电针“环跳”穴对腰椎间盘突出症家兔坐骨神经超微结构的影响

Effect of Electroacupuncture Stimulation of "Huantiao"(GB 30) on Walking Ability and Touch Sensation in Rabbits with Lumbar Intervertebral Disc Protrusion

目的:观察电针"环跳"穴对实验性腰椎间盘突出症(LIDP)家兔步态、触觉功能和坐骨神经超微结构的影响,探讨电针对LIDP的修复作用。方法:40只新西兰家兔随机分为正常组、模型组、环跳组和非穴组。采用LIDP动物病理模型造模器将家兔腰6、7的椎间盘组织推出到后纵韧带右前方建立模型。环跳组和非穴组予电针治疗,每次20min,每日1次,共7d。神经功能评分法检测家兔治疗前后步态、触觉功能的变化,透射电镜检测坐骨神经超微结构。结果:造模后家兔步态、触觉功能减弱;环跳组的步态、触觉功能治疗前后积分值的差值显著高于正常组、模型组、非穴组(P<0.01)。模型组坐骨神经纤维广泛洋葱状变性,雪旺氏细胞坏死、水肿;环跳组神经纤维大多数趋于正常,雪旺氏细胞丰富;非(组)旺氏细胞线粒体广泛水肿、空泡化。结论:电针"环跳"穴对实验性LIDP的损伤具有很好的修复作用。

Objective To observe the effect of electroacupuncture （EA） stimulation of ＂Huantiao＂（GB 30） on the wal- king ability and touch sensation in rabbits with lumbar intervertebral disc protrusion （LIDP）. Methods Forty New Zealand rab- bits were equally randomized into normal control, model, EA-GB 30 and EA-non-acupoint groups. The LIDP model was established by surgical operation under anesthesia. EA （30 Hz/100 Hz, 2- 4 V, 0.5 ms in pulse duration） was applied to bilateral ＂Huantiao＂ （GB 30） or non-acupoint. The rabbits＇ walking ability was assessed according to a 4-points scoring standard： 0 point： complete paralysis; 1 point： paralysis with muscular contraction and mild joint movement; 2 points： weaker strength of the affected limbs with bradykinesia and instable walking; 3 points： able to walk with only interphalangeal joint dyskinesia; 4 points： complete re- covery. The rabbit＇s touch sensation was assessed according to another 4-points scoring standard： 0 point： no any response to cotton swab stimulation;1 point： very mild response; 2 points： sluggish response; 3 points： relatively swifter response but wea- ker than the healthy limb; 4 points： normal. The ultrostructure changes of the sciatic nerve were analyzed by transmission electron microscope. Results Following modeling, the scores for walking ability and touch sensation were significantly reduced in the model, EA-GB 30 and EA-non-acupoint groups （P〈0.01 ）. While compared with the model group, both walking ability score and touch sensation score of the EA-GB 30 group were obviously increased （P〈0.01 ）, rather than in the EA-non-acupoint group. Out- comes of the ultrastructure showed that in the model group, extensive onion-like state of the myelin sheath of the sciatic nerve fi- bers, shrink or disappearance of the axon, kytoplasm edema or lysis of Schwann cells tending to necrosis, and mitochondrium vacuolization of the Schwann cells were found. In the EA-GB 30 group, majority of the nerve fibers and vascular endothelium were normal, with delamination and vacuolization of partial myelin sheath, edema of partial mitochondria and vacuolization of Schwann cells were found. In the EA-non-acupoint group, delamination and twist of partial myelin sheath, Schwann cellular plasma edema and mitochondrial edema of the axon with vacuolization change were found, suggesting a poorer effect of EA of non-acupoint.Conclusion EA-GB 30 can improve LIDP rabbits＇ walking ability and touch sensation function and reduce ultrastructure of sciatic nerve.