推拿联合脊髓电刺激对坐骨神经损伤大鼠脊髓前角运动神经元的抗凋亡机制研究  

Study on anti-apoptotic mechanism of Tuina combined with spinal cord electrical stimulation in anterior horn motor neurons of spinal cord in rats with sciatic nerve injury

作　　者：伍丹丹 卢新刚 尹露 陈霄 张涛 安云 闫慧新 严隽陶[1] WU Dandan;LU Xin’gang;YIN Lu;CHEN Xiao;ZHANG Tao;AN Yun;YAN Huixin;YAN Juntao(Department of Tuina,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院推拿科,上海200437

出　　处：《上海中医药杂志》2022年第10期83-89,共7页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(81603713)。

摘　　要：目的研究推拿联合脊髓电刺激(SCS)对坐骨神经损伤大鼠脊髓前角运动神经元的凋亡调控及B淋巴细胞瘤-2(Bcl-2)、B淋巴细胞瘤-2相关蛋白X(Bax)表达的影响。方法将24只清洁级SD大鼠随机分为假手术组、模型组和治疗组,每组8只。除假手术组外,其余16只大鼠均建立坐骨神经损伤(SNI)模型,造模后7 d开始干预。造模后21 d取材,观察大鼠行为学变化及神经纤维形态学改变,并采用尼氏染色及免疫组化观察L_(4)~L_(6)节段脊髓前角运动神经元细胞形态及Bcl-2、Bax蛋白表达情况,TUNEL检测脊髓前角运动神经元凋亡数目。结果与假手术组比较,造模后大鼠均出现神经纤维肿胀变形及功能受损。造模后21 d,与模型组比较,治疗组坐骨神经功能指数显著升高(P<0.05)。与假手术组比较,造模后大鼠均出现脊髓前角运动神经元凋亡;治疗组脊髓前角神经元凋亡数目显著低于模型组(P<0.05)。与模型组比较,治疗组脊髓前角运动神经元中Bcl-2蛋白表达显著升高(P<0.05),Bax蛋白表达显著降低(P<0.05)。结论推拿联合SCS干预可促进SNI大鼠神经功能恢复,同时对损伤的脊髓前角运动神经元具有保护作用,并且可能通过上调Bcl-2、下调Bax蛋白表达参与坐骨神经损伤后脊髓前角运动神经元的抗凋亡过程。Objective To investigate the effects of Tuina combined with spinal cord electrical stimulation(SCS)on the regulation of apoptosis and the expression of B-cell lymphoma-2(Bcl-2)and Bcl-2-associated X-protein(Bax)in anterior horn motor neurons of the spinal cord in rats with sciatic nerve injury(SNI).Methods Twenty-four clean SD rats were randomly divided into a sham operation group(n=8),a model group(n=8)and a treatment group(n=8).SNI model was established in 16 rats except those in the sham operation group,and interventions began 7 d after the model was established.Behavioral changes of rats and morphological changes of nerve fibers were observed at 21 d after modeling,and the neuronal cell morphology and expression of Bcl-2 and Bax proteins in the anterior horn of the spinal cord of L_(4)~L_(6) segments were observed by Nissl staining and immunohistochemistry.The number of apoptotic neurons was detected by TUNEL assay.Results Compared with rats in the sham operation group,the modeled rats showed swelling and deformation of nerve fibers and functional impairment.Compared with rats in the model group,rats in the treatment group showed significantly increased sciatic function index(SFI)at 21 d after modeling(P<0.05).Compared with rats in the sham operation group,modeled rats showed neuron apoptosis in anterior horn of the spinal cord;The number of apoptotic neurons in anterior horn of the spinal cord in treatment group was significantly lower than that in the model group(P<0.05).The Bcl-2 protein expression was significantly higher(P<0.05)and Bax protein expression was significantly lower(P<0.05)in anterior horn neurons of the spinal cord in the treatment group than those in the model group.Conclusion Tuina combined with SCS can promote the recovery of nerve function in SNI rats,protect injured spinal cord neurons,and may be involved in the anti-apoptosis process of neurons after sciatic nerve injury through up-regulating Bcl-2 protein expression and down-regulating Bax protein expression.

关 键 词：周围神经损伤 康复 推拿 脊髓电刺激 坐骨神经 神经再生 细胞凋亡 大鼠模型 

分 类 号：R244.1[医药卫生—针灸推拿学]