深刺“环跳”穴对大鼠损伤坐骨神经的修复作用  

Effect of Deep Electroacupuncture Stimulation of“Huantiao”(GB 30) on Changes of Function and Nerve Growth Factor Expression of the Injured Sciatic Nerve in Rats

作　　者：刘玉丽[1] 李野[2] 任路[1] 戴丽丽 白增华[1] 白茹 马铁明[1] 

机构地区：[1]辽宁中医药大学针灸推拿学院,沈阳110847 [2]辽宁中医药大学本溪校区,本溪117000 [3]辽宁卫生职业技术学院,沈阳110101 [4]山西省原平市第一人民医院,原平034000

出　　处：《针刺研究》2014年第2期93-99,共7页Acupuncture Research

基　　金：辽宁省自然科学基金(No.201102146);中国博士后科学基金面上资助(No.2012M510833)

摘　　要：目的:探讨深刺"环跳"穴触及神经干对大鼠损伤坐骨神经修复的作用机制。方法:健康SD大鼠随机分为正常组、模型组、深刺组与浅刺组,每组12只。钳夹法制成大鼠急性坐骨神经损伤模型。深刺组电针"环跳"穴,深度约为16mm,以瞬间出现肌肉抽搐、足趾颤动等现象为准;浅刺组电针"环跳"穴,深度约7mm,以刺入肌肉、不触及神经干为适宜深度。每日治疗1次,每次20min,连续治疗14d。检测运动神经传导速度、波幅和潜伏期;应用HE染色法观察坐骨神经病理变化;采用免疫组化法检测神经生长因子(NGF)和早期反应基因表达产物Fos蛋白在受损神经处的变化。结果:模型组与正常组比较神经干动作电位波幅降低(P<0.05)而潜伏期正常,神经传导速度减慢(P<0.01);与模型组比较,深刺组波幅明显升高(P<0.05),神经传导速度明显加快(P<0.05);浅刺组神经传导速度和波幅低于深刺组(P<0.05)。模型组受损坐骨神经与正常组比较神经纤维排列紊乱,轴突、髓鞘变性,雪旺细胞增多;而深刺组和浅刺组与模型组比较,神经排列紊乱程度减轻,髓鞘仅仅部分脱失,雪旺细胞减少,并且上述病理改善程度深刺组高于浅刺组。模型组受损坐骨神经NGF表达明显高于正常组(P<0.05),而深刺组和浅刺组NGF表达与模型组比较明显增强(P<0.05),并且深刺组明显高于浅刺组(P<0.05)。模型组坐骨神经Fos表达明显高于正常组(P<0.01),而深刺组和浅刺组Fos表达与模型组比较均下降(P<0.05),并且深刺组下降明显高于浅刺组(P<0.05)。结论:在受损神经轴突连续性基础上,深刺"环跳"穴加速损伤神经的病理修复,提高神经干电活动指数。增加修复损伤神经物质NGF蛋白的表达,调节Fos蛋白水平,可能是深刺"环跳"触及神经干治疗坐骨神经损伤疗效优于浅刺的机制之一。Objective To observe the effect of deep electroacupuncture （EA） stimulation of ＂Huantiao＂（GB 30） on the functional and pathological changes and nerve growth factor （NGF） expression of the damaged sciatic nerve in rats, so as to study its mechanisms underlying reliving sciatica. Methods Forty-eight SD rats were randomly divided into normal, model, deep EA and shallow EA groups （n = 12 in each group）. The sciatic nerve injury model was established by mechanical clamp of the sciatic nerve stem. For deep and shallow EA, the acupuncture needles were inserted into GB 30 about 16 mm and 7 mm, respectively. The EA treatment was given 20 min, once daily for 14 days. The evoked potentials of the injured sciatic nerve stem responding to electrical stimulation were recorded by using a biophysiological experimental system for calculating the motor conduction velocity. Pathological changes of the sciatic nerve were displayed by H.E. stain. The expression of NGF and Fos proteins was detected by immunohistochemistry. Results In comparison with the normal group, the conduction velocity and the amplitude of the evoked potentials of the sciatic nerve were significantly decreased in the model group （P〈0.05）. Following EA, both conduction velocity and amplitude of the evoked potentials in the deep EA group, and the conduction velocity in the shallow EA group were considera-bly increased （P〈0.05）. The therapeutic effects were significantly better in the deep EA group than that in the shallow EA group （P〈0.05）. No significant differences were found between the shallow EA and model groups in the amplitude of evoked potentials （P〉0.05）, and no significant changes of latencies of the evoked potentials in the four groups （P〉0.05）. In the model group, the disorganized nerve fibers axons, myelin and Schwann cells of the damaged sciatic nerve were found, which became milder in the EA groups particularly in the deep EA group. In regard to the NGF and Fos immunoactivity of the injured sciatic ne

关 键 词：深刺 “环跳”穴 坐骨神经损伤 传导速度神经生长因子 FOS蛋白 

分 类 号：R245.31[医药卫生—针灸推拿学]