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黄芪桂枝五物汤预防椎板切除后硬膜外瘢痕粘连实验研究

The Experimental Methods of Huangqi Guizhi Wuwu Decoction in Preventing Post-Laminectomy Fibrosis and Adhesion

【作者】 靳铁成

【导师】 黄异飞;

【作者基本信息】 新疆医科大学 , 中西医结合临床, 2009, 硕士

【摘要】 目的:观察和评价内服黄芪桂枝五物汤对椎板切除模型动物硬膜外瘢痕粘连的干预作用效果,并探讨其作用机制。方法:36只成年雄性SD大鼠随机分为三组:A生理盐水组为实验条件对照组、B双氯芬酸钠组为阳性对照组和C黄芪桂枝五物汤组为实验组,行L1椎板切除术,造成0.3cm×0.8cm大小缺损,术后A组、B组和C组分别连续灌服生理盐水、双氯芬酸钠混悬液和黄芪桂枝五物汤4周后停药。分别于术后第4周和第8周分两批处死动物,每组每批随机抽取5只取术段脊椎进行大体观察评估瘢痕粘连韧度、HE染色光学切片组织学观察及测定瘢痕组织中羟脯氨酸(HOP)含量。结果:术后4周,A组大体及组织学观察结果评分差于B组和C组,有统计学意义(P<0.05),A组和B组羟脯氨酸含量高于C组,有统计学意义(P<0.05)。术后8周,A组和B组大体观察、组织学观察结果和羟脯氨酸含量与C组比较均有统计学意义(P<0.05),A组、B组和C组三组间羟脯氨酸含量比较均有统计学意义(P<0.05)。结论:黄芪桂枝五物汤可以减少大鼠椎板切除后硬膜外瘢痕组织中胶原含量,阻止硬膜外瘢痕粘连形成。其有效性可能是通过加速局部血肿及炎性物质的清除,抑制炎性细胞、成纤维细胞的增殖和增加椎板切除区椎体的稳定性等作用来实现。黄芪桂枝五物汤早期有预防大鼠椎板切除后硬膜外瘢痕粘连的作用。

【Abstract】 Objective:To study the effectiveness of Huangqi Guizhi Wuwu Decoction on preventing post-laminectomy fibrosis and adhesion. Methods:36 adult rats were divided randomly into three groups: Group Nacl (Group A), Group Diclofenac Sodium Enteric-coated Tablets (Group B), and Group Huangqi Guizhi Wuwu Decoction (Group C). All the rats were established as the experimental models undergoing L1 laminectomy with 0.3cm×0.8cm dura mater exposed. All laminectomy levels were treated with relative medicine for four weeks: At the 4th and 8th weeks after laminectomy, the samples were obtained for gross observation, histological examinations and to detecting the contents of hydroxyprdine. Results: At the 4th week, the gross observation and histological examinations in Group A were significantly higher than those in Group B and Group C(P<0.05), the contents of hydroxyprdine of Group A and Group B were significantly different than those of Group C(P<0.05). At the 8th week, all the indexes of Group A and Group B were significantly higher than those of Group C(P<0.05), the contents of hydroxyprdine of Group A , Group B and Group C were significantly different (P<0.05). Conclusions:The drugs of Huangqi Guizhi Wuwu Decoction could reduce scar formation, loosen fibroscar and inhibit the formation of adhesion in rats.

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