柔和手法对家兔骨骼肌慢性损伤修复过程中超微结构的影响

Effect of Gentle Manipulation on Ultrastructure of Rabbit Skeletal Muscle during Chronic Injury Repair

目的基于"手法以柔和为贵,筋喜柔不喜刚"的传统中医推拿理论,旨在研究"柔和手法"对家兔骨骼肌慢性损伤过程超微结构的影响,为临床上应用"柔和类手法"治疗慢性软组织损伤提供客观依据。方法选用40只健康成年家兔,30只家兔成功造模后,随机分为柔和手法治疗组、重刺激手法治疗组、模型组,余下10只为正常组。柔和手法治疗组采用大鱼际揉法和指摩法治疗;重刺激手法治疗组采用点按法和弹拨法治疗;模型组,不采取任何治疗;正常组,不做任何治疗。采用电镜观察家骨骼肌超微结构的变化。结果实验组,肌纤维,Z线结构基本正常、部分残体,肌丝排列整齐,肌节排列正常,线粒体正常,肌浆网正常,间质小血管正常;对照组:肌肌纤维,Z线结构模糊、部分扭曲,肌丝溶解,肌节轻度肿大、A带明显增宽,线粒体固缩,肌浆网显示扩张,间质小血管显示出血;模型组显示:肌纤维,Z线模糊、呈波浪排列、明显收缩,肌丝溶解;肌节轻度肿大,线粒体固缩,肌浆网扩张,间质小血管轻度淤血;正常组:肌纤维显示正常、Z线结构正常,肌丝排列整齐,肌节正常;线粒体正常,肌浆网正常,间质小血管轻度瘀血。结论 "柔和手法"在家兔慢性软组织损伤修复过程中能够明显改善骼肌超微结构的损伤变化,能够促进骨骼肌肌纤维排列更加整齐,肌节更加清晰,线粒体结构更加完整,促进损伤修复,疗效明显优于"重刺激手法"治疗组,揭示"柔和手法"治疗慢性软组织损伤的作用机制。

Objective：To study the effect of gentle manipulation on the ultrastructure of rabbit skeletal muscle during chronic injury process on the bases of traditional Chinese medicine theory of “softness is more expensive,tendon prefers softness to hardness”,and provides an objective basis for the treatment of chronic soft tissue injuries in clinic. Methods：40 healthy adult rabbits were selected. After successful modeling,30 rabbits were randomly divided into gentle manipulation treatment group,re-stimulation treatment group and model group. The remaining 10 rabbits were in normal group. The gentle manipulation treatment group was treated with thenar eminence method and finger pressing method,and the re-stimulation treatment group was treated with point pressing method and poking channels manipulation. The model group was given no treatment and the normal group was given no treatment. The ultrastructural changes of skeletal muscle were observed by electron microscopy. Results：In the experimental group,the muscle fiber and Z-line structure of the rabbits were basically normal,partially residual body and the myofilament was in alignment,with normal sarcomere arrangement,normal mitochondria,normal sarcoplasmic reticulum and normal interstitial small vessels. In the control group,the myofiber and Z-line structure were blurred,partially distorted,and the myofilament dissolved,with mild swelling of sarcomere,markedly widened A,mitochondrial pyknosis,dilatate sarcoplasmic reticulumm and bleeding interstitial small vessels. In the model group,the muscle fibers and Z-line were blurred,presenting wave arrangement,obvious contraction and myofilament dissolution,mild swelling of sarcomere,mitochondrial pyknosis,sarcoplasmic reticulum expansion,mild interstitial small blood vessels. In the normal group,the muscle fibers and Z-line structure were normal,myofilament in alignment,normal sarcomere,normal mitochondria and normal sarcoplasmic reticulum and the interstitial small blood vessels were mildly stasis. Conclusion：The gentle manipulation can significantly improve the damage of skeletal muscle ultrastructure during the repair of chronic soft tissue injury in rabbits and promote the skeletal muscle fiber arrangement neater,make sarcomere more clear and mitochondrial structure more complete,thus promoting damage repair. Its curative effect is significantly better than the re-stimulation treatment.