电针联合甲强龙对椎间盘脱出大鼠的有效性和安全性研究

Study on the efficacy and safety of electroacupuncture combined with methylprednisolone sodium succinate in rat models of intervertebral disc extrusion

目的观察电针联合甲强龙与单独使用电针或甲强龙对椎间盘脱出24 h后大鼠模型的肢体运动功能和神经细胞尼氏小体的影响,为临床合理应用提供依据。方法将112只SD大鼠随机分为假手术组(Sham)、模型组(Model)、预先电针联合甲强龙组(EA+MP)、电针组(EA)和甲强龙组(MP),采用自制硅胶垫片压迫法制备椎间盘脱出模型,各组分别进行处理,并在不同时间点进行BBB肢体运动功能评分或采集脊髓组织Nissl染色观察神经细胞尼氏小体的变化,以及副作用和死亡率。结果 1)BBB评分,各组在治疗后均呈上升趋势,EA+MP组在第3、7天时压迫侧后肢与EA组和MP组相比显著升高(P<0.05),第14天时各组均显著高于Model组(P<0.05),并与Sham组接近(P> 0.05)。(2)Nissl染色可见,与模型组相比各治疗组神经细胞损坏程度轻,尼氏小体数量多,其中EA+MP组优于其他两组。(3)副作用发生率,MP组为30%,EA+MP组为4.16%,EA组为0;死亡率,MP组为20%,EA+MP组和EA组为0。结论 3种治疗方案均可不同程度增加尼氏小体数量,维持神经细胞形态,改善椎间盘脱出24 h(超过甲强龙作用时间窗)大鼠的肢体运动功能。其中,EA+MP效果最佳,且显著降低了MP疗法的副作用和死亡率的发生,也优于单独EA的疗效。

Objective To observe the effects of electroacupuncture combined with methylprednisolone sodium succinate and electroacupuncture or methylprednisolone sodium succinate alone for intervertebral disc extrusion.The effects on the limb movement function and Nissl bodies of rat models after24h were analyzed,and the incidence of side effects in each group was analyzed to provide a basis for clinical application.Methods A total of112SD rats were randomly divided into sham operation group(Sham),model group(Model),electroacupuncture before methylprednisolone sodium succinate group(EA+MP),electroacupuncture group(EA),and methylprednisolone sodium succinate group(MP).The intervertebral disc extrusion model was prepared using a custom-made silicone gasket compression method.Each group was treated separately,and the BBB limb motor function score or Nissl staining of spinal cord tissue was observed at different time points to observe the changes of nerve cell Nissl bodies,as well as side effects and mortality.Results1)BBB scores showed an upward trend in all groups after treatment,while on the third day and seventh day in the EA+MP group,the average BBB scores of hindlimbs of the compression side were significantly higher than those of the EA group and the MP group(P<0.05).Moreover,on the14th day,each group was significantly higher than the Model group(P<0.05)and was close to the Sham group(P>0.05).(2)Nissl staining showed that,compared with the levels in the model group,the damage of nerve cells in each treatment group was mild,and the number of Nissl bodies was high.The average BBB scores of EA+MP group was superior to the other two groups in Nissl bodies protection.(3)The incidence of side effects was30%in the MP group,4.16%in the EA+MP group,and0%in the EA group.The mortality rate in the MP group was20%,while that in the EA+MP and EA groups was0%.Conclusions The three treatment regimens increase the number of Nissl bodies to varying degrees,maintaine neuronal cell morphology,and improved limb motor function in rats with intervertebral disc extrusion for24h(more than the time window for methylprednisolone sodium succinate).Among the regimens,EA+MP has the best effect,significantly reduce the side effects and mortality rate of MP therapy,and produce a better curative effect than EA alone.