推拿手法对颈动脉粥样硬化斑块模型兔CD68、MMP-2表达的影响  

Effect of Tuina Manipulation on the Expression of CD68 and MMP-2 in Rabbits with Carotid Atherosclerotic Plaque

作　　者：袁钰 蒋涛 陈飞 陈辉 YUAN Yu;JIANG Tao;CHEN Fei;CHEN Hui(The Second Clinical Medical College of Anhui University of Chinese Medicine,Hefei,230038;The Second Affiliated Hospital of Anhui University of Chinese Medicine)

机构地区：[1]安徽中医药大学第二临床医学院,安徽省合肥市230038 [2]安徽中医药大学第二附属医院

出　　处：《中医杂志》2023年第22期2339-2345,共7页Journal of Traditional Chinese Medicine

基　　金：安徽中医药大学科研基金(2021efylc05);安徽省名中医及基层名中医工作室建设项目(中发展[2020]10号);“十四五”省级中医优势特色专科项目(皖中医药服务秘[2021]71号);2019年省级中医发展专项资金项目(皖卫中医药发[2019]8号)。

摘　　要：目的探讨不同颈椎旋转角度的推拿手法对颈动脉粥样硬化的影响。方法25只新西兰兔随机抽取5只作为对照组,其余20只兔作为造模组。造模组兔采用动脉内膜球囊损伤联合高脂饲料喂养的方式建立颈动脉粥样硬化模型,造模后随机分为模型组及颈椎旋转90°、105°、120°组,每组5只。颈椎旋转90°、105°、120°组采用一指禅推法、?法、拨法放松兔颈部肌肉后,分别进行颈椎旋转90°、105°、120°,左右各旋转1次。上述全部手法每天1次,共干预2周,其余两组不做干预。取兔左侧颈总动脉,用HE染色观察颈动脉组织病理形态,免疫组化染色观察颈动脉组织内巨噬细胞通用标志物CD68及基质金属蛋白酶2(MMP-2)表达情况并进行半定量分析。结果HE染色显示,对照组颈动脉未见明显病变;模型组可见内膜下泡沫细胞聚集,中膜血管平滑肌细胞增多、排列紊乱,部分血管平滑肌细胞由中膜进入内膜下,形成纤维帽;颈椎旋转90°、105°、120°组内膜下泡沫细胞大量聚集,管腔狭窄症状较模型组改善;与颈椎旋转90°组比较,颈椎旋转105°、120°组颈动脉内皮稍有脱落倾向。与对照组比较,模型组及颈椎旋转90°、105°、120°组颈动脉组织CD68、MMP-2表达升高(P<0.05);与模型组比较,颈椎旋转90°、105°、120°组颈动脉组织CD68、MMP-2表达降低(P<0.05);颈椎旋转90°、105°、120°组三组间两两比较,CD68阳性表达差异无统计学意义(P>0.05);颈椎旋转105°、120°组颈动脉组织MMP-2阳性表达较颈椎旋转90°组升高(P<0.05)。结论推拿手法可通过降低斑块内巨噬细胞CD68含量和MMP-2水平,促进斑块稳定;但随着颈椎旋转角度的增加,可能会导致MMP-2表达升高,从而一定程度上降低斑块稳定性。Objective To explore the effect of tuina manipulation with different cervical rotation angle on carotid atherosclerosis.Methods Twenty-five New Zealand rabbits were randomly selected,5 of which as the control group,and the other 20 rabbits as the modeling group.The modeling group were made by arterial intimal balloon injury combined with high-fat diet,and were randomly divided into model group,cervical rotation angle of 90°group,cervi?cal rotation angle of 105°group and cervical rotation angle of 120°group(5 rabbits in each group)after successful modeling.After relaxing the neck muscles of rabbits with manipulation of one-finger meditation,rolling and dialing,the cervical vertebrae of each group was rotated by 90°,105°and 120°respectively for 2 weeks,while the other two groups were not intervened.Then took the entire length of the left common carotid artery from the rabbit,observed the pathological morphology of the carotid artery tissue using HE staining,and observed the expression of CD68 and MMP-2 in the carotid artery tissue using immunohistochemistry staining,and conducted semi quantitative analysis.Results HE staining showed that there was no obvious pathological change in the carotid artery in the control group;the model group showed subintimal foam cells gathered,vascular smooth muscle cells increased and arranged disorderly,and some vascular smooth muscle cells entered the intima from the media to form a fibrous cap.Compared with the model group,the number of foam cells increased and the symptoms of lumen stenosis were improved in all groups of cervical rotation;compared with the group with 90°rotation,the endothelium tended to fall off slightly in the group with 105°ro?tation and 120°rotation.Compared with the control group,the model group and the cervical rotation angle of 90°group,cervical rotation angle of 105°group and cervical rotation angle of 120°group showed an increase in positive expression of CD68 and MMP-2(P<0.05);compared with the model group,the positive expression of CD68 and

关 键 词：颈动脉粥样硬化 推拿手法 巨噬细胞 基质金属蛋白酶 

分 类 号：R244.1[医药卫生—针灸推拿学]