穴位按摩对受损骨骼肌血管内皮生长因子表达、微泡超声造影及血液流变的影响

Effects of point massage on the expression of vascular endothelial growth factor mRNA, ultrasonic microbub-ble imaging and hemorheology after skeletal muscle contusion

目的将新西兰兔制成股四头肌钝挫伤模型，观察按摩损伤侧阳陵泉对受损骨骼肌血管内皮生长因子（VEGF）mRNA表达、微泡超声造影及血液流变的影响。方法采用随机数字表法将42只新西兰大白兔分为正常组（6只）、自然恢复组（18只）及按摩组（18只）。选用重物打击法将自然恢复组及按摩组实验兔制成股四头肌急性钝挫伤模型。按摩组实验兔于制模当日开始，在每天下午3：00时给予患侧阳陵泉按摩，每天持续15min，每天治疗1次。于制模后2h、3d、7d及10d时采用微泡超声影像技术检测各组实验兔局部肌肉病理改变；于制模后3d、7d及10d时采用逆转录一聚合酶链反应（RT-PCR）检测各组实验兔肌肉组织中VEGFmRNA表达；采用全自动血流变分析仪检测各组实验兔全血黏度及血浆黏度改变。结果制模后3d、7d及10d时发现自然恢复组肌肉组织中VEGFmRNA表达较正常组分别增加了35．00％、43．81％、17．94％；按摩组VEGFmRNA表达则较正常组分别增加了94．39％、85．69％、94．20％。微泡超声造影显示按摩组局部损伤修复情况明显优于自然恢复组。血液流变观察结果显示穴位按摩能调节实验兔全身血流状态，加速损伤愈合。结论按摩患侧阳陵泉能改善实验兔局部血供及全身血流状态，加速急性骨骼肌钝挫伤修复。

Objective To understand the effects of point massage on the expression of vascular endothelial growth factor （VEGF） mRNA expression after skeletal muscle contusion, and also its effects on ultrasonic microbub- ble imaging and hemorheology. Methods Forty-two New Zealand white rabbits were randomly divided into a normal group （n = 6）, a self-repairing group （n = 18 ） and a massage group （n = 18）. Rabbits in the self-repairing and massage groups were hit to generate acute contusion of the quadrieeps femoris. Beginning on the same day, the rab- bits in the massage group were treated by massage at the Yanglingquan aeupoint （GB34） for 15 minutes once daily. Ultrasonic microbubble imaging was used to examine any pathologic changes in the rabbits＇ muscles at 2 hours and then 3, 7 and l0 days after the insult. A reverse transcriptase-polymerase chain reaction （RT-PCR） was performed to detect VEGF mRNA expression in the rabbits＇ muscle tissues at days 3, 7 and 10. An automatic hemorbeology analy- zer was employed to detect any changes of in the viscosity of the blood and plasma. Results At days 3, 7 and 10, VEGF mRNA expression in the rabbits in the self-repairing group was 35% , 44% and 18% higher than in the normal group respectively. Average VEGF mRNA expression in the massage group was 94% , 86% and 94% higher than in the normal group at the same time points. Ultrasonic microbubble imaging suggested that in the massage group local tissue injury repaired much better than in the self-repairing group. The hemorheology observations suggested that point massage could regulate the hemorheology of the rabbits＇ entire body and hasten the damage recovery process. Conclusion Point massage at the Yanglingquan point （GB34） can hasten the recovery of skeletal muscle contusions by improving local blood supply and whole body hemorheology, at least in rabbits.