电针夹脊穴对压力诱导退变椎间盘纤维环的影响

Effect of electroacupuncture on Jiaji points(EX-B2)on pressure-induced degeneration of intervertebral disc annulus fibrosus

目的:探讨电针夹脊穴对压力诱导退变椎间盘纤维环形态结构的影响。方法:随机将20只成年雄性新西兰大白兔分为正常组、假手术组、模型组和电针组,每组5只。通过外置轴向加压器械诱导腰椎间盘退变(IVDD)模型,轴向加压28 d后使用MRI评估造模效果。电针组在造模成功后第1天开始电针双侧夹脊穴治疗28 d。电针干预结束后观察记录4组实验兔的精神状态、饮食、活动和对外界的刺激情况并评分;使用MRI观察各组椎间盘的信号强度并行Pfirrmann分级评估;采用HE染色和透射电镜比较4组椎间盘纤维环组织形态及亚细胞结构;采用免疫组化染色检测各组实验兔椎间盘纤维环细胞中的血小板反应蛋白解整合素金属肽酶-5(ADAMTS-5)抗体阳性表达。结果:与假手术组比较,模型组实验兔的综合反应评分降低(P<0.01),椎间盘信号消失,Pfirrmann分级明显升高,纤维环组织结构破坏,细胞排列紊乱,纤维软骨细胞增多,胶原纤维组织内的纤维细小,排列紊乱,纤维环细胞中ADAMTS-5抗体阳性表达明显增多(P<0.01);与模型组比较,电针组实验兔的综合反应评分升高(P<0.01),椎间盘信号改善,Pfirrmann分级降低,纤维环结构和胶原纤维形态改善,纤维环细胞中ADAMTS-5抗体阳性表达明显降低(P<0.01)。结论:轴向加压刺激能明显破坏纤维环细胞形态及组织结构,并引起纤维环细胞外基质的降解,而电针能在一定程度上改善退变的纤维环,进而延缓IVDD。

Objective:To observe the effect of electroacupuncture on Jiaji points(EX-B2)on the morphology and structure of the anulus fibrosus of intervertebral disc with pressure-induced degeneration.Methods:Twenty adult male New Zealand white rabbits were randomly divided into the control group,sham-operation group,model group and electroacupuncture group,5 rabbits in each group.Intervertebral disc degeneration(IVDD)model was induced by external axial compression instrument.After 28 days of axial compression,MRI was used to evaluate the effect of modeling.The electroacupuncture group started the treatment of bilateral Jiaji points(EX-B2)with electroacupuncture on the first day after the successful modeling,for 28 days in total.After the electroacupuncture intervention,the mental state,diet,activity and external stimulation of 4 groups of experimental rabbits were observed and scored.The signal intensity of intervertebral discs in each group was observed by MRI and evaluated by Pfirrmann grading.The tissue morphology and subcellular structure of the fibrous annulus of intervertebral disc were compared by HE staining and transmission electron microscopy.ADAMTS-5 antibody expression was detected by immunohistochemical staining in annulus fibrosus cells of intervertebral disc.Results:Compared with the sham-operation group,the comprehensive response score in the model group was decreased(P<0.01),the intervertebral disc signal was disappeared,Pfirrmann grade was significantly increased,the anulus fibrosus structure was destroyed,the cell arrangement was disordered,the fibrochondrocytes were increased,the fibers in the collagen fiber tissue were fine and disordered,and the positive expression of ADAMTS-5 antibody was significantly increased in annulus fibrosus cells(P<0.01).Compared with model group,the comprehensive response score in electroacupuncture group was increased(P<0.01),intervertebral disc signal was improved,Pfirrmann grade was decreased,annulus fibrous structure and collagen fiber morphology were improved,and the positive expression of ADAMTS-5 antibody in annulus fibrous cells was significantly decreased(P<0.01).Conclusions:Axial compression stimulation can obviously destroy the cell morphology and tissue structure of annulus fibrosus,and cause the degradation of extracellular matrix of annulus fibrosus,while electroacupuncture can improve the degeneration of annulus fibrosus to a certain extent,and then delay IVDD.