归芪活血胶囊对神经根型颈椎病大鼠炎性损伤和微循环血流的影响  

Effects of Guiqi Huoxue Capsules on Inflammatory Injury and Microcirculation Blood Flow in Rats with Cervical Spondylotic Radiculopathy

作　　者：嵇波[1] 刘翼天 赵国桢[2] 李博[2] 方洋 石天宇 谢亚娜 张玲[1] 郭亭廷 全烨 王一菲 吴乐 JI Bo;LIU Yitian;ZHAO Guozhen;LI Bo;FANG Yang;SHI Tianyu;XIE Yana;ZHANG Ling;GUO Tingting;QUAN Ye;WANG Yifei;WU Le(School of Acupuncture-moxibustion and Tuina,Beijing University of Chinese Medicine,Beijing 102401,China;Beijing Traditional Chinese Medicine Hospital,Beijing 100010,China)

机构地区：[1]北京中医药大学针灸推拿学院,北京102401 [2]首都医科大学北京中医医院,北京100010

出　　处：《世界中医药》2024年第6期793-801,共9页World Chinese Medicine

基　　金：国家“重大新药创制”科技重大专项(2018ZX09201010);北京中医药大学校级科研横向发展基金项目(2030071720017)。

摘　　要：目的:探究归芪活血胶囊(GQ)对神经根型颈椎病(CSR)大鼠的治疗效应及机制。方法:观察CSR大鼠自发痛、热痛阈、步态评分、前肢和颈部体表微循环状态、脊髓病理结构及超微结构变化、脊髓p38磷酸化情况以及血清白细胞介素-1β(IL-1β)、IL-6以及肿瘤坏死因子-α(TNF-α)。结果:GQ高、中剂量在干预第14天时可显著升高CSR模型大鼠的热痛阈(P<0.05),降低其步态评分和自发痛评分(P<0.05,P<0.01);GQ各剂量均可改善CSR大鼠脊髓炎症水肿变化,显著增加尼氏(Nissl)染色阳性细胞数目(P<0.05),恢复髓鞘和线粒体正常形态,且GQ中剂量效果较明显;GQ高、中剂量可显著升高CSR大鼠颈部和前肢皮肤血流灌注量(P<0.05),对前肢远端血流灌注量的改善程度优于芬必得组(P<0.01);与模型组比较,GQ中剂量可降低CSR大鼠脊髓p38磷酸化比率。结论:GQ可以缓解CSR大鼠热痛觉过敏和步态不稳的程度,改善脊髓炎症病理变化,恢复前肢和颈部体表血流灌注量,且GQ中剂量在改善CSR大鼠炎症损伤方面更有优势。Objective:To explore the therapeutic effect and mechanism of Guiqi Huoxue Capsules(GQ)on cervical spondylotic radiculopathy(CSR)in rats.Methods:Spontaneous pain,thermal pain threshold,gait score,body surface microcirculatory status of forelimbs and neck,pathological structural and ultrastructural changes of the spinal cord,phosphorylation of p38 in the spinal cord,and serum serum interleukin-1β(IL-1β),IL-6,and tumor necrosis factor-α(TNF-α)in CSR rats were observed.Results:High and medium-dose GQ could significantly increase the thermal pain threshold of CSR model rats after 14 days of intervention(P<0.05),reduce their gait score and spontaneous pain score(P<0.05,P<0.01).All GQ doses groups could improve spinal cord inflammatory edema in CSR rats,significantly increase the number of Nissl-stained positive cells(P<0.05),restore normal morphology of myelin sheaths and mitochondria.The medium-dose of GQ showed more significant effects.High and medium doses of GQ could significantly increase skin blood perfusion in the neck and forelimbs of CSR rats(P<0.05),with a greater improvement in distal forelimb blood perfusion than the ibuprofen group(P<0.01).Compared to the model group,the medium-dose GQ could reduce the phosphorylation ratio of p38 in the spinal cord of CSR rats.Conclusion:GQ can alleviate the degree of thermal hyperalgesia and gait instability,improve the inflammatory pathological changes in the spinal cord,and restore the volume of body surface perfusion in the forelimbs and neck in CSR rats,and the medium-dose GQ is more advantageous in improving inflammatory injury in CSR rats.

关 键 词：归芪活血胶囊 神经根型颈椎病 疼痛 炎性损伤 体表微循环 活血通络 抗炎镇痛 P38 

分 类 号：R274.9[医药卫生—中西医结合] R285.5[医药卫生—中医骨伤科学]