粗针督脉平刺治疗缺血性面瘫大鼠的机制探讨

Exploration of the Mechanism of Treatment of Rat Ischemic Facial Paralysis by Transverse Insertion of Thick Needles into the Du Meridian

目的观察粗针督脉平刺对缺血性面瘫大鼠的治疗效果,初步探讨产生疗效的可能机制。方法将6 0只W i s t a r大鼠随机分为A组(粗针平刺组)、B组(基础西药组)、C组(空白对照组)和D组(假手术组),每组1 5只。所有大鼠均采用改良血管栓塞法建立缺血性面瘫模型。在治疗期间对各组大鼠进行面神经功能缺损评分,A组于造模后1 d选取神道穴平刺,留针4 h,每日1次,共治疗1 4 d;B组于造模后1 d予强的松灌胃、维生素B1 2腹腔注射治疗,每日1次,共治疗1 4 d;C组与D组不进行治疗。分别在造模后第3、7、1 4天随机选取4只,采用免疫组织化学法进行面神经伴行固有血管组织H I F-1α蛋白测定,酶联免疫吸附测定法检测血清N O,放射免疫法检测血清E T含量。结果治疗7 d后,A组和B组神经功能缺损评分逐渐升高,与同组造模后比较,差异均具有统计学意义(P<0.0 1)。A组和B组治疗7 d后神经功能缺损评分与C组和D组比较,差异均具有统计学意义(P<0.0 5)。C组治疗7 d后神经功能缺损评分与D组比较,差异具有统计学意义(P<0.0 5)。A组和B组治疗1 4 d后神经功能缺损评分与C组比较,差异均具有统计学意义(P<0.0 5)。B组和C组治疗1 4 d后神经功能缺损评分与D组比较,差异均具有统计学意义(P<0.0 5)。A组治疗1 4 d后神经功能缺损评分与同组治疗7 d后相比较,差异具有统计学意义(P<0.0 5)。A组、B组和C组治疗3、7、1 4 d后H I F-1αM O D值与D组比较,差异均具有统计学意义(P<0.0 1)。A组和B组治疗3、7 d后H I F-1αM O D值与C组比较,差异均具有统计学意义(P<0.0 5)。A组和B组治疗3、1 4 d后H I F-1αM O D值与同组治疗7 d后比较,差异均具有统计学意义(P<0.0 5)。A组和B组治疗3、7 d后血清N O含量与D组比较,差异均具有统计学意义(P<0.0 1)。A组和B组治疗7 d后血清N O含量与同组治疗3 d后比较,差异均具有统计学意义(P<0.0 5)。A组、B组和C组治疗3、7 d后血清E T含量与D组比较,差异均具有统计学意义(P<0.0 5)。A组和B组治疗7 d后血清E T含量与同组治疗3 d后比较,差异均具有统计学意义(P<0.0 5)。结论粗针督脉平刺能够有效促进缺血性面瘫大鼠的恢复,其产生疗效机制可能是通过调控组织H I F-1α的表达及血清N O、E T含量。

Objective To investigate the efficacy of transverse insertion of thick needles into the Du meridian in treating rat ischemic facial paralysis and preliminarily explore the possible mechanism by which it produces a therapeutic effect. Methods Sixty Wistar rats were randomly allocated to groups A （transverse insertion of thick needles）, B （basic Western drugs）, C （blank control） and D （sham operation）, 15 rats each. A rat model of ischemic facial paralysis was made using a modified vascular occlusion method in all the rats. Facial nerve deficits were scored in every group of rats during treatment. At 1 day after model making, group A was treated by transverse insertion into point Shendao and 4-hour retention of needle, once daily, for a total of 14 days; group B was treated by an oral gavage of prednisone and intraperitoneal injection of vitamine BI2, once daily, for a total of 14 days, Groups C and D were not treated. In 4 rats randomly chosen at 3, 7 or 14 days after model making, facial nerve concomitant intrinsic vascular tissue HIF-leprotein was measured by an immunohistochemical method; serum NO, by enzyme-linked immunosorbent assay; serum ET content, by radioimmunoassay. Results After 7 days of treatment, the neurological deficit score increased gradually in groups A and B and there was a statistically significant difference compared with after model making in the two groups （P〈0.01）. After 7 days of treatment, there was a statistically significant difference in the neurological deficit score in groups A and B compared with groups C and D （P〈0.05） and between groups C and D （P〈0.05）. After 14 days of treatment, there was a statistically significant difference in the neurological deficit score between group A or B and group C （P〈0.05） and between group B or C and group D （P〈0.05）. In group A, there was a statistically significant difference in the neurological deficit score after 14 days of treatment compared with after 7 days of treatment （P〈0.05）. After 3, 7 and 14 days of treatment, there was a statistically significant difference in HIF-1aMOD value in groups A, B and C compared with group D （P〈 0.01）. After 3 and 7 days of treatment, there was a statistically significant difference in HIF-1aMOD value between group A or B and group C （P〈0.05）. In groups A and B, there was a statistically significant difference in HIF-1aMOD value after 3 and 14 days of treatment comtared with after 7 days of treatment （P〈0.05）. After 3 and 7 days of treatment, there was a statisticallv significant difference in serum NO content between group A or B and group D （P〈0.01）. In groups A and B, there was a statistically significant difference in serum NO content after 7 days of treatment compared with after 3 days of treatment （P〈0.05）. After 3 and 7 days of treatment, there was a statistically significant difference in serum ET content in groups A, B and C compared with group D （P〈 0.05）. In groups A and B, there was a statistically significant difference in serum ET content after 7 days of treatment compared with after 3 days of treatment （P〈0.05）. Conclusions Transverse insertion of thick needles into the Du meridian can effectively promote rat＇s recovery from ischemic facial paralysis. The mechanism by which it produces a therapeutic effect may be regulating the expression of tissue HIF-1a and the NO and ET contents of serum.