针刀干预对腰椎间盘退行性病变兔病变椎间盘中蛋白聚糖表达的影响  

Effect of acupotomy intervention on the expressions of proteoglycans in lumbar intervertebral disc of rabbits with lumbar intervertebral disc degeneration

作　　者：胡江杉 唐宏图 闫菁 李奕宏 胡霞 李佳 王华 HU Jiang-shan;TANG Hong-tu;YAN Jing;LI Yi-hong;HU Xia;LI Jia;WANG Hua(College of Acupuncture and Orthopedics,Hubei University of Chinese Medicine/Hubei Collaborative Innovation Center of Acupuncture and Moxibustion for Disease Prevention,Wuhan 430061,China;College of Basic Medicine,Hubei University of Chinese Medicine,Wuhan 430065)

机构地区：[1]湖北中医药大学针灸骨伤学院/针灸治未病湖北省协同创新中心,武汉430061 [2]湖北中医药大学基础医学院,武汉430065

出　　处：《针刺研究》2023年第5期454-460,共7页Acupuncture Research

基　　金：湖北省自然科学基金知识创新专项(No.2019CFC883);国家中医药管理局岐黄工程项目(No.国中医药人教函[2018]284号);国家中医药管理局全国老中医药专家学术经验继承工作项目(No.国中医药人教发[2017]29号)。

摘　　要：目的:观察针刀干预对腰椎间盘退行性病变(LIDD)病变兔椎间盘中组织二聚糖(BGN)、核心蛋白多糖(DCN)及半胱氨酸蛋白酶-3(Caspase-3)表达的影响,探讨针刀治疗LIDD的作用机制。方法:将30只成年雄性日本白兔随机分为正常组、模型组、针刀组,每组10只。采用轴向加压法制备LIDD兔模型,核磁共振成像(MRI)扫描判断造模是否成功。针刀组选取腰(L)4—L5棘突间隙及两侧横突进行松解,每周治疗2次,连续治疗4周。MRI扫描观察兔L4—L5椎间盘结构变化,HE染色观察兔L4—L5椎间盘纤维环和髓核组织形态学改变,免疫组织化学法检测兔L4—L5椎间盘髓核组织中Caspase-3表达,Western blot法检测兔L4—L5椎间盘组织中DCN、BGN蛋白表达水平。结果:造模后,模型组与针刀组兔L4—L5椎间盘信号强度降低,模型制备成功。与正常组比较,模型组兔运动迟缓,背部肌肉僵硬,有条索或结节出现;腰椎间盘纤维环结构紊乱,髓核细胞数量减少;MRI扫描结果显示L4—L5椎间盘信号强度降低;髓核组织中Caspase-3表达明显升高(P<0.05),椎间盘组织中DCN、BGN蛋白表达量明显降低(P<0.05)。与模型组比较,治疗后针刀组兔四肢运动较为灵活,背部条索状硬结有所改善;腰椎间盘纤维环结构轻度异常,髓核细胞数量有所增加;MRI扫描结果显示L4—L5椎间盘信号强度有所增强;髓核组织中Caspase-3表达明显降低(P<0.05),腰椎间盘组织中DCN、BGN蛋白表达量明显升高(P<0.05)。结论:针刀干预能抑制细胞凋亡,减轻腰椎间盘髓核细胞外基质的降解,恢复腰部正常的力平衡和动态平衡,这可能是针刀治疗LIDD的作用机制之一。Objective To observe the effect of acupotomy intervention on the expressions of biglycan(BGN),decorin(DCN)and Caspase-3in lumbar intervertebral disc of rabbits with lumbar intervertebral disc degeneration(LIDD),so as to ex-plore its possible mechanism in relieving LIDD.Methods Thirty male Japanese white rabbits were randomly divided into nor-mal,model and acupotomy groups,with 10rabbits in each group.The LIDD model was established by axial compression method,and magnetic resonance imaging(MRI)was used to judge whether the model was successful or not.After modeling,the acupoto-my was applied to lumbar(L)4—L5spinous process space and bilateral transverse processes for loosening,twice a week for 4weeks.The structural changes of L4—L5intervertebral disc were observed by MRI.The morphological changes of lumbar spine were observed by HE staining.The expression of Caspase-3in nucleus pulposus was observed by immunohistochemistry,and the protein expressions of DCN and BGN in intervertebral disc were detected by Western blot,separatively.Results After mode-ling,the rabbits showed slow movement,stiff back muscles with cords or nodules,the fibrous ring structure of lumbar interverte-bral disc was disordered,the number of nucleus pulposus cells was reduced,and the signal intensity of L4—L5intervertebral disc was decreased in the model group relevant to the normal group.At the same time,the expression of Caspase-3in nucleus pulpo-sus was increased significantly(P<0.05),and the expression levels of DCN and BGN in intervertebral disc were decreased sig-nificantly(P<0.05).After acupotomy treatment,the modeling induced slow movement,stiff back muscles and disordered struc-ture of lumbar intervertebral disc were significantly improved.The number of nucleus pulposus cells was increased,the signal in-tensity of L4—L5intervertebral disc was enhanced,the expression of Caspase-3in nucleus pulposus was decreased significantly(P<0.05),and the expression levels of DCN and BGN in intervertebral disc were increased significantly(P<0

关 键 词：针刀 腰椎间盘退行性病变 二聚糖 核心蛋白多糖 半胱氨酸蛋白酶-3 

分 类 号：R245.319[医药卫生—针灸推拿学]