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  

Effects of electroacupuncture at Point JIAJI( EX-B2) and Point governor vessel on neural function of hindlimbs in rabbits with acute spinal cord injury and the mechanism of action

作　　者：杜伟斌[1] 陈荣良[1] 俆亦生 全仁夫[1] 胡华辉[2] 鲍关爱 

机构地区：[1]浙江省杭州市萧山区中医院,浙江杭州311201 [2]浙江中医药大学,浙江杭州310053 [3]浙江省肿瘤医院,浙江杭州310022

出　　处：《中医正骨》2016年第12期13-20,共8页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：浙江省杭州市科技发展计划项目(20140733Q51);浙江省杭州市萧山区科技计划项目(2013313)

摘　　要：目的：观察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，并探讨其作用机制。方法：采用随机数字表将60只新西兰家兔随机分为假手术组、模型组、电针组，每组20只。假手术组咬除T13-L1棘突及全部椎板，暴露0．5cm宽硬膜，不损伤脊髓；模型组和电针组采用改良Allens法建立急性脊髓损伤家兔模型，并行脊髓MRI扫描鉴定模型。模型组和假手术组不给予治疗，电针组给予电针刺激受损脊髓节段上下两对夹脊穴及上下督脉穴（筋缩、命门）治疗，每次30min，每日1次，共7次。电针干预开始后1d、3d、7d采用改良Tarlov评分法评价家兔后肢神经功能。干预结束后每组取10只家兔，以4％多聚甲醛行心脏灌注后剖取损伤脊髓约1cm，制成切片后经HE染色于显微镜下观察脊髓组织形态，并采用免疫组织化学法观察脊髓细胞增殖情况和巢蛋白（Nestin）表达水平。将每组剩余的10只家兔麻醉，分离坐骨神经并注入5肛L的30％辣根过氧化物酶（horse—radishperoxidase，HRP），24h后取脊髓横断面背侧靠近损伤处脊髓，采用HRP逆行示踪法标记红核神经元细胞数。结果：①模型鉴定结果。MRI片上假手术组脊髓横断面信号正常，可见清晰的脑脊液通过。模型组和电针组脊髓横断面信号增强，脑脊液受压；受伤节段的脊髓在矢状位MRI片T2WI上呈明显的高信号，T1WI上呈低信号；提示脊髓断端周围充血、水肿，证明造模成功。②后肢神经功能评分。电针干预后不同时间点Tarlov评分比较，差异有统计学意义，即存在时间效应（F=6．920，P=0．001）；除假手术组外，干预后模型组和电针组Tarlov评分均逐渐升高。3组Tarlov评分总体上比较，组间差异有统计学意义，即存在分组效应（F=426．78，P=0．000）。干预开始后1d，电针组Tarlov评分高于模型组[（0．30±0．47）分，（0．20Objective ：To observe the effects of electroacupuncture at Point JIAJI （ EX - B2） and Point governor vessel on neural func- tion of hindlimbs in rabbits with acute spinal cord injury and to explore its mechanism of action. Methods：Sixty New Zealand rabbits were randomly divided into sham - operated group, model group and electroacupuncture group, 20 cases in each group. The random digits table was used for grouping. The spinous processes and ertebral plates of T13 - L1 of rabbits in sham - operated group were removed to expose 0.5 cm of endorachis in width without spinal cord injuries, while the models of acute spinal cord injury were built in rabbits in model group and electroacupuncture group by using improved Aliens method and the models were identified by spinal cord MRI scanning. The rabbits in model group and sham - operated group were untreated,while the rabbits in electroacupuncture group were treated with electroacupuncture at two pairs of Point JIAJI（EX- B2） and upper and lower Point governor vessel（ Point JINSUO and Point MINGMEN）at the injured seg- ments of spinal cord,30 minutes at a time, once a day for consecutive 7 times. At 1,3 and 7 days after the beginning of electroacupuncture intervention, the neural function of hindlimbs of rabbits were evaluated by using improved Tarlov scoring method. After the end of interven- tion, 10 rabbits were randomly selected from each group and were treated by perfusing their hearts with 4% paraformaldehyde. Then approx- imate 1 cm injured spinal cord were fetched out and sectioned for HE staining. The spinal cord tissue morphology were observed under the microscope and the proliferations of spinal cord cells and Nestin expression levels were detected by using immunohistochemical method. The sciatic nerves of the remaining 10 rabbits in each group were separated under anesthesia and 30% horseradish peroxidase（HRP） were injec- ted into the sciatic nerves in dosage of 5 μL. Twenty - four hours later, the dorsal spinal cord tissues near the injur

关 键 词：脊髓损伤 电针 穴 夹脊 穴位 督脉 神经干细胞 神经传导 兔 动物实验 

分 类 号：R245[医药卫生—针灸推拿学]