推拿改善坐骨神经损伤大鼠步行功能障碍的评价

Influence of Tuina manipulation on walking dysfunction in rats with sciatic nerve injury

背景:推拿手法治疗周围神经损伤疗效明确,但对相关步行功能的行为学疗效在基础研究中涉及较少。目的:探讨中医推拿手法对大鼠坐骨神经横断伤外膜缝合后步行功能改善的影响。方法:雄性SD大鼠24只,随机分为3组:推拿组、模型组、正常组,每组8只。推拿组和模型组大鼠建立坐骨神经横断伤外膜缝合模型,术后1周开始推拿组于术侧腓肠肌处采用小动物推拿手法模拟仪给予推拿捻揉手法干预,1次/d,模型组和正常组仅进行与推拿组相同的固定束缚,不进行其他干预。分别于干预后1,2,3,4个月,采用CatWalk小动物步态分析系统采集各组大鼠的步态数据,分析最大接触平均压力、最大接触面积、步周长和摆动速度。结果与结论:①由于神经损伤,造模后大鼠各个时间点最大接触平均压力、最大接触面积、步周长和摆动速度均显著低于正常组(P<0.05);②随着神经修复后再生,推拿组与模型组最大接触平均压力、最大接触面积、步周长和摆动速度均出现不同程度的恢复;③干预后2,3个月,推拿组最大接触面积显著低于模型组(P<0.05),干预后4个月,推拿组最大接触平均压力显著高于模型组(P<0.05);④干预后3,4个月,推拿组步周长、摆动速度显著高于模型组(P<0.05);⑤结果提示:推拿手法能够改善坐骨神经损伤大鼠步态功能障碍,促进患肢运动功能及整体协调性恢复。

BACKGROUND:Tuina manipulation has definite effects on peripheral nerve injury.However,the behavioral effect of walking function is less involved in basic research.OBJECTIVE:To explore the effect of Tuina manipulation on the improvement of motor function after adventitial suture of sciatic nerve transection in rats.METHODS:A total of 24 male Sprague-Dawley rats were randomly divided into three groups:Tuina group,model group and normal group,with 8 rats in each group.The rats in the Tuina group and model group were established with adventitial suture model of sciatic nerve transection injury.In the Tuina group,a small animal Tuina manipulation simulator was used at the gastrocnemius muscle on the operation side to give Tuina manipulation once a day.Rats in the model group and the normal group were only fixed and bound in the same way as those in the Tuina group,and no other intervention was performed.At 1,2,3 and 4 months after the intervention,the CatWalk small animal gait analysis system was used to collect gait data of rats in each group.Maximum contact mean intensity(MCMI),maximum contact area(MCA),stride length(SL)and swing speed(SS)were then analyzed.RESULTS AND CONCLUSION:Because of nerve injury,compared with the normal group,maximum contact mean intensity,maximum contact area,stride length and swing speed in the model and Tuina groups were significantly decreased at various time points after intervention(P<0.05).With regeneration after nerve repair,maximum contact mean intensity,maximum contact area,stride length and swing speed in the Tuina and model groups recovered to varying degrees.The maximum contact area in the Tuina group was significantly lower than that in the model group 2 and 3 months after intervention(P<0.05),while 4 months after intervention,the maximum contact mean intensity in the Tuina group was significantly higher than that in the model group(P<0.05).Stride length and swing speed in the Tuina group were significantly higher than those in the model group at 3 and 4 months after intervention(P<0.05).To conclude,Tuina manipulation can improve the gait dysfunction of rats with sciatic nerve injury and promote the recovery of motor function and overall coordination of the affected limb.