“环跳”穴深浅部电刺激对坐骨神经损伤大鼠背根神经节磷酸化p38及p53蛋白表达的影响  

Effect of deep and shallow electroacupuncture stimulation at“Huantiao”(GB30)on expression of phosphorylated-p38 and phosphorylated-p53 proteins and apoptosis in dorsal root ganglia in sciatic nerve injury rats

作　　者：杨书蔚 马铁明[2] 陶星 潘斯腾 马贤德[3] YANG Shu-wei;MA Tie-ming;TAO Xing;PAN Si-teng;MA Xian-de(Graduate School,Liaoning University of Traditional Chinese Medicine,Shenyang 110847,China;College of Acupunture-moxibustion and Massage,Liaoning University of Traditional Chinese Medicine,Shenyang 110847,China;Center of Teaching and Experimental Research,Liaoning University of Traditional Chinese Medicine,Shenyang 110847,China;Wuhan First Hospital,Wuhan 430000;Shenyang Sport University,Shenyang 110102)

机构地区：[1]辽宁中医药大学研究生学院,沈阳110847 [2]辽宁中医药大学针灸推拿学院,沈阳110847 [3]辽宁中医药大学教学实验中心,沈阳110847 [4]武汉市第一医院,武汉430000 [5]沈阳体育学院,沈阳110102

出　　处：《针刺研究》2019年第10期729-734,共6页Acupuncture Research

基　　金：国家自然科学基金项目(No.81574051);辽宁省高等学校创新团队项目(No.LT2015016);辽宁省科学事业公益研究基金(No.20170029);辽宁省针灸养生康复重点实验室(No.2017)

摘　　要：目的:基于p38丝裂原活化蛋白激酶(p38 MAPK)信号通路、细胞凋亡理论,探讨电针深刺"环跳"修复坐骨神经损伤的机制。方法:将SD大鼠随机分为空白组、模型组、浅刺组、深刺组,每组12只。采用坐骨神经硅胶管卡压损伤法制备坐骨神经损伤大鼠模型。深刺组予深刺大鼠左侧"环跳"穴,针刺至坐骨神经干,深度约皮下12~14 mm;浅刺组予浅刺大鼠左侧"环跳"穴,针刺至肌肉层不触及神经干,深度约皮下5~8 mm,均在超声影像系统引导下进行,配合电针治疗,每日1次,每次15 min,连续治疗14 d。测定治疗前后坐骨神经功能指数(SFI),采用HE染色法观察各组大鼠坐骨神经形态改变,TUNEL法检测各组大鼠患侧腰(L)4-L5背根神经节细胞凋亡情况,免疫组织化学法检测各组大鼠患侧L4-L5背根神经节磷酸化p38 MAPK(p-p38)、磷酸化p53(p-p53)蛋白表达水平。结果:与空白组比较,治疗前造模大鼠及治疗后模型组大鼠SFI明显降低(P<0.01),治疗后模型组大鼠L4-L5背根神经节细胞凋亡数及p-p38、p-p53蛋白表达水平明显升高(P<0.05)。与模型组比较,深刺组及浅刺组SFI均明显升高(P<0.01),L4-L5背根神经节细胞凋亡数及p-p38、p-p53蛋白表达水平明显降低(P<0.05);且深刺组各项指标的变化较浅刺组更明显(P<0.01,P<0.05)。与空白组比较,模型组坐骨神经纤维排列混乱,髓鞘排列不整齐,髓鞘、轴突出现崩解,部分变形呈空泡状,雪旺细胞增多;两治疗组坐骨神经神经纤维排列较规则,仅有部分髓鞘脱落,且深刺组较浅刺组神经纤维形态更好。结论:电针深刺"环跳"穴能明显改善坐骨神经功能,抑制p-p38和p-p53表达水平,对坐骨神经损伤大鼠背根神经节细胞凋亡有抑制作用。Objective To observe the effect of deep electroacupuncture(EA)stimulation at"Huantiao"(GB30)on hindlimb motor function and expression of p38 mitogen-activated protein kinase(p38 MAPK)and p53 proteins in dorsal root ganglia(DRG)in rats with chronic constrictive injury(CCI)of sciatic nerve.Methods Forty-eight SD rats(half male and half female)were randomly divided into control,model,shallow EA(SEA)stimulation and deep EA(DEA)stimulation groups(n=12 in each group).The CCI model was constructed by implanting a silicone tube close to the sciatic nerve of the left hind limb.For DEA group and SEA group,filiform acupuncture needles were inserted into GB30 about 12-14 mm deep and 5-8 mm deep(monitored by using a high-frequency ultrasound device),respectively,followed by electrical stimulation(2 Hz/100 Hz,1 m A)using an EA stimulator.The intervention was conducted for 15 min every time,once daily for 14 days.The sciatic nerve function index(SFI)calculated to assess the motor function status.Histopathological changes of the sciatic nerve were displayed by H.E.staining.The expression levels of phosphorylated-p38 MAPK(p-p38)and phosphorylated-tumor protein p53(p-p53)in DRGs of L4-L5 on the affected side were observed by immunohistochemical staining.Results Following modeling,the SFI were significantly decreased(P<0.01),and the expression levels of p-p38 and p-p53 proteins of L4-L5 DRGs were considerably increased in the model group(P<0.05).After the intervention,the SFI were obviously increased,and the expression levels of p-p38 and p-p53 proteins notably down-regulated in both DEA and SEA groups relevant to the model group(P<0.01,P<0.05).The therapeutic effect of DEA was significantly superior to that of SEA in raising SFI and down-regulating expression levels of p-p38 and p-p53 proteins(P<0.01,P<0.05).H.E.staining showed disordered arrangement of the sciatic nerve fibers and myelin,disaggregation of the myelin and axons with deformity and vacuolation in some of them and with an increase of Schwann cells in the model group,w

关 键 词：坐骨神经损伤 深刺 环跳穴 细胞凋亡 p38丝裂原活化蛋白激酶 

分 类 号：R245.97[医药卫生—针灸推拿学]