【作者】 李汉率；

【导师】 艾炳蔚；

【作者基本信息】 南京中医药大学 ， 针灸推拿， 2011， 博士

【摘要】 目的：根据中医针灸基本理论,结合现代医学研究成果,通过手术建立腰椎间盘突出症大鼠模型,观察电针结合维药穴位外敷对腰椎间盘突出症模型大鼠神经根受压神经根局部组织的病理变化、血浆血栓素B2/前列环素F1α含量变化的影响。初步探讨电针结合维药穴位外敷法在治疗腰椎间盘突出症中的消炎和镇痛机制,为进一步的研究提供前期实验研究基础。方法：选取Sprague-Dawley(SD)大鼠60只,体重180～200g,雌雄各半。建立大鼠腰神经根受压模型,随机分为空白组、模型组、电针组、维药组和电针+维药组五组。每组12只,雌雄各半。治疗结束后,比较各组大鼠血浆血栓素B2/前列腺素PGFlα含量神经根组织的病理变化、及大鼠神经行为学的评分。结果：1.模型大鼠分别经电针、维药及电针+维药治疗后,其血浆TXB2水平和TXB2/PGFlα比值均明显降低(P<0.01),而PGFlα水平则升高(P<0.01),均呈现良性变化。与模型组相比较,无论是电针组、维药组还是电针+维药组,其P值均<0.01,结果具有显著性差异,说明三种疗法均有较好的效果；电针+维药组分别与电针组和维药组相比较,其P<0.05,具有显著性差异,但电针组和维药组比较P>0.05,说明两种疗法具有较好的协同作用。2.大鼠患肢神经行为学评分表明：实验大鼠患肢大体观评分与模型组相比较,无论是电针治疗组、维药治疗组还是电针+维药治疗组,均明显下降,其P值均<0.05,结果具有显著性差异,说明三种疗法均有较好的效果；电针+维药治疗组分别与单纯电针组和单纯维药组相比较,其P<0.05,差异具有显著性。病理观察结果表明：造模后大鼠受压神经根组织可见有神经间质轻度水肿,并有少许血管增多、单核炎细胞浸润及少量纤维组织增生,部分可见有神经萎缩；分别给予电针、维药、电针加维药外敷治疗后,其病变程度有所改善,评分均有下降。其中电针治疗组、维药治疗组、电针加维药治疗组与模型组相比均为P<0.01；三组的病变评分从低到高依次为：电针加维药组、电针组、维药组。结论：电针结合维药穴位外敷是临床治疗腰椎间盘突出症的有效方法；同时,该法能有效降低腰椎间盘突出症模型大鼠血浆TXB2含量,升高PGFlα,改善TXB2与PGFlα之比值。进而表明电针结合维药穴位外敷对腰椎间盘突出症模型大鼠有消炎及镇痛作用。更多还原

【Abstract】 Objective:The basic theory of traditional Chinese medicine combined with modern research results, through the establishment of lumbar disc herniation surgery rat model of drug-dimensional observation of acupuncture points combined with external application of lumbar disc herniation model of nerve root compression of nerve roots in the pathological changes of the local, thromboxane B2 (TXB2)/prostacyclin Flα(PGF1α)content changes. Preliminary study medicine acupuncture points combined with external application of law dimension in the treatment of lumbar disc herniation in the anti-inflammatory and analgesic mechanism for deeper study provides the basis of preliminary studies.Method:Select the Sprague-Dawley (SD) 60 rats, weighing 180～200g, male and female. Copy lumbar nerve root compression model in rats, divided into control group, model group, EA group, drug group and EA D + D drug group five. N=12, male and female. Treatment after the end of treatment were compared among groups of nerve roots in the pathological changes of plasma thromboxane B2/prostaglandin PGF1αnerve activity levels and behavior ratings.Result:1 Rats by EA, EA Garvey Victoria drugs and drug therapy, plasma TXB2 levels and TXB2/PGF1a ratios were significantly decreased (P <0.01), while the PGF1a level was elevated (P<0.01), showed a positive change. Compared with model group, both the EA group, Victoria EA+ drug group or drug group D, the P values were<0.01, significant difference in the results, indicating that the three treatments had good effect; EA + dimensional drug group were compared with the EA group and medication group D compared with the P<0.05, significant difference, but EA group and medication group D P> 0.05, two treatments that have good synergy2 Score of neurological behavior in rats showed that compared with the model group, both the EA group, Victoria EA + drug group or drug group dimension, the general view of experimental rat limb score was significantly decreased, the P values were<0.05, the results significant differences, indicating that three kinds of treatments have good results; EA + D drug group were compared with the EA group and medication group D compared with the P<0.05, significant difference.Pathological observations in rats after the modeling of nerve root compression of nerve tissue, see mild interstitial edema, a little more blood vessels, mononuclear inflammatory cell infiltration and a small amount of fibrous tissue proliferation, some of nerve atrophy; by EA, Victoria medicine, electricity IF acupuncture treatment, the lesions improved ratings have dropped, in which EA group, EA Garvey drug group and model group were P<0.01, lesion score three groups were from low to high power Garvey medicine acupuncture group, EA group, Victoria drug group.Conclusion:Electroacupuncture combined with acupoint-dimensional medicine is a topical treatment of lumbar disc herniation clinical effective method; same time, the method can effectively reduce the rat model of lumbar disc herniation. Then show that the method of lumbar disc herniation rats with anti-inflammatory and analgesic effect.更多还原