金腰带联合甲基强的松龙对脊髓损伤大鼠行为学及脑源性神经营养因子表达的影响

Effect of Gold Belt combined with methylprednisolone on motor function and brain-derived neurotrophic factor expression in rats following traumatic spinal cord injury

目的探讨金腰带和甲基强的松龙联合应用对脊髓损伤(SCI)大鼠的疗效及其对脑源性神经营养因子(BDNF)表达的影响,为临床治疗脊髓损伤提供理论依据。方法将雌性SD大鼠30只随机分为:(1)假手术组;(2)脊髓挫伤组;(3)甲基强的松龙治疗组(术后8 h内肌注50 mg/kg,此后每天甲基强的松龙肌注量减少10 mg/kg);(4)金腰带治疗组(50 mg/kg,每日1次灌胃);(5)金腰带和甲基强的松龙联合治疗组(两种药物及给药方法相加)。采用BBB评分系统对后肢运动功能进行评分。对大鼠脊髓损伤术后4周的脊髓切片进行BDNF免疫组化染色,观察阳性细胞定位、分布以及数量变化。用方差分析进行多个样本间比较。结果BDNF免疫反应阳性产物主要分布于脊髓灰质腹角和背角神经元。联合治疗组BDNF阳性神经元数量以及BBB评分分值较假手术组、脊髓挫伤组、甲基强的松龙治疗组和金腰带治疗组均显著增高,差异有统计学意义(P<0.05)。结论甲基强的松龙和金腰带联合治疗脊髓损伤的疗效优于单纯甲基强的松龙治疗组和金腰带治疗组,其发挥疗效可能与上调BDNF表达有关。

Objective To study the effects of a Gold Belt（GB, a traditional Chinese herbal medicine） combined with methylprednisolone（MP） on the motor function and brain-derived neurotrophic factor（BDNF） expression in rats with contusive spinal cord injury（SCI）. Methods Thirty adult female SD rats were randomly divided into 5 equal groups, namely the sham-operated group, SCI group, SCI with MP treatment group（MP group, with intramuscular injection of 50 mg/kg MP within 8 hours after SCI and then dosage reduced 10 mg/kg daily）, SCI with GB treatment group（GB group, with intragastric gavage of GB 50 mg/kg once daily for 7 days）, and combined GB and MP treatment group. The Basso, Beattie Bresnahan（BBB） locomotor scale was used to evaluate the hindlimb motor function of the rats on days 1, 3, 7, 14, 21 and 28 after the injury. After the last evaluation the rats were sacrificed for immunohistochemistry to observe the localization of BDNF in the ventral and dorsal horn of spinal cord. Results BDNF were distributed mainly in neurons in the spinal cord grey matter ventral horn and dorsal horn of the rats. The number of BDNF-positive neurons and BBB scores in the combined treatment group were significantly higher than those in the other 4 groups（P〈0.05）. Conclusion GB combined with MP produces better therapeutic effects for treating SCI than GB or MP used alone, and such effects are probably related with enhanced BDNF expression in the spinal cord.