针刀疗法配合独活寄生汤对腰椎间盘突出症大鼠背根神经节炎症的干预效果

Intervention Effect of Acupotomy Therapy Combined with Duhuo Jisheng Decoction on Inflammation of Dorsal Root Ganglion in Rats with LDH

目的:探究针刀疗法配合独活寄生汤治疗腰椎间盘突出症大鼠的疗效及对背根神经节炎症的影响。方法:将70只SD大鼠随机分为假手术组、模型组、独活寄生汤组、针刀组及针刀联合独活寄生汤组,各14只。除假手术组外,其余各组大鼠均构建腰椎间盘突出症大鼠模型,假手术组以20μL生理盐水替代大鼠自体髓核混悬液,其他操作与模型组相同。建模3 d后独活寄生汤组灌胃13.8 mg/kg独活寄生汤,1次/d,连续灌胃2周;针刀组进行针刀疗法,3次/周,治疗2周;针刀联合独活寄生汤组灌胃13.8 mg/kg独活寄生汤并施以针刀疗法,干预2周;模型组及假手术组正常饲养。干预2周后以热痛测试仪检测并比较各组大鼠热痛刺激缩爪阈值;苏木精-伊红(HE)染色观察各组大鼠背根神经节组织病理学形态;酶联免疫吸附试验(ELISA)法及蛋白免疫印迹(WB)法检测并比较各组大鼠背根神经节组织炎性因子含量。结果:模型组干预前及干预2周后热痛刺激缩爪阈值均较假手术组缩短(P<0.05);与模型组及干预前比较,干预2周后独活寄生汤组、针刀组及针刀联合独活寄生汤组大鼠热痛刺激缩爪阈值均延长,且针刀联合独活寄生汤组长于独活寄生汤组、针刀组(P<0.05);模型组大鼠背根神经节组织IL-1、TNF-α含量及蛋白相对表达量较假手术组显著升高,而独活寄生汤组、针刀组及针刀联合独活寄生汤组较模型组显著降低,且针刀联合独活寄生汤组显著低于独活寄生汤组及针刀组(P<0.05)。结论:针刀疗法配合独活寄生汤可有效降低腰椎间盘突出症大鼠背根神经节组织炎性因子含量,改善其组织病变,进而明显提高大鼠热痛刺激缩爪阈值,减轻疼痛,具有明显的协同效应,治疗效果显著。

Objective:To explore the effect of acupotomy therapy combined with Duhuo Jisheng Decoction in the treatment of lumbar disc herniation(LDH)in rats and its influence to inflammation of dorsal root ganglion.Methods:70 SD rats were randomly divided into the sham-operation group,the model group,Duhuo Jisheng Decoction group(13.8 mg/kg),the acupotomy group(three times a week)and the combination group(acupotomy+Duhuo Jisheng Decoction),with 14 cases in each group.LDH model was established in all groups except the sham-operation group.Autologous nucleus pulposus mix suspension was replaced by 20μL normal saline in the sham-operation group.After two weeks of intervention,the thermal pain threshold was detected by thermal pain tester;pathology morphology of dorsal root ganglion tissue were observed by HE method;the contents of inflammatory cytokines of dorsal root ganglion tissue were detected by ELISA and Western blot methods.Results:Compared to the sham-operation group,the thermal pain threshold decreased in the model group after modeling(P<0.05);compared to the model group,the thermal pain threshold increased in Duhuo Jisheng Decoction group,the acupotomy group and the combination group after the interventions(P<0.05);of which the improvement in the combination group was most significant(P<0.05).In terms of the contents of IL-1 and TNF-αin dorsal root ganglion tissue,they were higher in the model group,after interventions,they were decreased in Duhuo Jisheng Decoction group,the acupotomy group and the combination group(P<0.05);the decreases in the combination group were most significant.Conclusion:Acupotomy therapy combined with Duhuo Jisheng Decoction can reduce the contents of inflammatory cytokines of dorsal root ganglion tissue in rats with LDH,improve the tissue lesions,enhance the thermal pain threshold and relieve pain,which has significant synergistic effect,the treatment effect is remarkable.