【作者】 胡丙成；

【导师】 孙申田；

【作者基本信息】 黑龙江中医药大学 ， 针灸推拿学， 2004， 博士

【摘要】 针刺能促进周围神经(PN)损伤的再生和功能恢复，效果肯定，大量的临床和实验研究已经证实。导师孙申田教授通过多年的临床实践，在对针刺经颅运动诱发电位的研究以及头针治疗面神经损伤、面肌痉挛等研究的基础上，提出经颅重复针刺(以下简称头针)治疗周围神经损伤的新观点。为进一步证实头针促进周围神经损伤再生和功能恢复的作用，探讨其作用机制，并为头针治疗周围神经损伤的推广应用提供实验依据，我们进行了头针促进周围神经损伤再生和功能恢复的实验研究。本实验采用大鼠坐骨神经钳夹伤的周围神经损伤模型，分三个时间段(7d、14d、28d)，动态观察头针和头体针结合对大鼠坐骨神经损伤后神经再生和功能恢复的影响，从神经功能、电生理、形态学等方面对头针和头体针结合治疗周围神经损伤进行综合评价；并从对相应节段脊髓运动神经元GDNF、CNTF表达的影响和对运动神经元凋亡的影响方面，探讨头针的作用机制。研究结果表明：1、头针对大鼠坐骨神经损伤后的相应脊髓运动神经元具有一定的保护作用，可以促进损伤神经再生和功能恢复，头体针结合效果最佳。2、头针能提高坐骨神经损伤大鼠坐骨神经功能指数(SFI)的恢复率。3、头针能促进坐骨神经损伤大鼠运动神经传导速度(MNCV)的恢复。4、头针能提高坐骨神经损伤大鼠腓肠肌湿重的恢复率。5、头针能减轻大鼠坐骨神经损伤后神经和相应神经元肿胀、变性，减少神经元死亡，促进轴突再生。6、头针可以抑制坐骨神经损伤大鼠相应节段脊髓运动神经元GDNF、CNTF表达水平的降低，促进其恢复，从而保护相应神经元，促进神经再生。7、目前研究认为周围神经损伤后引起的神经元死亡其实质是凋亡，头针能抑制坐骨神经损伤诱导的脊髓运动神经元凋亡，从而对相应神经元起一定的保护作用。8、头针在周围神经损伤中的运用为周围神经损伤的治疗增添了一项新方法。更多还原

【Abstract】 Acupuncture can promote the regeneration, repair and functional recover of peripheral nerve(PN)injury, which have been testified by a great deal of clinic study and experimental study. Professor Sun Shentian observed in the course of long treatment that the effect of both scalp and body acupuncture on the patients of PN injury was significantly superior to only body acupuncture. To testify the role of scalp acupuncture, study its functional mechanism and supply the evidence for its wide use, we set up the model of PN injury by crushing the sciatic nerve in rat .We observed the effect of scalp acupuncture as well as both scalp and body acupuncture on the regeneration and functional rehabilitation of injured PN on 7d, 14d, 28d of operative intervals. We value the role of scalp acupuncture as well as both scalp and body acupuncture in nerve function, electrophysiological ,histology as so on. We study the effect of scalp acupuncture on expression of GDNF, CNTF in spinal motor neurons and neurons apoptosis after PN nerve injured. The results show: 1. scalp acupuncture can protect corresponding neurons after PN injury, can promote the regeneration, repair and functional recover of PN injury. 2. It can improve the SFI recovery of rat injured sciatic nerve. 3. It can faster nerve conductive velocity (MNCV) of injured sciatic nerve. 4. It can enhance the recovery rate of wet weight of gastnocnemius. 5. It can lessen the pale and degeneration of injured sciatic nerve and corresponding neurons, decrease the death of neurons, promote nerve regeneration. 6. It can restrain the expressing level CNTF, GDNF from declining in spinal motor neurons of rat injured sciatic nerve so as to protect the corresponding neurons and promote regeneration. 7. It’s accepted at present that the essence of motor neurons’ death is apoptosis after PN injured Head-acupuncture can restrain corresponding neurons of injured PN from apoptosis so as to have protective effect on the corresponding neurons.8.The utilization of scalp acupuncture in PN injure supplies a new therapy for the treatment of PN injure.更多还原