针刀松解对腰椎间盘突出症根性神经痛大鼠中枢与外周血CCK-8、5-HT的影响

Effect of Needle Knife Lysis on Nerve Center and Peripheral Blood CCK-8 and 5-HT in Rats with Radicular Neuralgia Caused by Lumbar Intervertebral Disc Herniation

目的探讨针刀松解对腰椎间盘突出症(LDH)根性神经痛SD大鼠中枢与外周血八肽胆囊收缩素(CCK-8)、5-羟色胺(5-HT)的影响及其作用机制。方法 40只SD大鼠随机分为假手术组、模型组、针刀组和电针组,每组10只,假手术组正常造模但不环扎神经根,模型组、针刀组、电针组参照陆志东非压迫性腰椎间盘髓核突出模型造模方法进行造模。在造模3 d后,假手术组正常饲养,针刀组给予针刀干预,每周1次,共3次;电针组进行电针干预,取环跳、委中,隔日治疗1次,每次20 min,1周治疗3次,共治疗3周。在实验过程中检测后肢热刺激缩爪的潜伏期,3周后检测各组大鼠下丘脑与外周血中CCK-8、5-HT含量的变化。结果模型组在术后第1周时开始出现热刺激痛觉过敏现象,与术前及假手术组比较差异有统计学意义(P<0.05);第3周时潜伏期缩短最明显,与术前及假手术组比较差异有统计学意义(P<0.01);针刀组、电针组大鼠在治疗第2周时开始出现热刺激痛觉过敏现象减轻,与模型组比较差异有统计学意义(P<0.01);假手术组大鼠在各时相点热刺激缩爪潜伏期差值与针刀组、电针组比较差异无统计学意义(P>0.05)。模型组下丘脑及血浆中CCK-8浓度明显高于假手术组(P<0.01);针刀组下丘脑及血浆中CCK-8浓度明显下降,与模型组比较差异有统计学意义(P<0.01),与假手术组比较差异无统计学意义(P>0.05);电针组下丘脑及血浆中CCK-8浓度亦有所下降,与模型组比较差异有统计学意义(P<0.05)。模型组下丘脑及血浆中5-HT浓度明显低于假手术组(P<0.01);针刀组下丘脑及血浆中5-HT浓度明显上升,与模型组比较差异有统计学意义(P<0.01),与假手术组比较差异无统计学意义(P>0.05);电针组下丘脑及血浆中5-HT浓度亦有所上升,与模型组比较差异有统计学意义(P<0.05)。结论针刀和电针均可降低LDH根性神经痛大鼠中枢与外周血CCK-8含量,提高5-HT的含量,但针刀效果比电针更为明显。

Objective To investigate the effect of needle knife lysis on nerve center and peripheral blood CCK-8 and 5-HT and its mechanism of action in rats with radicular neuralgia caused by lumbar intervertebral disc herniation(LDH).Method Forty SD rats were randomized to sham-operation,model,needle knife and elecroacupuncture groups,10 rats each.A model of non-compressive lumbar herniated nucleus pulposus was made by reference to Lu Zhidong’method in the model,needle knife and elecroacupuncture groups.The same model was made without circumferential nerve root ligation in the sham-operation group.After three days following model making,the sham-operation group was normally fed;the needle knife group received needle knife intervention,once a week for a total of three times;the elecroacupuncture group received elecroacupuncture at points Huantiao(GB30)and Weizhong(BL40)20 min,once every other day,three times a week for a total of three weeks.The paw withdrawal latency of the hind limb to thermal stimulus was measured during the experimental process.The CCK-8 and 5-HT contents of the hypothalamus and peripheral blood were measured in every group of rats after three weeks.Result Hyperalgesia to thermal stimulus began to appear in the model group at one week after operation and had a statistically significant difference compared with before operation and with the sham-operation group(P<0.05).The latency shortened most significantly at week three and had a statistically significant difference compared with before operation and with the sham-operation group(P<0.01).Hyperalgesia to thermal stimulus was reduced in the needle knife and elecroacupuncture groups of rats and had a statistically significant difference compared with the model group(P<0.01).The difference values of paw withdrawal latency between various time points had no statistically significant differences in the sham-operation group of rats compared with the needle knife and elecroacupuncture group(P>0.05).CCK-8 concentration in the hypothalamus and plasma was significantly higher in the model group than in the sham-operation group(P<0.01).CCK-8 concentration in the hypothalamus and plasma decreased significantly in the needle knife group and had a statistically significant difference compared with the model group(P<0.01)and no statistically significant difference compared with the sham-operation group(P>0.05).CCK-8 concentration in the hypothalamus and plasma also decreased somewhat in the elecroacupuncture group and had a statistically significant difference compared with the model group(P<0.05).5-HT concentration in the hypothalamus and plasma was significantly lower in the model group than in the sham-operation group(P<0.01).5-HT concentration in the hypothalamus and plasma increased significantly in the needle knife group and had a statistically significant difference compared with the model group(P<0.01)and no statistically significant difference compared with the sham-operation group(P>0.05).5-HT concentration in the hypothalamus and plasma also increased somewhat in the elecroacupuncture group and had a statistically significant difference compared with the model group(P<0.05).Conclusion Both needle knife therapy and elecroacupuncture can decrease the CCK-8 content of the nerve center and peripheral blood and increase the 5-HT content of them in rats with LDH radicular neuralgia,but the effect of needle knife therapy is even better than that of elecroacupuncture.