电针“后三里”结合四君子汤对奥沙利铂致周围神经病变大鼠坐骨神经传导速度及NGF的影响

Effects of Electro-Needling ST36 Combined with Sijunzi Decoction on Sciatic Nerve Conduction Velocity and NGF in Rats with OIPN

目的:观察电针“后三里”结合中药四君子汤对奥沙利铂致周围神经病变(OIPN)大鼠的坐骨神经传导速度及神经营养因子(NGF)的影响。方法:雄性SD大鼠随机分为空白组、模型组、电针组、中药组和针药结合组,每组各5只。采用腹腔注射奥沙利铂2 mg/kg诱导建立OIPN大鼠模型,进行机械缩足阈值测定确认造模成功。电针组予以电针双侧“后三里”、中药组予以四君子汤灌胃、针药结合组给予电针“后三里”结合四君子汤灌胃干预,1次/d,连续干预14 d。各组于干预第1、5、9与14天观察大鼠的机械性缩足阈值的变化;干预结束后,PowerLab数据采集分析系统检测坐骨神经传导速度,Western blot法检测坐骨神经NGF含量,HE染色观察背根神经节的形态学变化。结果:与空白组比较,模型组机械缩足阈值及坐骨神经传导速度均降低,差异具有统计学意义(P<0.01);与模型组比较,干预第14天电针组和针药结合组机械缩足阈值显著升高,差异具有统计学意义(P<0.05或P<0.01),电针组、中药组及针药结合组坐骨神经传导速度均升高,差异具有统计学意义(P<0.01)。与空白组比较,模型组坐骨神经NGF表达降低;与模型组比较,电针组、中药组和针药结合组大鼠坐骨神经内NGF蛋白表达均明显升高,差异具有统计学意义(P<0.01)。与空白组比较,模型组背根神经节大神经元直径减小,细胞核、核仁形态模糊,多见偏心核、多核仁;与模型组比较,电针组、中药组及针药结合组神经元内细胞核形态规则,仅少量偏心核、多核仁。结论:针药结合可提升坐骨神经传导速度及其NGF水平,减轻奥沙利铂蓄积于背根神经节的伤害,改善OIPN大鼠痛觉过敏症状。针药结合效果较电针和中药单独应用无明显优势。

Objective:To observe the effects of electro-needling Zusanli(ST36)combined with Sijunzi Decoction on sciatic nerve conduction velocity and nerve growth factor(NGF)in rats with oxaliplatin-induced peripheral neuropathy(OIPN).Methods:Male SD rats were randomly divided into the blank group,the model group,the electro-acupuncture(EA)group,the Chinese medication group and the combination group,with 5 rats in each group.The OIPN model was induced by intraperitoneal injection of Oxaliplatin(2 mg/kg),and the mechanical paw withdrawal threshold(MWT)was measured to confirm the successful modeling.The EA group was treated with electro-needling both ST36,the Chinese medication group was intervened with Sijunzi Decoction,and the combination group was treated with EA combined with Sijunzi Decoction,once per day for 14 days.The changes of mechanical paw withdrawal threshold were observed in each group on 1st,5th,9th and 14th days of the intervention.After the intervention,the sciatic nerve conduction velocity was detected by PowerLab data recording analysis system,the NGF content of sciatic nerve was detected by Western blot,and the morphological changes of dorsal root ganglion were observed by HE staining.Results:Compared with those in the blank group,the mechanical paw withdrawal threshold and the sciatic nerve conduction velocity were decreased in the model group(P<0.01).Compared with those in the model group,the mechanical paw withdrawal threshold was significantly increased in the EA group and the combination group(P<0.05,P<0.01),and the sciatic nerve conduction velocity was increased in the EA group,the Chinese medication group and the combination group after 14 days of intervention(P<0.01).Compared with that in the blank group,the expression of NGF in the sciatic nerve was reduced in the model group(P<0.01);compared with that in the model group,the expression of NGF in the sciatic nerve was significantly increased in the EA group,the Chinese medication group and the combination group(P<0.01).Compared with those in the blank group,the diameter of dorsal root ganglion neurons was reduced,the shape of nuclei and nucleoli was blurred,and more eccentric nuclei and multiple nucleoli were seen in the model group;compared with those in the model group,the nuclei in neurons were morphologically regular,with only a few eccentric nuclei and multiple nucleoli in the EA group,the Chinese medication group and the combination group.Conclusion:The combination of EA and Chinese medication can enhance the conduction velocity of sciatic nerve and the NGF level,reduce the injury of Oxaliplatin accumulation in dorsal root ganglion,and improve the symptoms of hyperalgesia in OIPN rats.There was no significant advantage in the effect of the combined treatment compared with single application of EA or Chinese medication.