓减压联合督脉电针对急性脊髓压迫损伤大鼠疗效影响的实验研究()
分享到:

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第26卷
期数:
2018年02期
页码:
3-7
栏目:
病证结合,从督论治
出版日期:
2018-01-15

文章信息/Info

Title:
Effects of Spinal Cord Decompression Surgery Combined with Du Meridian Electro-acupuncture for Treating Rats with Acute Spinal Cord Compression Injury
文章编号:
1005-0205(2018)02-0003-05
作者:
王延雷1 齐英娜1 董春科1 王威1 移平1 杨峰1 唐向盛1 郝庆英1 谭明生1△
1中日友好医院(北京,100029)
Author(s):
WANG Yanlei1 QI Yingna1 DONG Chunke1 WANG Wei1 YI Ping1 YANG Feng1 TANG Xiangsheng1 HAO Qingying1 TAN Mingsheng1△
1China-Japan Friendship Hospital,Beijing 100029,China.
关键词:
脊髓损伤 手术减压 电针 血小板活化因子 细胞凋亡
Keywords:
Keywords: spinal cord injury decompression surgery electro-acupuncture platelet activating factor cell apoptosis
分类号:
R-33
文献标志码:
A
摘要:
目的:探究脊髓减压联合督脉电针对持续脊髓压迫12 h的急性脊髓损伤大鼠的治疗效果和可能的作用机理。方法:SPF级Wistar大鼠24只随机分为假手术组、督脉电针组、甲强龙组和模型组,每组6只,采用经寰枕间隙置入球囊导管加压造成脊髓压迫损伤的方法构建脊髓损伤模型。假手术组置入球囊导管后不加压,督脉电针组、甲强龙组及模型组加压12 h后进行脊髓减压。督脉电针组取百会、大椎穴进行电针干预,连续波,频率2 Hz,治疗时间15 min,持续治疗14 d; 甲强龙组经大鼠尾静脉注射甲强龙进行冲击治疗; 模型组不再进行干预。督脉电针干预14 d后4组大鼠全部行脊髓损伤组织取材,采用BBB评分法对4组大鼠减压后0 h,干预1 d,3 d,7 d及14 d后等5个时间点进行运动功能评价,ELISA法检测损伤组织血小板活化因子(Platelet-Activating Factor,PAF)的含量,Western blot法检测损伤组织中Caspase-3和Caspase-9的表达。结果:BBB评分:假手术组在5个时间点的评分均为(21±0.00)分,督脉电针组与甲强龙组各时间点评分相近,差异无统计学意义(P>0.05); 督脉电针组与甲强龙组在干预1 d,3 d及7 d后等时间点BBB评分较模型组高,差异有统计学意义(P<0.05); 在干预14 d时督脉电针组、甲强龙组及模型组BBB评分相近,差异无统计学意义(P>0.05)。ELISA法测PAF结果显示:模型组脊髓损伤组织中PAF浓度较假手术组、督脉电针组及甲强龙组高,差异有统计学意义(P<0.05); 甲强龙组组织中PAF浓度较督脉电针组和假手术组高,差异有统计学意义(P<0.05); 督脉电针组组织PAF浓度较假手术组高,差异有统计学意义(P<0.05)。Western blot法检测结果显示:Caspase-3和Caspase-9各组表达结果变化一致,模型组蛋白表达较假手术组、督脉电针组及甲强龙组高,差异有统计学意义(P<0.05); 甲强龙组蛋白表达较督脉电针组和假手术组高,差异有统计学意义(P<0.05); 督脉电针组蛋白表达较假手术组高,差异有统计学意义(P<0.05)。结论:脊髓减压联合电针通过降低脊髓损伤组织中PAF的含量与下调其Caspase9蛋白的表达来治疗急性脊髓压迫损伤,较单纯早期(<12 h)减压可取得更好的临床效果。
Abstract:
Abstract Objective:To explore the therapeutic effect and underlying mechanism of spinal cord decompression surgery combined with Du meridian electro-acupuncture(DMEA)for treating the rats with acute spinal cord compression injury.Methods:All 24 SPF rats were randomly divided into sham-operated group,DMEA group,methylprednisolone group,and model group,with 6 rats in each group.The model of spinal cord injury was established by compressing the balloon catheter through the atlanto-occipital space,while the sham-operated group without compression.The spinal cord decompression surgery was using in DMEA group,methylprednisolone group,and model group 12 h after modeling.The acupuncture point of Baihui and Dazhui were used in DMEA group,with continuous wave,frequency 2 Hz,and 15 min a day for 14 d.The rats in methylprednisolone group were received methylprednisolone impact therapy by tail vein injection.The model group did not receive any intervention.The injured spinal cord tissues were collected 14 d after treatment.The function of hind limbs motor in each group at the five time points,0 h,1 d,3 d,7 d,and 14 d after treating with DMEA were evaluated by BBB score method.The content of platelet activating factor(PAF)in injured spinal cord tissue were detected by ELISA method.And the expression of Caspase-3 and Caspase-9 in injured spinal cord tissue was detected by Western blot method.Results:The results of BBB score showed that the score of sham operation group was 21±0.00 at 5 time points,and there was no significant difference between DMEA group and methylprednisolone group at each time point(P>0.05).The score of BBB in methylprednisolone group was higher than that in model group at the time points of 1 d,3 d,7 d(P<0.05).The score of BBB in GVEA group,methylprednisolone group,and model group was similar at 14 d(P>0.05).The results of ELISA showed that the content of PAF in model group was higher than that in sham group,DMEA group and methylprednisolone group(P<0.05).The content of PAF in methylprednisolone group was higher than DMEA group and sham group.The content of PAF in DMEA group was higher than sham operation group(P<0.05).The results of Western blot showed that the expression of Caspase-3 and Caspase-9 in different groups were similar changed.The expression of the protein in model group were higher than that in Sham group,DMEA group and methylprednisolone group(P<0.05).The expression in methylprednisolone group was higher than that in DMEA group and Sham group(P<0.05).And the expression in DMEA group was higher than that in Sham group(P<0.05).Conclusion:Spinal cord decompression surgery combined with DMEA is more effective than surgery only for treating acute spinal cord compression injury though reducing the content of PAF and decreasing the expression of Caspase-9 protein.

参考文献/References:

[1] Batchelor PE,Wills TE,Skeers P,et al.Meta-analysis of pre-clinical studies of early decompression in acute spinal cord injury:a battle of time and pressure[J].Plos One,2013,8(8):e72659.
[2] Quraishi NA,Rajagopal TS,Manoharan SR,et al.Effect of timing of surgery on neurological outcome and survival in metastatic spinal cord compression[J].European Spine Journal,2013,22(6):1383-1388.
[3] Fehlings MG,Vaccaro A,Wilson JR,et al.Early versus delayed decompression for traumatic cervical spinal cord Injury:results of the surgical timing in acute spinal cord injury study(STASCIS)[J].Plos One,2012,7(2):e32037.
[4] Dakson A,Brandman D,Thibaulthalman G,et al.Optimization of the mean arterial pressure and timing of surgical decompression in traumatic spinal cord injury:a retrospective study[J].Spinal Cord,2017,52(11):1033-1038.
[5] 李永文,庞梅桂,薛翠珍,等.益气通络汤对脊髓型颈椎病术后残余脊髓神经功能的影响[J].中国中医骨伤科杂志,2017,25(6):15-18.
[6] 湛梅圣,邹季.前路减压内固定结合中药治疗脊髓型颈椎病[J].湖北中医药大学学报,2015,17(1):85-87.
[7] 刘金辉,易满.脊髓损伤中医病因病机及认识[J].新疆中医药,2014,32(5):116-119.
[8] 谭明生,李显,张恩忠,等.寰枢椎脱位外科治疗与疏通督脉瘀阻相关性研究[J].中国骨伤,2012,25(11):915-919.
[7] 李晓宁,迟蕾.夹脊配合督脉电针治疗脊髓损伤后功能障碍临床观察[J].上海针灸杂志,2015,34(10):972-975.
[9] 刘鹏民,李灵玲,王良,等.督脉电针结合游泳训练对大鼠全横断脊髓损伤后GAP-43和Nogo-A表达的影响[J].中国康复医学杂志,2016,31(4):399-404.
[10] 谭明生,齐英娜,姜良海,等.球囊导管构建大鼠督脉瘀阻型上颈脊髓损伤模型的研究[J].中医正骨,2016,28(12):1-5.
[11] 郭义.实验针灸学[M].北京:中国中医药出版社,2008:414.
[12] 王明新,汪茜,姚共和.中医对脊髓损伤病机的认识[J].湖南中医药导报,2004,10(6):7.
[13] 杜伟斌,陈荣良,俆亦生,等.电针夹脊穴和督脉穴对急性脊髓损伤家兔后肢神经功能的影响及其作用机制[J].中医正骨,2016,28(12):13-20.
[14] 王赛,邹恩苗,林海燕,等.夹脊、督脉电针对大鼠脊髓损伤前炎性细胞因子表达的影响[J].中国康复医学杂志,2013,28(5):389-392.
[15] 李晓宁,迟蕾.夹脊配合督脉电针治疗脊髓损伤后功能障碍临床观察[J].上海针灸杂志,2015,34(10):972-975.
[16] 肖建如,赵定麟.脊髓损伤组织血小板活化因子变化与脊髓水肿的关系[J].中华创伤杂志,1995(6):332-334.
[17] 郭农建,常亚丽,肖东杰,等.血小板活化因子参与血小板-中性粒细胞活化的研究[J].中国实验血液学杂志,2005,13(3):447- 451.
[18] Brewer C,Bonin F,Bullock P,et al.Platelet activating factor induced apoptosis is inhibited by ectopic expression of theplatelet activating factor G-protein coupled receptor [J].J Neurochem,2002,82(6):1502-1511.
[19] Hostettler ME,Knapp PE,Carlson SL.Platelet- activating factor induces cell death in cultured astrocytes and oligodendrocytes involvement of caspase-3[J].Glia,2002,38(3):228-239.
[20] 赵道洲,张绍文,周红.脊髓损伤后神经细胞凋亡相关抑制蛋白表达的实验研究[J].西部中医药,2015,28(12):18-20.
[21] Park HH.Structural features of caspase-activating complexes [J].Int J MolSci,2012,13(4):4807-4818.
[22] 岳原亦,张扬,张一奇,等.Caspase家族与细胞凋亡[J].中国医疗前沿,2011,6(6):25-26.
[23] Du M,Chen R,Quan R,et al. A brief analysis of traditional chinese medical elongated needle therapy on acute spinal cord injury and its mechanism[J].Evid Based Complement Alternat Med,2013:828754.

备注/Memo

备注/Memo:
基金项目:北京市科技计划首都临床特色应用研究项目 (Z16110000516009) 通信作者 E-mail:zrtanms@sina.com
更新日期/Last Update: 2018-02-15