血府逐瘀汤对兔颈髓急性损伤减压术后神经元及血管灌注的干预效果

Effect of Xuefu Zhuyu decoction on neurons and vascular perfusion in rabbits after decompression of acute cervical spine cord damage in an early time

目的:观察活血化瘀利水消肿中药血府逐瘀汤对兔颈髓急性损伤减压术后神经元、血管灌注的影响。方法:实验于2003-11/2005-07在广西中医学院内完成。健康新西兰白兔8只,雌雄不拘,三四月龄,体质量2.1～2.7kg,按数字表法随机分为实验组4只,对照组4只。采用手术方式造成脊髓损伤,建立兔颈髓急性损伤模型。实验组在脊髓减压术后给予灌服血府逐瘀汤(血府逐瘀汤由桃仁,红花,当归,生地,白芍、川芎、牛膝、枳壳、桔梗、丹参、柴胡、葛根、甘草各10g组成,煎水成100mL;中药购自广西中医学院附属瑞康医院药房。),每次50mL,2次/d;对照组只做脊髓减压术处理。两组兔在减压术后36,48,72,120h处死,取动物颈脊髓进行超微显微镜下观察组织病理学变化,并进行脊髓组织丙二醛检测。结果:实验新西兰白兔8只全部存活,进入结果分析。①实验白兔脊髓组织病理学检查结果:对照组神经元细胞周围水肿、微血管瘀阻明显,微循环血栓严重,细胞凋亡数多;实验组神经元周围水肿减轻,白质肿胀减轻,微血管血栓改变,胶质细胞出现少,有明显微血管再通,细胞凋亡数少。实验组神经元水肿、血管再灌注情况明显优于对照组。②随着术后时间推移,脊髓丙二醛含量两组均呈现逐渐降低的趋势。实验组丙二醛在减压术后36,48,72,120h含量明显均低于对照组(54.1,52.5,47.1,43.3;69.3,61.1,56.7,49.5mmol/g),两组比较差异有显著性意义眼(49.25±4.9702),(59.15±8.2855)mmol/g,P<0.05演;但实验组丙二醛含量仍高于正常兔颈髓(26.8mmol/g,P<0.05)。结论:中药活血化瘀组方的血府逐瘀汤,对急性颈髓损伤具有促进脊髓瘀阻微循环再灌注,降低脊髓丙二醛含量,促进脊髓水肿缓解的作用,从而起到保护受伤脊髓组织作用。

AIM： To observe the influence of Xuefu Zhuyu decoction that can promote blood flow and induce diuresis to alleviate edema on the neuron and the blood vessel of the acute damage cervical spine cord of rabbits after decompression procedure. METHODS： The experiment was conducted at the Guangxi College of Traditional Chinese Medicine from November 2003 to July 2005. Totally 8 healthy New Zealand albino rabbits aged 3 or 4 months with body mass of 2.1-2.7 kg, no matter male or female, were selected and assigned randomly into experimental group with 4 rabbits and control group with 4 rabbits. Spinal injury was made by operation to establish cervical spine cord acute damage rabbit models. The rabbits in the experimental group drenched with Xuefu Zhuyu decoction （composed of semen, safflower, angelica, rehmannia dride rhizome, paeoniae radix, chuanxiong, achyranthis, fructus, platycodon, danshen root, bupleuri, pueraria and liquiritia, each 10 g, decocted into 100 mL; the herbs were purchased from pharmacy of Ruikang Hospital Affiliated to Guangxi College of Traditional Chinese Medicine） after decompression of spinal cord, 50 mL every time, twice a day. The rabbits in the control group only received decompression of spinal cord. All the rabbits were killed after decompression at hours 36, 48, 72 and 120. The histopathological change of cervical spinal cord was observed under uhramicre-microscope. Malondaldehyde （MDA） of myeloid tissue was detected. RESULTS： The 8 experimental New Zealand albino rabbits were living and involved in the result analysis. ① Examination finding of histopathology of spinal cord of experimental albino rabbits： In the control group there were edema around neuron, significant micrangium obstruction, severe minicirculation thrombus and a mass of apoptotic cells. In the experimental group, there were light edema around neurons, light swelling of white matter, change of micrangium thrombus, less glial cells, obvious micrangium recanalization and few apoptotic cells. The experimental group obviously surpassed the control group on neuron dropsy and reperfusion of vessel. ②With the time-lapse of operation, the content of MDA in spinal cord had the trend of decrease. The content of MDA in the experimental group was markedly lower than that in the control group at hours 36, 48, 72 and 120 after decompression procedure （54.1,52.5,47.1,43.3 ;69.3, 61.1,56.7,49.5 mmol/g）. There was remarkable difference between the two groups [（49.25±4.9702）, （59.15±8.2855） mmol/g,P 〈 0.05]. However, the content of MDA in the experimental group was still higher than that in the normal rabbits （26.8 mmol/g,P 〈 0.05）. CONCLUSION： The Xuefu Zhuyu decoction has the effect of promoting microcirculation repoffusion of spinal obstruction, decreasing the content of MDA and accelerating edema remittence in order to play a protective function on damaged cervical spinal cord.