补气通络方对大鼠坐骨神经急性挤压伤后功能恢复的干预效应

Interventional effect of Buqi Tongluo Fang on the functional recovery of rats after acute crush injury of sciatic nerve

目的:比较补气通络方和神经外膜切开对周围神经急性挤压伤的治疗效果。方法:实验于2002-03／12在广州中医药大学国家中医药管理局细胞生物学实验室进行。取128只SD大鼠,制成精确的右坐骨神经神经急性挤压伤模型。造模成功后随机分成4组,每组32只:①补气通络方组:从造模后第2日起予补气通络胶囊混悬液1μL／(kg·d)灌胃[相当于生药0．9 g／(kg·d)],1次／d。补气通络胶囊由黄芪、人参、当归、川芎、丹参等组成。②手术组:予造模处神经外膜切开。③补气通络方+手术组:既给补气通络胶囊又行神经外膜切开手术治疗。④对照组:给予生理盐水 1 μL／(kg·d)灌胃。给药后1 d、1,4,8周每组取8只大鼠作坐骨神经电生理测定,包括传导速度、阈强度、最大波幅,以判断神经功能的修复情况。结果:128只大鼠全部进入结果分析。①坐骨神经阈强度:给药第4,8周补气通络方及补气通络方+手术组低于对照组(P<0．05,0．01),手术组亦优于对照组,但无统计学意义(P>0．05)。②坐骨神经传导速度:给药第4,8周补气通络方及补气通络方+手术组快于对照组(P<0．05, 0．01),手术组亦优于对照组,但无统计学意义(P>0．05)。③最大波幅: 给药第4,8周补气通络方及补气通络方+手术组大于对照组(P<0.05, 0．01),但两组间无差异,但无统计学意义(P>0．05)。结论:单纯神经外膜切开对周围神经急性挤压伤早期可能有帮助,但远期疗效并不确切;补气通络方可促进神经传导功能恢复,作用途径可能为促进损伤局部血液循环,改善神经营养,促进周围神经轴突再生。

AIM：To compare the effect of Buqi Tongluo Fang and epineurium incision in treating acute crush injury of peripheral nerve. METHODS：The experiment was carried out in the laboratory of cell biology, State Administration of Traditional Chinese Medicine, Guangzhou University of Traditional Chinese Medicine between March and December 2002.Totally 128 SD rats were made into models of acute crush injury of right sciatic nerve, and then they were randomly divided into 4 groups with 32 rats in each group： ① Buqi Tongtu, o Fang group：the rats were treated with gastric perfusion of Buqi Tongtu, o capsule suspension 1μL/kg per day （crude drug of 0.9 g/kg per day） from the 2^rd day after model establishment,once a day.Buqi Tongluo capsule was composed by membranous milkvetch root, ginseng,Chinese angelica,Szechwan lovge rhizome, danshen, etc.②operated group：epineurium incision was performed at the site of model establishment.③Buqi Tongluo Fang＋operated gToup： the rats were treated with both Buqi Tongluo capsule and epineuriam incision. ④control group：the rats were treated with gastric, per＇fusion of saline （1μL/kg per day）. At 1 day, 1, 4 and 8 weeks after administratiori, 8 rats were selected from each group for the electrophysiological detection of sciatic nerve, including conduction velncity, threshold intensity and the maximal wave amplitude, so as to judge the repair of neurological function. RESULTS：All the 128 rats were involved in the analysis of results. ① Threshold intensity of sciatic nerve： At ,4 and 8 weeks after administration, it was lower in the Buqi Tongluo Fang group and Buqi Tongluo Fang＋operated pup than in the control pup （P 〈 0.05, 0.01）, also better in the operated group than in the control group without significant difference （P 〉 0.05）.② Conduction velocity of sciatic nerve： At 4 and 8 weeks after administration, it was faster in the Buqi Tongluo Fang group and Buqi Tonb, luo Fang＋ operated group than in the control group （P 〈 0.05, 0.01）, also better in the operated group than in the control group without significant difference （P 〉 0.05）. ③The nmxirtml wave amplitude： At 4 and 8 weeks after administration, it was lager in the Buqi Tongluo Fang group and Buqi Tonb, luo Fang＋operated group than in the control group （P 〈 0.05,0.01）,but there was no significant difference between the former two groups （P 〉 0.05）. CONCLUSION：Simple epineurium incision may help the acute crush injury of peripheral nerve at early period,but the long-term effect is not definite.Buqi Tonb, luo Fang can promote the functional recovery of nerve conduction,the action pathway may be the promotion of lncal blood circulation of injury, amelioration of nervous nutrition, and acceleration of the axis-cylinder regeneration of peripheral nerve.