颈部推拿对兔颈动脉粥样硬化重度狭窄病变的血管拉伸力学特性的影响

Effects of cervical manipulation on carotid artery atherosclerosis with severe stenosis in tensile mechanical characterizations

目的探讨颈部推拿手法对兔颈动脉粥样硬化(CAS)重度狭窄的血管拉伸力学特性的影响。方法 45只新西兰兔随机分为颈椎旋转组(n=12)、推桥弓组(n=12)、模型对照组(n=12)和空白对照组(n=9),在颈椎旋转组、推桥弓组和模型对照组建立左侧CAS模型,并分别接受颈椎旋转手法、推桥弓手法干预3周,模型对照组和空白对照组不作手法干预。取左侧颈动脉进行单轴拉伸试验和病理观察,比较四组兔颈动脉的拉伸力学特性。结果 (1)26只兔造模成功,其中颈椎旋转组、推桥弓组、模型对照组兔颈动脉的最大载荷显著高于空白对照组,同时最大应变显著低于空白对照组(P<0.05);(2)颈椎旋转组兔颈动脉的弹性模量显著高于模型对照组、推桥弓组和空白对照组(P<0.05),而推桥弓组兔颈动脉的弹性模量与模型对照组相比差异无统计学意义(P>0.05)。结论动脉粥样硬化病变可致兔颈动脉血管拉伸力学特性下降,而颈部旋转推拿治疗可导致严重粥样硬化病变并重度狭窄的兔颈动脉弹性下降,为临床安全应用颈部推拿手法提供了参考。

Objective To explore the effects of cervical manipulation on carotid artery atherosclerosis with severe stenosis in tensile mechanical properties. Methods 45 healthy New Zealand white rabbits were divided into four groups randomly, including the Cervical Rotatory Manipulation（CRM） group（n=12）, the manipulation of Pushing On Qiaogong（MPQ） group（n=12）, the model control group（n=12） and the blank control group（n=9）. In the CRM, the model control and the MPQ groups, rabbits models of carotid artery atherosclerosis were generated by carotid artery balloon injury combined with a high-fat diet. Then,manipulation of Pushing On Qiaogong or Cervical Rotatory Manipulation was applied on these rabbits in the MPQ group or CRM group separately for 3 weeks. Histological analysis and uniaxial failure test were performed in four groups in the end. Results（1） A total of 26 rabbits in the CRM, the model control and the MPQ groups had some typical atherosclerotic changes in carotid arteries as detected by color Doppler ultrasonography.（2） Compared to the blank control group, carotid arteries of other three groups had lower level of ultimate strain but higher level of ultimate load and elastic modulus.（3） Young＇s modulus increased more significantly in the CRM group than the model control group. Conclusion The mechanical characteristics of the atherosclerotic rabbit artery decreased significantly than the normal artery. The cervical manipulation may decrease the tensile mechanical properties of the atherosclerotic rabbit carotid artery, which is valuable to explore the safety of cervical manipulation.