电针改善前庭功能障碍所致颈性眩晕的实验研究

【作者】 李国臣；

【导师】 胡玲香；

【作者基本信息】 成都中医药大学 ， 针灸学， 2004， 硕士

【摘要】 目的 采用眼震诱发反应、测听术和直接前庭诱发电位(VsEPs)技术，探讨电针改善前庭功能障碍，治疗椎动脉型颈椎病所致颈性眩晕的机理。方法 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(vertebro-arterial cervical spondylosis，VCS)慢性椎-基底动脉供血不足(vertebrobasilar insufficiency,VBI)模型，对照组用生理盐水注射。电针组家兔作双侧“风池(GB20)”“听宫(SI19)”“外关(SJ5)”电针治疗后，分别测定3组左侧外耳道20℃水灌注刺激试验(caloric test)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(ABR)、左侧短声耳蜗电图(Electrocochleogram ECochG)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)较对照组延长(P＜0.05；P＜0.05)，电针组较模型组缩短(P＜0.05；P＜0.05)，电针组与对照组无显著差异(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、V1-V3波IPL、V2-V3波IPL较对照组延长(P＜0.01；P＜0.01；P＜0.05)，电针组V3波PL和V1-V3波IPL较模型组缩短(P＜0.05；P＜0.01)，电针组VsEPs与对照组无显著差异(P＞0.05)。模型组耳蜗电图-SP/AP值和眼震持续时间分别较对照组增高和缩短(P＜0.01；P＜0.01)，电针组分别较模型组降低和延长(P＜0.01；P＜0.05)，与对照组无显著差异(P＞0.05)。结论 慢性VBI时前庭神经和半规管功能容易严重受累，电针可改善神经元突触效能和前庭蜗神经通路传导，恢复前庭蜗器官功能，改善眩晕症状。更多还原

【Abstract】 Objective To investigate the mechanism of the electroacupuncture which is used to treat the cervicogenic vertigo caused by vertebro-arteiial cervical spondylosis by improving the vestibular dysfunction with the methods of the nystagmus elicited; audiometry and direct vestibular evoked potentials (VsEPs).Methods The rabbits in the model group and 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 vertebro-arterial cervical spondylosis (VCS) achieved by the stenosis in the left vertebral arteries and the lower blood flow in the basilar and bilateral vertebral arteries.The rabbits were injected Ns as the contrast group. Electroacupuncture of points at both sides of "Fengchi(GB20)" "Tinggong(SI19)" and"Waiguan(SJ5)" were administered to the rabbits in the electroacupuncture group .The animals allowed to be measured the duration of nystagmus by the caloric test -infusing 20 ℃ wiariito the external ear canal, the auditory brainstem response (ABR) induced by click at low(10Hz) and high (50Hz) stimulating rate ,the electrococheogram evoked by click, and the electro-stimulating vestibular evoked potentials(VsEPs) respectively from the left side of ears . and then the results are compared between electroacupuncture group , model group , and contrast groups. Results: The HI wave peak latency(PL) and the I-III wave interpeak latency(TPL) of ABR at 50Hz high stimulating rate in the model group became longer than those in the contrast group ( P<0.05;P<0.05) , compareing with model group, those in eclectroacupuncture group is shorter obviously (P<0.05 ;P<0.05) and there was no remarkable distinction between those in the electroacupuncture group and in the contrast group (P>0.05) .There was no significant difference of ABR at 10Hz low stimulating rate among three groups (P>0.05).The V3 wave PL, and V1-V3 V1-V3 wave IPL of VsEPs in the model group became longer than those in the contrast group (P<0.01; P<0.01; P<0.05) . The V3 wave PL and the V1-V3 wave IPL in the electroacupuncture group became shorter than those in the model group obviously (P<0.05; P<0.01). There was less difference between VsEPs in the electroacupuncture group and in the contrast group (P>0.05).The -SP/AP ratios of the electrococheogram and the duration of nystagmus in the model group increased and shortened more than those in the constrast group respectively ( P<0.01;P<0.01) ,and decreased and prolonged in the electroacupuncture group individually ( P<0.01; P<0.05 ) , and there was no obvious difference between those in the electroacupuncture group and in the contrast group(P>0.05). Conclusion: The function of the vestibular nerves including the semicircular canals is more severely affected than is the cochlear nerves , The electroacupuncture can improve the neure synapses efficiency of the brainstem and the conduction of the vestibulocochlear nerves path, recover the function of the vestibulocochlear organs, and improve cervical vertigo.更多还原