针刀对颈椎病兔颈后深肌硬度和纤维化的影响  

Effect of Acupotomy on Hardness and Fibrosis of Deep Posterior Cervical Muscle in Rabbits with Cervical Spondylosis

作　　者：刘洪[1] 张泽升 张良志 张晓菁 陈斌[1] 林泽豪 潘细桂 刘晶 修忠标[1] LIU Hong;ZHANG Zesheng;ZHANG Liangzhi(The People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou City,Fujian Province 350004;不详)

机构地区：[1]福建中医药大学附属人民医院骨伤二科,福建省福州市350004 [2]福建中医药大学附属康复医院运动医学科(骨科) [3]福建中医药大学附属人民医院超声医学科 [4]福建中医药大学中医学院

出　　处：《医学理论与实践》2024年第12期1985-1989,共5页The Journal of Medical Theory and Practice

基　　金：国家中医药管理局高水平中医药重点学科建设项目中医骨伤科学(yyzdxk-2023106);福建省自然科学基金资助项目(2020J011049);福建中医药大学优势学科专项课题资助(X2022019-专项)。

摘　　要：目的:观察针刀干预对颈椎病兔颈后深肌群硬度和纤维化的影响。方法:健康新西兰大白兔15只(雄性)随机分为空白组、模型组和针刀组,每组5只。采用改良的长期头低位法制作兔颈椎病模型,造模周期持续8周。建模成功后,针刀组每周接受一次针刀干预治疗,共4次。治疗结束1周后,进行兔颈椎MRI成像、颈后深肌超声检查、HE和Masson染色观察颈后深肌的形态学改变。结果:普通超声显示:模型组颈后深肌的横截面积与纵向肌肉厚度均较空白组缩小(P<0.05),而针刀组则较模型组增大(P<0.01)。弹性超声可见:空白组颈后深肌肌肉轮廓相对清晰,弹性成像多呈绿色,同时伴有少量红色的低弹性图像;模型组肌肉轮廓模糊,弹性图像以蓝色为主,弹性较高;针刀组颈后深部肌肉轮廓趋于正常,弹性成像显示为中弹性图像,以蓝、绿色为主。Masson染色观察:与空白组相比,模型组颈后深肌撕裂明显,形态不规则,伴大量蓝色胶原充斥在肌细胞内,纤维间隙增大;针刀组可有效改善上述表现,且显著降低胶原容积分数(P<0.05)。另外,与空白组相比,模型组HE染色的细胞形态较混乱,胞质染色不均,细胞核增多,排列不规则,可见部分炎性细胞的浸润,伴大量肌纤维的撕裂等;而针刀组较模型组的形态学明显好转。结论:针刀干预可有效改善颈椎病兔颈后深层肌肉的组织硬度,促进慢性损伤纤维化的修复,这可能是针刀治疗颈椎病的关键所在。Objective:To observe the effect of acupotomy on the stiffness and fibrosis of posterior cervical deep muscle group in rabbits with cervical spondylosis.Methods:15 healthy New Zealand white rabbits(male)were randomly divided into blank group,model group and acupotomy group,with 5 rabbits in each group.The rabbit cervical spondylosis model was established by modified long-term head down position method,and the modeling period lasted for 8 weeks.After successful modeling,the acupotomy group received acupotomy treatment once a week,a total of 4 times.1 week after the treatment,the cervical spine MRI,ultrasound,HE and Masson staining were performed to observe the morphological changes of the posterior deep cervical muscle.Results:Ultrasound showed that the cross-sectional area and longitudinal muscle thickness of the deep posterior cervical muscle in the model group were smaller than those in the blank group(P<0.05),while the acupotomy group was larger than that in the model group(P<0.01).The elastic ultrasound showed that the muscle outline of the deep posterior cervical muscle in the blank group was relatively clear,and the elastic imaging was mainly green with low elastic map accompanied by red.In the model group,the muscle outline was blurred,and the elastic image showed a high elastic map dominated by blue.In the acupotomy group,the muscle contour of the deep posterior neck muscle tended to be normal,and the elastic image was mainly blue and green.Masson staining observation:Compared with the blank group,the posterior deep neck muscle of the model group was torn obviously,with irregular shape,a large amount of blue collagen filled in the muscle cells,and the fiber gap increased.Acupotomy group can effectively improve the above manifestations,and significantly reduce the collagen volume fraction(P<0.05).In addition,compared with the blank group,the cell morphology of the model group stained by HE was more chaotic,with uneven cytoplasmic staining,increased nuclei,irregular arrangement,infiltration of some inflammat

关 键 词：针刀 颈椎病 颈后肌 纤维化 

分 类 号：R-33[医药卫生]