电针改善前庭功能障碍所致颈源性眩晕的实验研究

Study of ameliorating effect of the electroacupuncture on the cervical vertigo caused by vestibular dysfunction

目的:采用眼震诱发反应、测听术和直接前庭诱发电位(vestibularevokedpoteutials,VsEPs)技术,探讨电针改善前庭功能障碍,治疗颈源性眩晕的机制。方法:48只家兔随机分为3组,每组16只。将组织硬化剂-775注射液注射至模型组和电针组家兔左侧颈椎横突软组织,造成左侧椎动脉狭窄、基底动脉及双侧椎动脉血流降低以建立椎动脉型颈椎病慢性椎-基底动脉供血不足(vertebrobasilarinsufficiency,VBI)模型,对照组作生理盐水注射。从注射后第6周开始,电针组家兔作双侧“风池(GB20)”、“听宫(SI19)”、“外关(SJ5)”穴电针治疗2周,分别测定左侧外耳道20℃水灌注冷刺激试验眼震持续时间、低刺激率(10Hz)和高刺激率(50Hz)左侧短声听性脑干反应(auditortbrainstemresponse,ABR)、左侧短声耳蜗电图和左侧电刺激前庭诱发电位(VsEPs),将3组结果进行比较。结果模型组50Hz高刺激率ABR的III波峰潜伏期(PL)和I-III波峰间潜伏期(IPL)犤(3.14±0.11)ms;(1.61±0.13)ms犦较对照组犤(2.88±0.27)ms;(1.40±0.12)ms犦延长(t=4.1772,P<0.05;t=5.5692,P<0.01),电针组犤(3.06±0.08)ms;(1.51±0.09)ms犦与对照组差异无显著性意义(t=2.7472;t=2.8442,P>0.05)。各组之间10Hz低刺激率ABR无显著改变(P>0.05)。模型组VsEPs的V3波PL。

AIM:To explore the mechanism of the electroacupuncture in improving the vestibular dysfunction to the cervical vertigo by nystagmus evoked response,audiometry and direct vestibular evoked potentials(VsEPs). METHODS:Forty eight rabbits were randomly divided into three groups of 16 in each group. The rabbits in the model group and the electroacupuncture group were injected tissue sclerosing remedy 775 injection into the soft tissue on the left side of cervical vertebral transverse processes to set up the chronic vertebrobasilar insufficiency(VBI) models of the vertebral artery type of cervical spondylosis achieved by the stenosis in the left vertebral arteries and the lower blood flow in the basilar and bilateral vertebral arteries.The rabbits in the control group were injected with saline.From the 6th week,electroacupuncture of points at“Fengch'ih(GB20)”“T'ingkung(SI19)”and“Waikuan(SJ5)”of both sides were administered to the rabbits in the electroacupuncture group lasting for 2 weeks.The rabbits were measured the duration of nystagmus by the caloric test infusing 20 ℃water into the external ear canal,the auditory brainstem response(ABR) induced by click at low(10 Hz) and high(50 Hz) stimulating rate, the electrocochleogram evoked by click,and the electro stimulating vestibular evoked potentials(VsEPs) respectively from the left side of ears.The results were compared among the three groups. RESULTS:The III wave peak latency(PL) and the I III wave interpeak latency(IPL) of ABR at 50 Hz high stimulating rate in the model group[(3.14±0.11)ms;(1.61±0.13)ms] became longer than those in the control group[(2.88±0.27)ms;(1.40±0.12)ms]t=4.177 2,P< 0.05;t=5.569 2,P< 0.01),and there were no remarkable differences between the electroacupuncture group[(3.06±0.08)ms;(1.51±0.09)ms] and the control group(t=2.747 2;t=2.844 2,P >0.05).There were no significant difference of ABR at 10 Hz low stimulating rate among the three groups (P >0.05).The V3 wave PL,the V2 V3 and V1 V3 wave IPL of VsEP in the model group[(5.00±0.46)ms;(1.89±0.63)ms; (3.21±0.49)ms]ecame longer than those in the control group[(3.81±0.69)ms;(1.07±0.50)ms;(2.12±0.40)ms](t=7.436 2,P<0.01;t=4.647 8,P< 0.05;t=7.730 1,P< 0.01).The V3 wave PL and the V1 V3 wave IPL in the electroacupuncture group[(4.24±0.45)ms;(2.53±0.46ms)] became shorter than those in the model group obviously(t=4.746 2,t=4.829 1,P< 0.01).There was no significant differences in VsEPs between the electroacupuncture group[including V2 V3 wave IPL:(1.10±0.24)ms] and the control group(t=2.329 5,t=1.763 1,t=2.512 3,P >0.05).The electrocochleogram SP/AP ratios and the duration of nystagmus in the model group increased and shortened significantly than those in the control group(t=6.471 5,t=5.405 7,P< 0.01),and decreased and prolonged in the electroacupuncture group respectively(t=4.937 2,t=4.095 0,P< 0.01),and there were no significant differences between the electroacupuncture group and the control group(t=1.534 3,t=1.449,P >0.05).There was an obvious correlation in the changes of the I IV wave IPL of ABR at 50Hz high stimulating rate and those of the V1 V3 wave IPL of VsEPs(r=0.528 8,P=0.007 9,F=8.539 0). CONCLUSION:The function of the vestibular nerves and the semicircular canals is easier affected severely,and the changes of ABR at high stimulating rate can reflect the function of the vestibular nerves indirectly.The electroacupuncture can improve the neuron synapses efficiency of the brain stem and the conduction of the vestibulocochlear nerves path,and recover the function of the vestibulocochlear organs.