活血止痛汤对硬膜外瘢痕凋亡基因p53及Ⅰ、Ⅲ型前胶原蛋白mRNA表达的影响

Effect of HUOXUE ZHITONG decoction on mRNA expression of epidural cicatrix apoptosis genes p53,type Ⅰ procollagen and type Ⅲ procollagen

目的:探讨活血止痛汤对硬膜外瘢痕凋亡基因p53及Ⅰ、Ⅲ型前胶原蛋白mRNA表达的影响。方法:将45只雌性新西兰白兔随机分成假手术组(A组)、空白对照组(B组)和活血止痛汤组(C组),每组15只。手术切除B组和C组白兔的L4、L5椎板,造成1.0 cm×1.0 cm硬脊膜裸露区。术后对C组白兔予以活血止痛汤灌胃2周。术后第2、4、8周末时每组各处死动物5只,观察硬膜外瘢痕组织与硬膜的粘连程度,以逆转录聚合酶链式反应测定其硬膜外瘢痕组织中p53及Ⅰ、Ⅲ型前胶原蛋白mR-NA的表达水平。结果:A组无硬膜外瘢痕形成,C组硬膜外瘢痕组织与硬膜粘连程度较B组轻。B、C组各时相的p53及Ⅰ、Ⅲ型前胶原蛋白mRNA的表达水平均高于A组(P<0.05)。术后第2、4、8周末时,C组p53及Ⅰ、Ⅲ型前胶原蛋白mRNA的表达水平均低于B组(P<0.05)。总体观察也发现C组较B组粘连程度明显低(P<0.05)。结论:活血止痛汤可能通过调节p53及Ⅰ、Ⅲ型前胶原蛋白mRNA的表达,减少了椎板切除术后成纤维细胞增殖和胶原等细胞外基质的沉积,减少了硬膜外瘢痕增生、粘连。

Objective： To explore the effect of HUOXUE ZHITONG decoction on mRNA expression of epidural cicatrix apoptosis genes p53, type Ⅰ procollagen and type Ⅲ procollagen. Methods ：45 female New Zealand rabbits were randomly divided into sham - operated group （group A） ,blank control group（ group B） and HUOXUE ZHITONG decoction group（ group C） , 15 cases in each group. L4 and L5 vertebral plates of rabbits in group B and C were surgically excised to expose a 1.0 cm × 1.0 cm area of spinal dura mater. Rabbits were fed with HUOXUE ZHITONG decoction by gavage in group C for 2 weeks. At the end of 2nd ,4th and 8th week after operation ,5 rabbits were sacrificed for each group. The degree of adhesion between epidural cicatrix and dura mater were observed, and the mRNA expression levels of p53, type Ⅰ procollagen and type Ⅲ procollagen in epidural cicatrix tissue were measured by reverse transcription polymerase chain reaction. Results ： There was no epidural cicatrix formed in group A. The degree of adhesion between epidural cicatrix tissue and dura mater of group C was lower than that of group B. The mRNA expression levels of p53, type Ⅰ procollagen and type Ⅲ procollagen of group B and C were higher than those of group A at every phase（ P 〈0.05 ）. At the end of 2nd,4th and 8th week after operation,the mRNA expression levels of p53, type Ⅰ proeollagen and type Ⅲ procollagen of group C were lower than those of group B （ P 〈 0.05 ）. The degree of adhesion between epidural cicatrix tissue and dura mater of group C was lowered more obviously than that of group B through overall observation（ P 〈 0.05 ）. Conclusion：Through regulating the mRNA expression of p53, type Ⅰ procollagen and type Ⅲ procollagen, HUOXUE ZHITONG decoction can reduce proliferation of fibroblast and deposition of collagen and other extracellular matrixes after laminectomy, so it can decrease the hyperplasy and adhesion of epidural cicatrix.