中枢神经可塑性在电针促进面神经损伤修复量效研究中的应用探讨

Application Study of CNS Plasticity in the Facial Nerve Repair Quantity-Effect Study Facilitated by Electro-Acupuncture Treatment

面神经损伤在临床上表现为面瘫,是针灸治疗的优势病种,电针治疗本病疗效确切,但刺激量不当易继发后遗症,给患者造成极大的身心负担。我们在前期完成的国家自然科学基金面上项目证实了电针可促进面神经损伤修复,但刺激量与效应不呈正相关。为什么不同刺激量会有不同的效应,其量效机制亟待深入研究。中枢神经可塑性在面神经损伤神经功能重建中发挥重要作用;最新研究发现神经突起因子neuritin与中枢神经可塑性密切相关,在面神经核中大量表达。本课题在前期研究的基础上,以面神经损伤兔为研究对象,从影响面神经功能重建的关键因素—中枢神经可塑性及neuritin入手,运用组织形态学、神经电生理、激光散斑、PCR以及Western Blot等方法技术,观察不同频率、疗程下电针刺激"地仓"、"颊车"、"翳风"、"合谷"对面神经功能重建的作用,拟揭示电针不同刺激量的量效机制,以期为电针治疗本病的临床应用提供坚实的理论依据。

The facial nerve injury is a dominant disease of acupuncture in the clinical manifestations of facial paralysis, and electro - acupuncture （EA） is an effective treatment for this disease, but improper stimulation amount is easy to secondary complication, which brings patients with significant physical and mental burden. The project of National Natural Science Foundation of China that we have done in the earlier stage has confirmed the EA can promote the repair of the facial nerve injury, but the amount of stimulation and its effect does not present positive correlation. Why the amount of different stimulations has different effects？ Its quantity - effect mechanism needs further study. CNS plasticity plays an important role in the reconstruction of the facial nerve injury. The latest study has found that neurite factor （neuritin） is closely related to the central nervous plasticity, abundantly manifested in the facial nucleus. On the basis of previous studies, by taking facial nerve injury rabbits as the study object and using the key factors of facial nerve function reconstruction, i.e. the central nervous system plasticity and neuritin, and through histomorphology, electroneurophysiology, laser speckle, PCR as well as Western Blot, the facial nerve function reconstruction of EA stimulation treatment at points of ＂Dicang＂, ＂Jiache＂, ＂Yifeng＂, and ＂Hegu＂ in different frequency courses were observed so as to reveal the quantity - effect mechanism of the different amount of stimulation by EA and provide a solid theoretical basis for the clinical application of EA treatment of this disease.