推拿对腰间盘突出症大鼠的治疗作用及对TLRs/MyD88信号通路的影响  

Therapeutic Effect of Tuina on Rats With Lumbar Disc Herniation and Its Effect on Tlrs/Myd88 Signaling Pathway

作　　者：何涛 闫素敏 张学良[1] 马书彬[2] HE Tao;YAN Su-min;ZHANG Xue-liang;MA Shu-bin(Department of Pain,the First Affiliated Hospital of Henan University,Kaifeng Henan 475004;Nanyang Medical College,Nanyang Henan 473061)

机构地区：[1]河南大学第一附属医院疼痛科,河南开封475004 [2]南阳医学高等专科学校,河南南阳473061

出　　处：《世界中西医结合杂志》2021年第2期288-293,297,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：河南省高等学校重点科研项目(18A890004)。

摘　　要：目的观察推拿对腰椎间盘突出症(LDH)大鼠的治疗作用及对Toll样受体(TLRs)/髓样分化因子(MyD88)信号通路的影响。方法取45只大鼠采用自体髓核移植法建立LDH大鼠模型,造模成功大鼠随机分为模型组、模型+抑制剂组、推拿组、推拿+激活剂组,每组10只,剩余10只为假手术组。模型+抑制剂组给予TLR4抑制剂TAK-242,推拿组施用推拿手法,推拿+激活剂组施用推拿手法并给予TLR4激活剂脂多糖(LPS),模型组、假手术组固定的同时给予生理盐水。测定各组大鼠造模后1、7、14、21 d机械性缩足反射阈值(PWMT)、热刺激缩足反射潜伏期(PWTL);造模21 d处死各组大鼠,观察背根神经节病理变化,并比较背根神经节肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-1β水平及髓核组织TLR4、MyD88、核转录因子κB(NF-κB)p65 mRNA及蛋白相对表达量。结果与模型组比较,模型+抑制剂组、推拿组7、14、21 d PWMT及PWTL升高(P<0.05),推拿+激活剂组7、14、21 d PWMT及PWTL降低(P<0.05)。HE染色显示,模型组、推拿+激动剂组背根神经节细胞肿胀,形状不规则,有空泡变性,尼氏小体排列不均;推拿组、模型+抑制剂组背根神经节病理形态较模型组有所改善,细胞排列较清晰,存在少数细胞空泡变性,尼氏小体较均匀。与模型组比较,模型+抑制剂组、推拿组背根神经节TNF-α、IL-6、IL-1β水平,髓核组织TLR4、MyD88、NF-κBp65 mRNA及蛋白相对表达量降低,且推拿组低于模型+抑制剂组(P<0.05),推拿+激活剂组背根神经节TNF-α、IL-6、IL-1β水平,髓核组织TLR4、MyD88、NF-κBp65 mRNA及蛋白相对表达量升高(P<0.05)。结论推拿可能通过抑制TLR4/MyD88信号通路发挥消炎止痛作用,改善LDH症状。Objective To observe the therapeutic effect of Tuina on rats with lumbar disc herniation(LDH)and the effect on toll like receptors(TLRs)/myeloid differentiation factor 88(MyD88)signaling pathway.Method Forty five rats were selected to establish LDH rat model by autologous nucleus pulposus inhibition method.Rats successfully modeled were randomly divided into:model group,model+inhibitor group,Tuina group,Tuina+activator group,10 rats in each group,the remaining 10 rats were sham operation group.The model+inhibitor group was given TLR4 inhibitor TAK-242,Tuina group was given Tuina method,Tuina+activator group was given Tuina method and TLR4 activator lipopolysaccharide(LPS),the model group and the sham operation group were given fixed saline at the same time.The mechanical threshold of paw withdrawal mechanical threshold(PWMT)and the paw withdrawal thermal latency(PWTL)were observed at 1,7,14 and 21 days after the model was established,21 days after the model was established the rats were sacrificed to observe the pathological changes of dorsal root ganglion and compared the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-1βin the dorsal root ganglion and the relative expression of TLR4,MyD88,nuclear transcription factorκB(NK-κB)p65 mRNA and protein in the nucleus pulposus tissue.Results Compared with the model group,the PWMT and PWTL of the model+inhibitor group and the Tuina group were increased on 7,14,and 21 days(P<0.05),and the PWMT and PWTL of the Tuina+activator group were decreased(P<0.05).HE staining showed that the dorsal root ganglion cells in the model group and the massage+agonist group were swollen,irregular in shape,with vacuolesdegeneration,and the arrangement of nissl bodies were uneven,the model group had improved,the cell arrangements were clear,there were a few cell vacuoles degeneration,and the nissl bodies were more uniform.Compared with the model group,the TNF-α,IL-6,IL-1βlevels of dorsal root ganglion and the relative expression levels of TLR4,MyD88,NF-κBp65 mRNA and

关 键 词：椎间盘突出症 推拿 TOLL样受体 

分 类 号：R246[医药卫生—针灸推拿学]