经皮穴位神经电刺激对兔胫骨骨缺损骨痂中降钙素基因相关肽的影响

Effects of Transcutaneous Electrical Nerve Stimulation on Calcitonin Gene Related Peptide on Rabbit Bone Defect of Tibia in Callus

目的:观察经皮穴位神经电刺激对兔胫骨骨缺损骨痂中降钙素基因相关肽(CGRP)表达的影响,探讨周围神经对胫骨骨缺损愈合的影响及其调控机制。方法:选用健康新西兰雄兔80只,随机分配为实验组及对照组,实验组行单侧胫骨近端骨缺损造模并给予足阳明胃经穴位足三里、解溪经皮神经电刺激,对照组行单侧胫骨近端骨缺损造模,穴位部粘贴电极片不予电刺激。分别在术后第1、2、3、4周在两组随机抽取10只实验动物,通过X线片及骨密度测定检测骨痂质量,应用免疫组化及HE染色测定CGRP在新生骨痂中的表达。结果:实验组术后1周骨痂中可见大量CGRP阳性神经纤维表达,集中分布于肉芽、骨膜及新生骨痂中。对照组骨痂中CGRP表达较少,明显低于实验组,且呈递减趋势。实验组骨痂生长及后期塑形迅速,对照组骨缺损局部骨痂生长较慢,后期编织骨成熟度低,骨痂成熟度、骨小梁排列及骨密度均不及实验组。结论:周围神经系统通过CGRP等神经肽物质在早期骨修复及后期骨痂塑形改建过程中发挥重要调节作用,经皮穴位神经电刺激可以通过调节CGRP等神经肽物质达到促进骨缺损愈合的作用。

Objective： To observe the effect of transcutaneous electric nerve stimulation of calcitonin gene related peptide on the expression of Calcitonin Gene Related Peptide （CGRP） in rabbit bone defect of tibia callus, to investigate the effect of peripheral nerve on the healing of bone defect of tibia and its regulation mechanism. Methods： The thirty healthy male New Zealand 80 rabbits, randomly assigned into experimental and control groups; the experimental group underwent unilateral proximal tibial bone defect model and receive transcutaneous electrical nerve stimulation in “＇Zusanli”（ST36） and ＂＇Jiexi＇（ST41）＂ of the Foot Yangming Meridian; the control group underwent unilateral proximal tibial bone defect model, the acupuncture point paste electrode without electrical stimulation. Respectively after operation first, 2ed, 3rd, 4th weeks in two groups were randomly selected from 10 experimental animal; determination of callus quality through the plate and bone mineral density; immunohistochemistry and HE staining was used to study the expression of CGRP in neonatal in callus. Results： In the experimental group, bone callus can be seen in a large number of CGRP positive nerve fibers expressions, concentrated in the granulation tissue, periosteum and bone callus in newborn, at the 1st weeks after operation. In the control group, CGRP expression was significantly lower than that of experimental group, and showed a decreasing trend. In the experimental group, the callus growth and later shaping quickly, while in the control group, bone defect of local bone callus grew slowly; later woven bone maturity is low; callus maturity, arrangement of the trabeculae and bone density of experimental group were less than experimental group. Conclusion： The peripheral nervous system play an important role in the early and late stage bone repair bone callus remodeling process by CGRP and other neuropeptides; transcutaneous electrical nerve stimulation can be achieved by adjusting the CGRP neuropeptide substance to promote bone defect healing.