推拿手法对家兔腰椎间盘突出症模型外周血超氧化物歧化酶、丙二醛、一氧化氮含量的影响
|
摘要
目的:研究推拿对腰椎间盘突出症神经根炎性损伤模型家兔血清中NO、SOD及MDA含量的影响,探讨推拿手法腰椎间盘突出症神经根炎性损伤的治疗作用及机理。
方法:普通级家兔24只,雌雄各半。所有动物随机分为3组,每组8只。手法治疗组、模型组、空白对照组。本实验采用蒋位庄采用的家兔腰椎间盘突出症造模方法复制家兔腰椎间盘突出症模型,并与术后7天伤口基本愈合后拆线。同时开始对治疗组进行推拿手法治疗,选用揉法、按法、点法。穴位选取环跳﹑腰夹脊穴。手法刺激以中等量刺激。用按揉法在腰夹脊穴操作5min,然后用点法在腰部两侧竖脊肌操作2～3min,最后按揉所选穴位,每只家兔每次治疗8～10min,每日1次。第24天采血后处死模型家兔,检测相应腰椎间盘突出模型家兔血清中NO、SOD及MDA含量,并与对照组和空白组作对比。
结果:模型组家兔血清中MDA、NO的含量增加,SOD含量减少;治疗组可明显降低SOD的含量增加,血清中MDA、NO含量减少,与模型组比较P<0.05。
Purpose: Research massage to radiculitis damage model domestic rabbit blood serum in NO, SOD and MDA content influence, discussion massage technique radiculitis damage therapeutic action and mechanism.
Method: Ordinary level domestic rabbit 24, are half and half female and male. All animals divide into 3 groups stochastically, each group of 8. Technique treatment group, model group, blank control group. This experiment uses the domestic rabbit waist intervertebral disc which Jiang Weizhuang uses prominently sickness to make the norm law duplication domestic rabbit waist intervertebral disc prominent sickness model, and after technique latter 7 day of wound basic cicatrization opens the line. Simultaneously starts to the treatment group to carry on the massage technique treatment, selects rubs the law, the pressing, the spot law. The acupuncture point selection HUANTIAO and YAOJIAJI. Technique stimulation by isometric stimulation. With according to rubs the law to clamp the keel hole in the waist to operate 5min, then sets upright the keel with a law in the waist both sides myo to operate 2~3min, finally presses rubs chooses the acupuncture point, each domestic rabbit each time treats 8~10min, daily 1 time. After the 24th day picks the blood, executes the model domestic rabbit, in the examination corresponding lumbar intervertebral disc herniation model domestic rabbit blood serum NO, SOD and the MDA content, and makes the contrast with the control group and the blank group.
Result: In the model group domestic rabbit blood serum MDA, the NO content increases, the SOD content reduces; The treatment group may reduce SOD the content to increase obviously, in the blood serum MDA, the NO content reduces, compares P <0.05with the model group
方法:普通级家兔24只,雌雄各半。所有动物随机分为3组,每组8只。手法治疗组、模型组、空白对照组。本实验采用蒋位庄采用的家兔腰椎间盘突出症造模方法复制家兔腰椎间盘突出症模型,并与术后7天伤口基本愈合后拆线。同时开始对治疗组进行推拿手法治疗,选用揉法、按法、点法。穴位选取环跳﹑腰夹脊穴。手法刺激以中等量刺激。用按揉法在腰夹脊穴操作5min,然后用点法在腰部两侧竖脊肌操作2～3min,最后按揉所选穴位,每只家兔每次治疗8～10min,每日1次。第24天采血后处死模型家兔,检测相应腰椎间盘突出模型家兔血清中NO、SOD及MDA含量,并与对照组和空白组作对比。
结果:模型组家兔血清中MDA、NO的含量增加,SOD含量减少;治疗组可明显降低SOD的含量增加,血清中MDA、NO含量减少,与模型组比较P<0.05。
Purpose: Research massage to radiculitis damage model domestic rabbit blood serum in NO, SOD and MDA content influence, discussion massage technique radiculitis damage therapeutic action and mechanism.
Method: Ordinary level domestic rabbit 24, are half and half female and male. All animals divide into 3 groups stochastically, each group of 8. Technique treatment group, model group, blank control group. This experiment uses the domestic rabbit waist intervertebral disc which Jiang Weizhuang uses prominently sickness to make the norm law duplication domestic rabbit waist intervertebral disc prominent sickness model, and after technique latter 7 day of wound basic cicatrization opens the line. Simultaneously starts to the treatment group to carry on the massage technique treatment, selects rubs the law, the pressing, the spot law. The acupuncture point selection HUANTIAO and YAOJIAJI. Technique stimulation by isometric stimulation. With according to rubs the law to clamp the keel hole in the waist to operate 5min, then sets upright the keel with a law in the waist both sides myo to operate 2~3min, finally presses rubs chooses the acupuncture point, each domestic rabbit each time treats 8~10min, daily 1 time. After the 24th day picks the blood, executes the model domestic rabbit, in the examination corresponding lumbar intervertebral disc herniation model domestic rabbit blood serum NO, SOD and the MDA content, and makes the contrast with the control group and the blank group.
Result: In the model group domestic rabbit blood serum MDA, the NO content increases, the SOD content reduces; The treatment group may reduce SOD the content to increase obviously, in the blood serum MDA, the NO content reduces, compares P <0.05with the model group
引文
[1]程英升,钟烽为.腰椎间盘退行性病变的影像学评价.国外医学临床放射学分册,1996, 19(4):194
[2]张顺财内毒素基础与临床北京科学出版社,2003;1 :128-129
[3]潘家祜江明华生化药理学复旦大学出版社2004年第一版:77-113
[4]温振杰等中医药综合疗法对腰椎间盘突出症患者血清SOD活性、NO含量的影响及相关临床研究2004河南中医学院学报[J]2004,19(112):24-31
[5]KutrykMJB,Maddaford TG,Ramjiawan B Oxidation of membrane cholesterol Alters active and passive transarcolenmmal calcium movement .Cire Res(J),1991,68:88.
[6]. Ladeco la C. Bright and dark sides of nitric oxide in ischemic brain injury[J]. TNS , 1997; 20 (3):132
[7].Lepoivre M , Flaman JM , Herry Y. Early loss of the tyrosyl radical in ribonucleo tide reductase of adenocar cells producing nit ric oxide [J]. Biolchem, 1992; 267:22994
[8].Freeman B. Free radical chemisty of nitric oxide [J]. Chest , 1994, 105:79
[9]万超等译突出腰椎间盘中一氧化氮的组织化学证明中国中医骨伤科杂志1998,(6)2:59-61
[10] Kawakami M,Hashizume H,et al.Yhe rule of phosphohpase A and nane oxide on pain-related behavior produced by an allografis of intervertebral disc meteral to the ecnaic nerve of the rat.[J].Spine,1997,22:1074
[11]Kokubun JG,Watson RW,Mclormack D,et a1.Intervertebral discs which cause low pain back secrete high levels of proinflammatory mediators.[J].J Bore Joint Surg Br,2002,84(2):196
[12]李升汉,推拿对血液动力学影响的实验研究,按摩与导引,1994; 3: 1
[13]费季翔,推拿对血浆及尿中单胺类物质含量改变的探讨,中国骨伤,1994(增刊下):91-93
[14]张建华,推拿牵引治疗腰椎间盘突出症疗效观察及血单胺类物质含量变化分析,中医正骨,1992; 4 (3 ): 11-14
[15]刘志诚,推拿牵引镇痛调整作用与5-经色胺等含量变化的研究,中西医结合杂志,1985; 5(10 ): 615-618
[16]姜宏,腰腿痛患者血浆B-EP的观察与致痛机理探讨,中国中医骨伤科,1990;6(3):6-8
[17]侯筱魁、董凡、戴克成等,斜扳时腰椎后部结构的动态观察和生物力学分析,中华骨科杂志,1993; 18: 51
[18]王希,直腿抬高手法治疗腰椎间盘突出症与影像学区域定位的相关性分析,中国中医骨伤杂志,2001; 1: 1
[19]伊志雄,实用中医脊柱病学,人民卫生出版社,2002,第1版:46
[20]王安民,推拿治疗机理探讨.中华现代中西医结合,2004,1(3):87
[21]张长江等,中医骨伤推拿手法,中医古籍出版社,1986;(9 ): 22
[22]易金根,张军,孙树椿.颈椎病推拿治疗前后的血液流变学变化,中医正骨, 1996;8(6):5-7
[23]桂寿清,罗德生,董加喜等.足部按摩治疗颈椎病对人体自由基的影响.中华理疗杂志,1998;21(2):92
[24]Vernon.HT.et al:J.Manipulative and physiological therapeutics,l986; 9:115
[25]姜宏等.手法治疗颈肩腰腿痛的神经生理学基础.上海中医药杂志,1991; (12):32
[26]姜宏等.推拿镇痛的神经机理研究与假说.中国康复,1990;(1):44
[27]彭裕文.《局部解剖学》,人民卫生出版社,第五版:121
[1]. Luoma K, Riihimaki H, Luukkonen R, et al. Low back pain in relation to lumbar disc degeneration. Spine, 2000, 25:487-492.
[2] Lotz JC,Chin JR.Intervertebral disc cell death is dependent on the magnitude andduration of spinal loading [J].Spine,2000,25(12):1477~1483
[3] Lotz JC,Colliou OK,Chin JR et al. Generation of nitric oxide by lapine meniscal cells and its effect on matrix metabolism:stimulation of collagen production by arginine. Spine,1998;23(23):2493一2506
[4]. Tuyuda T,Seedhonn BB,Kirlcbam J,et al. Upregulation of a grecan and type II collagen mRNA expression in bovine clondrocytes by the applicalion of hydrostatic pressure [J] Biorheology , 2003 , 40 (1-3):79-85.
[5]彭宝淦,施祀,沈培芝,等.软骨终板钙化于椎间盘退变关系的实验研究.中华外科杂志,1999, 37( 8) : 613- 615 [6 ]Hutton WC,Toribatake Y,Elmer WA,et al.The effect of compressive force applied to the intervertebral disc invivo[J].Spine,1998,23:2524-2537
[7] Liu GZ, Ishihara H, OsadaR, et al. Nitric Oxide,mediates the changes of proLeoglycan synthesis in the human lumbar intervertebral disc in response to hydrostatic pressure Spine, 2001, 26:134- 141
[8]陈立,詹红生,应航,等.异常应力环境下兔须椎软骨终板蛋白聚糖变化的实验研究.中国矫形外科杂志,2003,11(2):110- 112
[9]陈立,詹红生,应航,等.长时间异常应力负荷下兔须椎间盘的组织病理学观察.中国骨伤,2003, 16( 6):374- 375
[10]Boos N ,Weissbach S Rohroach H, et al Classification of age-relatedchanges in lumbar intervertebral discs 2002 Volvo Award in basic science[J]. Spine, 2002, 27: 2631-2644
[11] Ishihara H, Urban JP. Effects of low oxygen concentrations and metabolic inhibitors on proteoglycan and protein synthesis rates in the intervertebral disc [J]. J Orthop Res 1999,17:829-835
[12] Uroan JP. The role of the physicochem ical environment in deteminingdisc cell behaviors [J]. Biochem Soc Trans 2002, 24 858-864.
[13] Melrose J,Ghosh P.Development of an avidin-biotin competitive inhibition assay and validation of its use for the quantitation of human intervertebral disc serine proteinase inhibitoryproteins[J].Anal Bilchem,1992,204(4):372
[14] Fujita K, Nakagawa T .Hirahayashi K, et al. Neutral proteinases in human intervertebra ldisc[J].Spine,1993, 18(13):1766
[15] Andrews JL,Melrose J ,Ghosh P. A comparative study of the low-molecular mass serine proteinase inhibitors of human connective tissues [J].Biol Chem Hoppc Seyler, 1992,373(2):111
[16]. Sedowofia KA,Tomlinson IW,Weiss JB,et al.Collagenolytic enzyme systems inhuman intervertebral disc: their control, mechanism,and their possible role in theinitiation of biomechanical failure.Spine.1982 May-Jun;7(3):213-222.
[17]. Trout JJ,Buckwalter JA,Moore KC,et a1.Ultrastructure of human intervertebral disc j .Changes in notocordal cells with age.Tissue and Ce11.1982;14(2):359-369.
[18] Gruber HE,Hanley EN Jr.Analysis of aging and degeneration of the human intervertebral disc. Comparison of surgicalwith normal controls.Spine.1998 Apr 1;23(7):751-757.
[19] .Lotz J.C, Chin J.R, Intervertebral Disc Cell Death Is Dependent on the Magnitude and Duration of Spinal Loading. Spine 2002 25(12) 1477-1483
[20] .Kohyama K,Saura R,Doita M,et a1.Intervertebral disc cell apoptosis by nitricoxide:biological understanding of intervertebral disc degeneration.Kobe J MedSci.2000 Dec;46(6):283-295.
[21] Steraner G,Studnrcka一Benke A,Witmana G,et al. Soluble receptors for the tumor necrosis factor and interleukine-2 in serium and synovial fluid ofpatient with rheumayoid arthritis reactive arthritis and osteoarthritis [J]. Rheumatal. 1995 , 22(3):406一412
[22] Kang D J,Rack,S M,Mcltyre L A,et al . Toward a biochemical understanding of human intervertebral disc degeneration and herniation. Spine. 1997 ;22(10):1065一1073
[23] Takahashi H. A mechanism for sciatic pain caused by lumbar disc hermiation involvement of inflammation cytokines with sciatic pain [J].Nippon Seikeigela Gakkai Zasshi. 1995,69(1):17-29.
[24] Kanemoto M,Hukuda S,Komiya Y,et al. Immunohistochemical study of matrix metaaloproteinase-3 and tissue inhibitor of metalloproteinase-1 in hu-man intervertebral discs.Spine,1996;21(1):1-8
[25]Habtemariam A,Gronblad M,Virri J,et al. Immunocytochemical localization of immunoglobulins in disc herniations. Spine 1996;21(16):1864-1869.
[26] OlmarkerK, Larsson K Tumornecrosis factor alpha and nucleus-pulposus-induced nerve root injury Spine, 1998 23: 2538-2544
[27] Redford EI Hall SM, Smith KJ Vascularchanges and demyelination induced bythe intraneural injection of tumour necrosis factor Brain 1995, 118 : 869- 878
[28] Murakami S Lefebvre V de Crombrugghe B. Potent inhibition of the masterchondrogenic factorSox9 gene by interleukin-1 and tumor necrosis factor-alpha J Biol Chem, 2000 275: 3687-3692
[29] Hirotaka H , Tsuyoshi K , Hiromichi K , et al. Vascular endothelial growthfactor(VEGF)-induced angiogenesis in herniated disc resorption.[J] Orthop Res. 2002 ,20(3);409一415
[24] HashizumE H,Kkawakami K,Nishi H,et al. Histochemical demonstrationof nitric oxide in herniated lumbar discs:a cllincal and animal model study. Spine,1997;22(10):1080-1084.
[31] Kchyarna K,Sauna R,Dwta M,et al. Intervertebral disc cell apoptosis by ni-tric oxide:biological understanding of intervertebral disc degeneration. [J],Kobe. Med Sci 2000;46; 283-295.
[32] Liu GZ,Ishihara H,Osada R,et al. Nitric oxide mediates the change of pro-teoglycan synthesis in the human lumbar intervertebral disc in response to hy-drostatic pressure [J] .spine,200 1,2(2):134-141.
[33]Kang D J,Racic S M,Mclntyre L A,et al. Toward a biochemical under- standing of human intervertebral disc degeneration and herniation. Spine. 1997;22(10):1065-1073.
[34] Penington BJ, Mclarron FR, Laros SG. Identification of IgG in the canine intervertebral disc[J].Spine, 1988, 13 (8):909一912
[35] Spiliopou I,Kprpressis P, Konstantinou D, et al. IgG and IgM concentration in the prolapsed human intervertebral disc and sciaticaetiology[J}.Spine, 1994, 19 (12):1320-1323
[36]杜豫,吴晓玲.退变椎间盘组织中IgG表达及其意义.第二军医大学学报[J], 2000, 21(7):12-13
[37] Kirita T, Takebayashi T, Mizuno S, et al. Electrophys iologic changes in dorsal root ganglion neurons and behavioral changes in a lumbar radiculopathy model. Spine 2007; 32(2): 65-72
[38] Haque R, Winfree CJ . Spinal nerve root s timulation. Neurosurg Focus 2006; 21(6): E4
[39]Igarashi T, Yabuki S, Kikuchi S, et al. Effect of acute nerve root compression on endoneurial fluid pressure and blood flow in rat dorsal root ganglia. J Orthop Res 2005; 23(2): 420-424
[40] Arai I, Mao GP, Otani K. Indomethacin blocks the nucleus pulposus -induced effects on nerve root function. An experimental s tudy in dogs with assessment of nerve conduction and blood flow following experimental disc herniation. Eur Spine J 2004; 13(8): 691-694
[41].Yi XN, Zheng LF, Zhang JW, et al. Dynamic changes in Robo2 and Slit1 expres sion in adult rat dorsal root ganglion and sciatic nerve after peripheral and central axonal injury. Neurosci Res 2006; 56(3): 314-321
[42].Osamura N, Ikeda K, Ito T, et al. Induction of interleukin-6 in dors al root ganglion neurons after gradual elongation of rat sciatic nerve. Exp Neurol 2005; 195(1): 61-67
[43].郑杰,杨米雄,裴君,等.慢性卡压对大鼠坐骨神经影响的实验研究[J].中国比较医学杂志, 2004, 14(4): 200-204
[44].Ginanneschi F, Cervelli C, Milani P, et al. Ventral and dors al root injury after oxygen-ozone therapy for lumbar disk herniation. Surg Neurol 2006; 66(6): 619-620
[45].罗才贵等大鼠炎性神经根髓鞘形态学变化及复方中药栓剂对神经根损伤的修复中国组织工程研究与临床康复杂志[J] 2007,11(19)3748-3751
[47]Boden SD,Davis DO,Dina TS,etal.Abnormal magnetic resonance scans of the lumbar spine:in asymptomatic subjects.J Bone Joint Surg,1990,72:403—405;
[48]Spencer DL.Mechanisms of nerve root compression clue to a herniated disc the lumber Spine.phiadelphia:W.B.Saunders Co,1990.141.
[49]Murphy,RW Nerve roots and sponal nerve in degenera tive disk disease.Clin Orthop,1997,129:41;
[50]侯树勋,等.髓核突出类型与腰腿痛严重程度的比较研究.解放军医学杂志.1993,18:348;
[51] Gertzbein SD.Auto immunity in degenerative disc disease of the lumbar spine.Orthop Clim N Am,1995,6:67;
[52]awakami M,Weinstein JN,chatani K,et al.Experimental lumbar radiculopathy:behavioral and histologic changes in a model of radicular pain after spinal nerve root irrtation with chronic gut ligatures in the rat.Spine,1994,19:1795—1802;
[53].Saal JS,Frason RC,Dobrow R.High level ofinflammatory phospholipase:an activity in lumbar disc herniations,spine,1990,15:674;
[54].Lewis A.Interleukin activates phospholipase A2 in rabbit condrocytes.J Inmmunol,1996,136:1283;
[55].吴闻文,侯树勋.腰椎间盘组织中磷脂酶A2活性水平与神经根性疼痛的关系.中国脊柱脊髓杂志,1996,6﹙1﹚:2—6;
[56].Olmarker K,Rydevik B,Nordborg C.Autologous nucleus pulposus induces neurophysiologic and histologic changes in porcine cauda equina nerve roots.spine,1993,18:1425—1432;
[57].Takahashi H,Suguro T,Okazima Y,et al.Inflammatory cytokines in the hemiated disc of the lumbar spine.Spine,1996,21:218—224;
[58].Bgrod G rydevik B,Nordborg C.etal Early effects of of nuclus pulposus application on Spinal nerve root morphology and function,Eur Spine J.1998,7﹙6﹚:445—449;
[59].Marshall LL,Trerhnie ER,Curtain CC,chemical radiculitis: a clihical,physiologyical study.cliu Orthop.1994,129:61;
[60].Smyth,MJ.Wright V . Sciantca the intervertebral.disc.An experimental Study.J Bone Joint Surg 1958,40A:1401;
[61]Young WF.Transient blindness after lumbar epidural steroid injectiin:a case report and literature review.Spine 2002 Nov 1;27(21):E176-7
[62].Gertzbein SD. Auto immunity in degenerative disc.disease of the lumbar spine. Orthop clim N Am, 1975,6:67;
[63]彭宝淦等﹙译自Spine Vol 20(3):271﹚施杞﹙校﹚。突出椎间盘组织血管内的碱性纤维组织细胞生长因子的免疫反应性。中国中医骨伤科.1996;4﹙3﹚.
[64]. Klara PM, Ray CD. Atificial nucleus replacement: clinical experience. Spine, 2002,27:1374-1377.
[65] Schoenmayr R,Lotz,C,Lotz-MetzG,etal.The implantation of a Hydrogel disc nucleus prosthesis in degeneration lumbar disc disease:Early experiences with 10 patients.Proceedings of the International Therapy Society,tenth Annual Meeting,Naples,FL, 1997;34-41
[66]. Matsuzaki H, Wakabayashi K, Ishihara K, et al. Allografting intervertebral discs in dogs: a possible clinical application. Spine, 1996, 21:178-183.
[67]Nishimura K, Mochida J. Percutaneous reinsertion of the nucleus pulposus: an experimental study. Spine, 1998;23:1531-8;discussion 1539.
[68] Okuma M, Mochida J, Nishimura K, et aL J Orthop Res, 2000;18(6):988 - 997
[69] Nomura T, Mochida 1, Okuma M, et al. Clin Orthop. 2001;389;94-101
[70]冯天有,赵平,梁国跃,等.腰椎管内突出髓核的临床意义探讨[J].中国中西医结合杂志,2000,20(5):347.
[71] BaladuniC,DelucaGC,PassiA,etal.The effect of oxygen and lactate concentration on keratan sulfate and chodroitin sulfate biosynthesis in bovine cornea.Bioche mica Biophysica Acta,1992,1115:187
[72]陈小刚.伸膝抬腿手法为主治疗腰椎间盘突出症119例[J].广西中医药,1994,17(4):17.
[73]井夫杰.手法对实验性退变兔颈软骨终板超微结构的影响.中医正骨[J]2006, 18(5):327-328.
[74]王安民.推拿治疗机理探讨.中华现代中西医结合,2004,1(3):87
[75]丁原全.推拿与活血化瘀.《按摩与导引》,1996,6:29
[76]Antoniou .J,Gousouian NM, Halthfield TF, et al. The human lum bar endplate:.Spine, 1996, 21, 1153-1161
[77]陈立应航詹红生井夫杰推拿手法对兔颈椎终板蛋白多糖变化的影响,浙江中医学院学报[J]2004, 28(2):54-55
[78]姜宏等,穴位指压推拿治疗腰腿痛的镇痛疗效观察与研究颈腰痛杂志,1994;(1):9-11
[79]张建华,孙安达推拿牵引治疗腰椎间盘突出症前后血单胺类物质含最变化分析.中国骨伤,1999;9(12):47-48
[80]费季翔.陆千珍,刘志诚,等从血浆与尿中儿茶酚胺和它的代谢产物含量说明排拿的镇痛作用.颈腰痛杂志,1994;15(4):199-200
1.ParkeWW,etal.Arterial vaseulalization of the eaudaequina,J Bone Joint Surg(Am) 1981;63:53
2.Parke WW , etal.The intrinsic vaseulature of the lumbascral spinal nerve roots.Spine 1985:10:508
3.Rauschning W.Computed tomography and cryomicrotomy of lumbar specimens:a new technique for multiplanar anatomic correlation.Spine,1983,8:170;
4.Stoclieck Ls,Beel JA,Luttges MW.Structural properties of spinal nerve root:protein composition.Exp Neural,1986,91:41;
5.Paker ww,Watanabe R.The intrinsic vasculature of the lumbosacral spinal nerve roots.Spine,1985,10:508;
6.Patterson CAV,olsson Y.Blood supply of spinal nerve roots:an experimental study in the rat.Acta Neuropathol,1989,78:455;
7.Hasue M,Kunogi J,Konnos,et al,classification by position of dorsa root ganglia in the lumbosacral region.Spine,1989,14:126;
8.Boden SD,Davis DO,Dina TS,etal.Abnormal magnetic resonance scans of the lumbar spine:in asymptomatic subjects.J Bone Joint Surg,1990,72:403—405;
9.Spencer DL.Mechanisms of nerve root compression clue to a herniated disc the lumber Spine.phiadelphia:W.B.Saunders Co,1990pp.141.
10.Murphy,RW Nerve roots and sponal nerve in degenera tive disk disease.Clin Orthop,1997,129:41;
11.侯树勋,等.髓核突出类型与腰腿痛严重程度的比较研究.解放军医学杂志.1993,18:348;
12. Gertzbein SD.Auto immunity in degenerative disc disease of the lumbar spine.Orthop Clim N Am,1995,6:67;
13.awakami M,Weinstein JN,chatani K,et al.Experimental lumbar radiculopathy:behavioral and histologic changes in a model of radicular pain after spinal nerve root irrtation with chronic gut ligatures in the rat.Spine,1994,19:1795—1802;
14.Saal JS,Frason RC,Dobrow R.High level ofinflammatory phospholipase:an activity in lumbar disc herniations,spine,1990,15:674;
15.Lewis A.Interleukin activates phospholipase A2 in rabbit condrocytes.J Inmmunol,1996,136:1283;
16.吴闻文,侯树勋.腰椎间盘组织中磷脂酶A2活性水平与神经根性疼痛的关系.中国脊柱脊髓杂志,1996,6﹙1﹚:2—6;
17.Olmarker K,Rydevik B,Nordborg C.Autologous nucleus pulposus induces neurophysiologic and histologic changes in porcine cauda equina nerve roots.spine,1993,18:1425—1432;
18.Takahashi H,Suguro T,Okazima Y,et al.Inflammatory cytokines in the hemiated disc of the lumbar spine.Spine,1996,21:218—224;
19.Bgrod G rydevik B,Nordborg C.etal Early effects of of nuclus pulposus application on Spinal nerve root morphology and function,Eur Spine J.1998,7﹙6﹚:445—449;
20.Marshall LL,Trerhnie ER,Curtain CC,chemical radiculitis:a clihical,physiologyicalstudy.cliu Orthop.1994,129:61;
21Smyth,MJ.Wright V . Sciantca the intervertebral.disc.An experimental Study.J Bone Joint Surg 1958,40A:1401;
22Gertzbein SD. Auto immunity in degenerative disc.disease of the lumbar spine. Orthop clim N Am, 1975,6:67;
23.彭宝淦等﹙译自Spine Vol 20﹝3﹞:271﹚施杞﹙校﹚。突出椎间盘组织血管内的碱性纤维组织细胞生长因子的免疫反应性。中国中医骨伤科.1996.4﹙3﹚.
24.张显松等.腰椎旋转手法治疗腰椎间盘突出症的机理〔J〕.中医正骨,1993;5﹙3﹚:5;
25.姜宏等,穴位指压推拿治疗腰腿痛的镇痛疗效观察与研究颈腰痛杂志,1994;(1):9-11
26.张建华,孙安达推拿牵引治疗腰椎间盘突出症前后血单胺类物质含最变化分析.中国骨伤,1999;9(12):47– 48
27.费季翔.陆千珍,刘志诚,等从血浆与尿中儿茶酚胺和它的代谢产物含量说明排拿的镇痛作用.颈腰痛杂志,1994:15(4):199-200
28.冯天友,中西医结合治疗软组织损伤〔M〕,北京,人民卫生出版社
29.李智斌,丹镁注射液治疗腰椎间盘突出症机理研究〔A〕,现代中医药.2002.6.
30.郭明阳严清明冯太升,壮督活血通络法治疗腰椎间盘突出症35例,成都中医药大学学报,2001,4(2):55一56;
31.王拥军沈培芝石印玉等,逐痰通络汤对腰椎间盘突出模型的利水消炎作用,中医正骨,1999,11(6):326一328;
32.左玉潭等,腰康胶囊治疗60例腰椎间盘突出症疗效观察,中国中医骨伤科杂志,2002,10(2):45一46;
33.哇承志等,脊痛消胶囊治疗腰椎间盘突出症临床观察,中医正骨,1998,1O(3):7—9;
34.艾进伟黄昌林张建福等,腰腿痛胶囊对腰椎间盘突出症大鼠炎性细胞的影响,中医正骨,2003,15(8):455—458;
35.王军,复方南星止痛膏治疗腰椎间盘突出症50例.中国中医药科技.2004.11﹝1﹞.
36.鲍杰韦坚韦贵康,中药热熨治疗血疲型腰椎间盘突出症疗效观察及对其血液流变学的影响,中医正骨,2002,4(11):7—8;
37.李沛等,腰突定痛贴配合推拿治疗腰椎间盘突出症105例,山东中医杂志,2001,20(4):222—223;
38.蒋松鹤等,蛇鳖软膏灸治疗腰椎间盘突出症临床观察及机理探讨,中国针灸,1999,19(2):46—47;
39.张世明支满霞苗艳玲,脉络宁硬膜外注射治疗腰椎间盘突出症临床观察及初步动物实验,中国骨伤,1995,8(5):15;
40.韩志邦王勤来,硬膜外注射复方当归液治疗腰腿痛,中华麻醉学杂志,1989,9(3):185;
41.张文田张中英刘新元等,神经根松解注射治疗腰椎间盘突出症的临床观察,颈腰痛杂志,2002,23(1):48—49;
42.韩金华侯斌裴福刚,脉络宁硬膜外腔滴注治疗腰椎间盘突出症46例,沈阳医学院学报,1999,1(2):85—86;
43.朱长俊徐银秀等,神经根注射皮质类固醇治疗腰腿痛病例分析,颈腰痛杂志,2002,23(4):317—318;
44.邓运明吴友平杨伟民等,硬膜外封闭加传统手法治疗腰椎间盘突出症288例小结,江西中医学院学报,1998,10(1):9;
45.张社会岳志季曹红,硬膜外腔注药中配伍咪安定治疗慢性腰腿痛,颈腰痛杂志,2001;22(4):19;
46.程伟支满霞,硬膜外腔注射脉络宁对腰椎间盘突出症患者脑脊液中P物质的影响,中国骨伤,2001,14(2):97—98;
47.付建峰倪家骧宋子贤等,腰椎旁经椎间孔硬膜外腔注药治疗腰椎间盘突出症的研究,中国疼痛医学杂志,1998,4(3):148—153;
48.吴兴杰张灵邓庆芝,脊痛舒治疗腰椎间盘突出症的实验研究,中国正骨,1997,9(6):3—5;
49.张伟国等,甲基强地松龙局部浸润对脊神经根炎性损伤后影响的实验研究,中国临床药理学与治疗学,2001,6(1):28—30;
50.沈霖高兰谢晶等,鹿丹通督片对大鼠实验性腰神经根炎的影响,中国正骨,2000,12(3):3—6;
51.张军孙树椿,中药对模拟颈神经炎大鼠血浆前列腺素E2作用的放免测定观察,中国骨伤,2000,13(5):273—275;
52.佐藤二郎,硬膜透过い关する研究,麻醉,1986,25(6):917;
53.新树敦,硬膜外モネ注入关する研究,麻醉,1984,33(1):2;
54.孙锦年,硬膜外腔注射地塞米松引起精神障碍2例报道,颈腰痛杂志,1987, 18(1):72;
55.Ishikawa H, Nohara Y, Miyanti S. action of chondroitinase ABC on eqidurally transplanted nucleus pulposus in the tabbit〔J〕. Spine ,199924:﹙15﹚.
[2]张顺财内毒素基础与临床北京科学出版社,2003;1 :128-129
[3]潘家祜江明华生化药理学复旦大学出版社2004年第一版:77-113
[4]温振杰等中医药综合疗法对腰椎间盘突出症患者血清SOD活性、NO含量的影响及相关临床研究2004河南中医学院学报[J]2004,19(112):24-31
[5]KutrykMJB,Maddaford TG,Ramjiawan B Oxidation of membrane cholesterol Alters active and passive transarcolenmmal calcium movement .Cire Res(J),1991,68:88.
[6]. Ladeco la C. Bright and dark sides of nitric oxide in ischemic brain injury[J]. TNS , 1997; 20 (3):132
[7].Lepoivre M , Flaman JM , Herry Y. Early loss of the tyrosyl radical in ribonucleo tide reductase of adenocar cells producing nit ric oxide [J]. Biolchem, 1992; 267:22994
[8].Freeman B. Free radical chemisty of nitric oxide [J]. Chest , 1994, 105:79
[9]万超等译突出腰椎间盘中一氧化氮的组织化学证明中国中医骨伤科杂志1998,(6)2:59-61
[10] Kawakami M,Hashizume H,et al.Yhe rule of phosphohpase A and nane oxide on pain-related behavior produced by an allografis of intervertebral disc meteral to the ecnaic nerve of the rat.[J].Spine,1997,22:1074
[11]Kokubun JG,Watson RW,Mclormack D,et a1.Intervertebral discs which cause low pain back secrete high levels of proinflammatory mediators.[J].J Bore Joint Surg Br,2002,84(2):196
[12]李升汉,推拿对血液动力学影响的实验研究,按摩与导引,1994; 3: 1
[13]费季翔,推拿对血浆及尿中单胺类物质含量改变的探讨,中国骨伤,1994(增刊下):91-93
[14]张建华,推拿牵引治疗腰椎间盘突出症疗效观察及血单胺类物质含量变化分析,中医正骨,1992; 4 (3 ): 11-14
[15]刘志诚,推拿牵引镇痛调整作用与5-经色胺等含量变化的研究,中西医结合杂志,1985; 5(10 ): 615-618
[16]姜宏,腰腿痛患者血浆B-EP的观察与致痛机理探讨,中国中医骨伤科,1990;6(3):6-8
[17]侯筱魁、董凡、戴克成等,斜扳时腰椎后部结构的动态观察和生物力学分析,中华骨科杂志,1993; 18: 51
[18]王希,直腿抬高手法治疗腰椎间盘突出症与影像学区域定位的相关性分析,中国中医骨伤杂志,2001; 1: 1
[19]伊志雄,实用中医脊柱病学,人民卫生出版社,2002,第1版:46
[20]王安民,推拿治疗机理探讨.中华现代中西医结合,2004,1(3):87
[21]张长江等,中医骨伤推拿手法,中医古籍出版社,1986;(9 ): 22
[22]易金根,张军,孙树椿.颈椎病推拿治疗前后的血液流变学变化,中医正骨, 1996;8(6):5-7
[23]桂寿清,罗德生,董加喜等.足部按摩治疗颈椎病对人体自由基的影响.中华理疗杂志,1998;21(2):92
[24]Vernon.HT.et al:J.Manipulative and physiological therapeutics,l986; 9:115
[25]姜宏等.手法治疗颈肩腰腿痛的神经生理学基础.上海中医药杂志,1991; (12):32
[26]姜宏等.推拿镇痛的神经机理研究与假说.中国康复,1990;(1):44
[27]彭裕文.《局部解剖学》,人民卫生出版社,第五版:121
[1]. Luoma K, Riihimaki H, Luukkonen R, et al. Low back pain in relation to lumbar disc degeneration. Spine, 2000, 25:487-492.
[2] Lotz JC,Chin JR.Intervertebral disc cell death is dependent on the magnitude andduration of spinal loading [J].Spine,2000,25(12):1477~1483
[3] Lotz JC,Colliou OK,Chin JR et al. Generation of nitric oxide by lapine meniscal cells and its effect on matrix metabolism:stimulation of collagen production by arginine. Spine,1998;23(23):2493一2506
[4]. Tuyuda T,Seedhonn BB,Kirlcbam J,et al. Upregulation of a grecan and type II collagen mRNA expression in bovine clondrocytes by the applicalion of hydrostatic pressure [J] Biorheology , 2003 , 40 (1-3):79-85.
[5]彭宝淦,施祀,沈培芝,等.软骨终板钙化于椎间盘退变关系的实验研究.中华外科杂志,1999, 37( 8) : 613- 615 [6 ]Hutton WC,Toribatake Y,Elmer WA,et al.The effect of compressive force applied to the intervertebral disc invivo[J].Spine,1998,23:2524-2537
[7] Liu GZ, Ishihara H, OsadaR, et al. Nitric Oxide,mediates the changes of proLeoglycan synthesis in the human lumbar intervertebral disc in response to hydrostatic pressure Spine, 2001, 26:134- 141
[8]陈立,詹红生,应航,等.异常应力环境下兔须椎软骨终板蛋白聚糖变化的实验研究.中国矫形外科杂志,2003,11(2):110- 112
[9]陈立,詹红生,应航,等.长时间异常应力负荷下兔须椎间盘的组织病理学观察.中国骨伤,2003, 16( 6):374- 375
[10]Boos N ,Weissbach S Rohroach H, et al Classification of age-relatedchanges in lumbar intervertebral discs 2002 Volvo Award in basic science[J]. Spine, 2002, 27: 2631-2644
[11] Ishihara H, Urban JP. Effects of low oxygen concentrations and metabolic inhibitors on proteoglycan and protein synthesis rates in the intervertebral disc [J]. J Orthop Res 1999,17:829-835
[12] Uroan JP. The role of the physicochem ical environment in deteminingdisc cell behaviors [J]. Biochem Soc Trans 2002, 24 858-864.
[13] Melrose J,Ghosh P.Development of an avidin-biotin competitive inhibition assay and validation of its use for the quantitation of human intervertebral disc serine proteinase inhibitoryproteins[J].Anal Bilchem,1992,204(4):372
[14] Fujita K, Nakagawa T .Hirahayashi K, et al. Neutral proteinases in human intervertebra ldisc[J].Spine,1993, 18(13):1766
[15] Andrews JL,Melrose J ,Ghosh P. A comparative study of the low-molecular mass serine proteinase inhibitors of human connective tissues [J].Biol Chem Hoppc Seyler, 1992,373(2):111
[16]. Sedowofia KA,Tomlinson IW,Weiss JB,et al.Collagenolytic enzyme systems inhuman intervertebral disc: their control, mechanism,and their possible role in theinitiation of biomechanical failure.Spine.1982 May-Jun;7(3):213-222.
[17]. Trout JJ,Buckwalter JA,Moore KC,et a1.Ultrastructure of human intervertebral disc j .Changes in notocordal cells with age.Tissue and Ce11.1982;14(2):359-369.
[18] Gruber HE,Hanley EN Jr.Analysis of aging and degeneration of the human intervertebral disc. Comparison of surgicalwith normal controls.Spine.1998 Apr 1;23(7):751-757.
[19] .Lotz J.C, Chin J.R, Intervertebral Disc Cell Death Is Dependent on the Magnitude and Duration of Spinal Loading. Spine 2002 25(12) 1477-1483
[20] .Kohyama K,Saura R,Doita M,et a1.Intervertebral disc cell apoptosis by nitricoxide:biological understanding of intervertebral disc degeneration.Kobe J MedSci.2000 Dec;46(6):283-295.
[21] Steraner G,Studnrcka一Benke A,Witmana G,et al. Soluble receptors for the tumor necrosis factor and interleukine-2 in serium and synovial fluid ofpatient with rheumayoid arthritis reactive arthritis and osteoarthritis [J]. Rheumatal. 1995 , 22(3):406一412
[22] Kang D J,Rack,S M,Mcltyre L A,et al . Toward a biochemical understanding of human intervertebral disc degeneration and herniation. Spine. 1997 ;22(10):1065一1073
[23] Takahashi H. A mechanism for sciatic pain caused by lumbar disc hermiation involvement of inflammation cytokines with sciatic pain [J].Nippon Seikeigela Gakkai Zasshi. 1995,69(1):17-29.
[24] Kanemoto M,Hukuda S,Komiya Y,et al. Immunohistochemical study of matrix metaaloproteinase-3 and tissue inhibitor of metalloproteinase-1 in hu-man intervertebral discs.Spine,1996;21(1):1-8
[25]Habtemariam A,Gronblad M,Virri J,et al. Immunocytochemical localization of immunoglobulins in disc herniations. Spine 1996;21(16):1864-1869.
[26] OlmarkerK, Larsson K Tumornecrosis factor alpha and nucleus-pulposus-induced nerve root injury Spine, 1998 23: 2538-2544
[27] Redford EI Hall SM, Smith KJ Vascularchanges and demyelination induced bythe intraneural injection of tumour necrosis factor Brain 1995, 118 : 869- 878
[28] Murakami S Lefebvre V de Crombrugghe B. Potent inhibition of the masterchondrogenic factorSox9 gene by interleukin-1 and tumor necrosis factor-alpha J Biol Chem, 2000 275: 3687-3692
[29] Hirotaka H , Tsuyoshi K , Hiromichi K , et al. Vascular endothelial growthfactor(VEGF)-induced angiogenesis in herniated disc resorption.[J] Orthop Res. 2002 ,20(3);409一415
[24] HashizumE H,Kkawakami K,Nishi H,et al. Histochemical demonstrationof nitric oxide in herniated lumbar discs:a cllincal and animal model study. Spine,1997;22(10):1080-1084.
[31] Kchyarna K,Sauna R,Dwta M,et al. Intervertebral disc cell apoptosis by ni-tric oxide:biological understanding of intervertebral disc degeneration. [J],Kobe. Med Sci 2000;46; 283-295.
[32] Liu GZ,Ishihara H,Osada R,et al. Nitric oxide mediates the change of pro-teoglycan synthesis in the human lumbar intervertebral disc in response to hy-drostatic pressure [J] .spine,200 1,2(2):134-141.
[33]Kang D J,Racic S M,Mclntyre L A,et al. Toward a biochemical under- standing of human intervertebral disc degeneration and herniation. Spine. 1997;22(10):1065-1073.
[34] Penington BJ, Mclarron FR, Laros SG. Identification of IgG in the canine intervertebral disc[J].Spine, 1988, 13 (8):909一912
[35] Spiliopou I,Kprpressis P, Konstantinou D, et al. IgG and IgM concentration in the prolapsed human intervertebral disc and sciaticaetiology[J}.Spine, 1994, 19 (12):1320-1323
[36]杜豫,吴晓玲.退变椎间盘组织中IgG表达及其意义.第二军医大学学报[J], 2000, 21(7):12-13
[37] Kirita T, Takebayashi T, Mizuno S, et al. Electrophys iologic changes in dorsal root ganglion neurons and behavioral changes in a lumbar radiculopathy model. Spine 2007; 32(2): 65-72
[38] Haque R, Winfree CJ . Spinal nerve root s timulation. Neurosurg Focus 2006; 21(6): E4
[39]Igarashi T, Yabuki S, Kikuchi S, et al. Effect of acute nerve root compression on endoneurial fluid pressure and blood flow in rat dorsal root ganglia. J Orthop Res 2005; 23(2): 420-424
[40] Arai I, Mao GP, Otani K. Indomethacin blocks the nucleus pulposus -induced effects on nerve root function. An experimental s tudy in dogs with assessment of nerve conduction and blood flow following experimental disc herniation. Eur Spine J 2004; 13(8): 691-694
[41].Yi XN, Zheng LF, Zhang JW, et al. Dynamic changes in Robo2 and Slit1 expres sion in adult rat dorsal root ganglion and sciatic nerve after peripheral and central axonal injury. Neurosci Res 2006; 56(3): 314-321
[42].Osamura N, Ikeda K, Ito T, et al. Induction of interleukin-6 in dors al root ganglion neurons after gradual elongation of rat sciatic nerve. Exp Neurol 2005; 195(1): 61-67
[43].郑杰,杨米雄,裴君,等.慢性卡压对大鼠坐骨神经影响的实验研究[J].中国比较医学杂志, 2004, 14(4): 200-204
[44].Ginanneschi F, Cervelli C, Milani P, et al. Ventral and dors al root injury after oxygen-ozone therapy for lumbar disk herniation. Surg Neurol 2006; 66(6): 619-620
[45].罗才贵等大鼠炎性神经根髓鞘形态学变化及复方中药栓剂对神经根损伤的修复中国组织工程研究与临床康复杂志[J] 2007,11(19)3748-3751
[47]Boden SD,Davis DO,Dina TS,etal.Abnormal magnetic resonance scans of the lumbar spine:in asymptomatic subjects.J Bone Joint Surg,1990,72:403—405;
[48]Spencer DL.Mechanisms of nerve root compression clue to a herniated disc the lumber Spine.phiadelphia:W.B.Saunders Co,1990.141.
[49]Murphy,RW Nerve roots and sponal nerve in degenera tive disk disease.Clin Orthop,1997,129:41;
[50]侯树勋,等.髓核突出类型与腰腿痛严重程度的比较研究.解放军医学杂志.1993,18:348;
[51] Gertzbein SD.Auto immunity in degenerative disc disease of the lumbar spine.Orthop Clim N Am,1995,6:67;
[52]awakami M,Weinstein JN,chatani K,et al.Experimental lumbar radiculopathy:behavioral and histologic changes in a model of radicular pain after spinal nerve root irrtation with chronic gut ligatures in the rat.Spine,1994,19:1795—1802;
[53].Saal JS,Frason RC,Dobrow R.High level ofinflammatory phospholipase:an activity in lumbar disc herniations,spine,1990,15:674;
[54].Lewis A.Interleukin activates phospholipase A2 in rabbit condrocytes.J Inmmunol,1996,136:1283;
[55].吴闻文,侯树勋.腰椎间盘组织中磷脂酶A2活性水平与神经根性疼痛的关系.中国脊柱脊髓杂志,1996,6﹙1﹚:2—6;
[56].Olmarker K,Rydevik B,Nordborg C.Autologous nucleus pulposus induces neurophysiologic and histologic changes in porcine cauda equina nerve roots.spine,1993,18:1425—1432;
[57].Takahashi H,Suguro T,Okazima Y,et al.Inflammatory cytokines in the hemiated disc of the lumbar spine.Spine,1996,21:218—224;
[58].Bgrod G rydevik B,Nordborg C.etal Early effects of of nuclus pulposus application on Spinal nerve root morphology and function,Eur Spine J.1998,7﹙6﹚:445—449;
[59].Marshall LL,Trerhnie ER,Curtain CC,chemical radiculitis: a clihical,physiologyical study.cliu Orthop.1994,129:61;
[60].Smyth,MJ.Wright V . Sciantca the intervertebral.disc.An experimental Study.J Bone Joint Surg 1958,40A:1401;
[61]Young WF.Transient blindness after lumbar epidural steroid injectiin:a case report and literature review.Spine 2002 Nov 1;27(21):E176-7
[62].Gertzbein SD. Auto immunity in degenerative disc.disease of the lumbar spine. Orthop clim N Am, 1975,6:67;
[63]彭宝淦等﹙译自Spine Vol 20(3):271﹚施杞﹙校﹚。突出椎间盘组织血管内的碱性纤维组织细胞生长因子的免疫反应性。中国中医骨伤科.1996;4﹙3﹚.
[64]. Klara PM, Ray CD. Atificial nucleus replacement: clinical experience. Spine, 2002,27:1374-1377.
[65] Schoenmayr R,Lotz,C,Lotz-MetzG,etal.The implantation of a Hydrogel disc nucleus prosthesis in degeneration lumbar disc disease:Early experiences with 10 patients.Proceedings of the International Therapy Society,tenth Annual Meeting,Naples,FL, 1997;34-41
[66]. Matsuzaki H, Wakabayashi K, Ishihara K, et al. Allografting intervertebral discs in dogs: a possible clinical application. Spine, 1996, 21:178-183.
[67]Nishimura K, Mochida J. Percutaneous reinsertion of the nucleus pulposus: an experimental study. Spine, 1998;23:1531-8;discussion 1539.
[68] Okuma M, Mochida J, Nishimura K, et aL J Orthop Res, 2000;18(6):988 - 997
[69] Nomura T, Mochida 1, Okuma M, et al. Clin Orthop. 2001;389;94-101
[70]冯天有,赵平,梁国跃,等.腰椎管内突出髓核的临床意义探讨[J].中国中西医结合杂志,2000,20(5):347.
[71] BaladuniC,DelucaGC,PassiA,etal.The effect of oxygen and lactate concentration on keratan sulfate and chodroitin sulfate biosynthesis in bovine cornea.Bioche mica Biophysica Acta,1992,1115:187
[72]陈小刚.伸膝抬腿手法为主治疗腰椎间盘突出症119例[J].广西中医药,1994,17(4):17.
[73]井夫杰.手法对实验性退变兔颈软骨终板超微结构的影响.中医正骨[J]2006, 18(5):327-328.
[74]王安民.推拿治疗机理探讨.中华现代中西医结合,2004,1(3):87
[75]丁原全.推拿与活血化瘀.《按摩与导引》,1996,6:29
[76]Antoniou .J,Gousouian NM, Halthfield TF, et al. The human lum bar endplate:.Spine, 1996, 21, 1153-1161
[77]陈立应航詹红生井夫杰推拿手法对兔颈椎终板蛋白多糖变化的影响,浙江中医学院学报[J]2004, 28(2):54-55
[78]姜宏等,穴位指压推拿治疗腰腿痛的镇痛疗效观察与研究颈腰痛杂志,1994;(1):9-11
[79]张建华,孙安达推拿牵引治疗腰椎间盘突出症前后血单胺类物质含最变化分析.中国骨伤,1999;9(12):47-48
[80]费季翔.陆千珍,刘志诚,等从血浆与尿中儿茶酚胺和它的代谢产物含量说明排拿的镇痛作用.颈腰痛杂志,1994;15(4):199-200
1.ParkeWW,etal.Arterial vaseulalization of the eaudaequina,J Bone Joint Surg(Am) 1981;63:53
2.Parke WW , etal.The intrinsic vaseulature of the lumbascral spinal nerve roots.Spine 1985:10:508
3.Rauschning W.Computed tomography and cryomicrotomy of lumbar specimens:a new technique for multiplanar anatomic correlation.Spine,1983,8:170;
4.Stoclieck Ls,Beel JA,Luttges MW.Structural properties of spinal nerve root:protein composition.Exp Neural,1986,91:41;
5.Paker ww,Watanabe R.The intrinsic vasculature of the lumbosacral spinal nerve roots.Spine,1985,10:508;
6.Patterson CAV,olsson Y.Blood supply of spinal nerve roots:an experimental study in the rat.Acta Neuropathol,1989,78:455;
7.Hasue M,Kunogi J,Konnos,et al,classification by position of dorsa root ganglia in the lumbosacral region.Spine,1989,14:126;
8.Boden SD,Davis DO,Dina TS,etal.Abnormal magnetic resonance scans of the lumbar spine:in asymptomatic subjects.J Bone Joint Surg,1990,72:403—405;
9.Spencer DL.Mechanisms of nerve root compression clue to a herniated disc the lumber Spine.phiadelphia:W.B.Saunders Co,1990pp.141.
10.Murphy,RW Nerve roots and sponal nerve in degenera tive disk disease.Clin Orthop,1997,129:41;
11.侯树勋,等.髓核突出类型与腰腿痛严重程度的比较研究.解放军医学杂志.1993,18:348;
12. Gertzbein SD.Auto immunity in degenerative disc disease of the lumbar spine.Orthop Clim N Am,1995,6:67;
13.awakami M,Weinstein JN,chatani K,et al.Experimental lumbar radiculopathy:behavioral and histologic changes in a model of radicular pain after spinal nerve root irrtation with chronic gut ligatures in the rat.Spine,1994,19:1795—1802;
14.Saal JS,Frason RC,Dobrow R.High level ofinflammatory phospholipase:an activity in lumbar disc herniations,spine,1990,15:674;
15.Lewis A.Interleukin activates phospholipase A2 in rabbit condrocytes.J Inmmunol,1996,136:1283;
16.吴闻文,侯树勋.腰椎间盘组织中磷脂酶A2活性水平与神经根性疼痛的关系.中国脊柱脊髓杂志,1996,6﹙1﹚:2—6;
17.Olmarker K,Rydevik B,Nordborg C.Autologous nucleus pulposus induces neurophysiologic and histologic changes in porcine cauda equina nerve roots.spine,1993,18:1425—1432;
18.Takahashi H,Suguro T,Okazima Y,et al.Inflammatory cytokines in the hemiated disc of the lumbar spine.Spine,1996,21:218—224;
19.Bgrod G rydevik B,Nordborg C.etal Early effects of of nuclus pulposus application on Spinal nerve root morphology and function,Eur Spine J.1998,7﹙6﹚:445—449;
20.Marshall LL,Trerhnie ER,Curtain CC,chemical radiculitis:a clihical,physiologyicalstudy.cliu Orthop.1994,129:61;
21Smyth,MJ.Wright V . Sciantca the intervertebral.disc.An experimental Study.J Bone Joint Surg 1958,40A:1401;
22Gertzbein SD. Auto immunity in degenerative disc.disease of the lumbar spine. Orthop clim N Am, 1975,6:67;
23.彭宝淦等﹙译自Spine Vol 20﹝3﹞:271﹚施杞﹙校﹚。突出椎间盘组织血管内的碱性纤维组织细胞生长因子的免疫反应性。中国中医骨伤科.1996.4﹙3﹚.
24.张显松等.腰椎旋转手法治疗腰椎间盘突出症的机理〔J〕.中医正骨,1993;5﹙3﹚:5;
25.姜宏等,穴位指压推拿治疗腰腿痛的镇痛疗效观察与研究颈腰痛杂志,1994;(1):9-11
26.张建华,孙安达推拿牵引治疗腰椎间盘突出症前后血单胺类物质含最变化分析.中国骨伤,1999;9(12):47– 48
27.费季翔.陆千珍,刘志诚,等从血浆与尿中儿茶酚胺和它的代谢产物含量说明排拿的镇痛作用.颈腰痛杂志,1994:15(4):199-200
28.冯天友,中西医结合治疗软组织损伤〔M〕,北京,人民卫生出版社
29.李智斌,丹镁注射液治疗腰椎间盘突出症机理研究〔A〕,现代中医药.2002.6.
30.郭明阳严清明冯太升,壮督活血通络法治疗腰椎间盘突出症35例,成都中医药大学学报,2001,4(2):55一56;
31.王拥军沈培芝石印玉等,逐痰通络汤对腰椎间盘突出模型的利水消炎作用,中医正骨,1999,11(6):326一328;
32.左玉潭等,腰康胶囊治疗60例腰椎间盘突出症疗效观察,中国中医骨伤科杂志,2002,10(2):45一46;
33.哇承志等,脊痛消胶囊治疗腰椎间盘突出症临床观察,中医正骨,1998,1O(3):7—9;
34.艾进伟黄昌林张建福等,腰腿痛胶囊对腰椎间盘突出症大鼠炎性细胞的影响,中医正骨,2003,15(8):455—458;
35.王军,复方南星止痛膏治疗腰椎间盘突出症50例.中国中医药科技.2004.11﹝1﹞.
36.鲍杰韦坚韦贵康,中药热熨治疗血疲型腰椎间盘突出症疗效观察及对其血液流变学的影响,中医正骨,2002,4(11):7—8;
37.李沛等,腰突定痛贴配合推拿治疗腰椎间盘突出症105例,山东中医杂志,2001,20(4):222—223;
38.蒋松鹤等,蛇鳖软膏灸治疗腰椎间盘突出症临床观察及机理探讨,中国针灸,1999,19(2):46—47;
39.张世明支满霞苗艳玲,脉络宁硬膜外注射治疗腰椎间盘突出症临床观察及初步动物实验,中国骨伤,1995,8(5):15;
40.韩志邦王勤来,硬膜外注射复方当归液治疗腰腿痛,中华麻醉学杂志,1989,9(3):185;
41.张文田张中英刘新元等,神经根松解注射治疗腰椎间盘突出症的临床观察,颈腰痛杂志,2002,23(1):48—49;
42.韩金华侯斌裴福刚,脉络宁硬膜外腔滴注治疗腰椎间盘突出症46例,沈阳医学院学报,1999,1(2):85—86;
43.朱长俊徐银秀等,神经根注射皮质类固醇治疗腰腿痛病例分析,颈腰痛杂志,2002,23(4):317—318;
44.邓运明吴友平杨伟民等,硬膜外封闭加传统手法治疗腰椎间盘突出症288例小结,江西中医学院学报,1998,10(1):9;
45.张社会岳志季曹红,硬膜外腔注药中配伍咪安定治疗慢性腰腿痛,颈腰痛杂志,2001;22(4):19;
46.程伟支满霞,硬膜外腔注射脉络宁对腰椎间盘突出症患者脑脊液中P物质的影响,中国骨伤,2001,14(2):97—98;
47.付建峰倪家骧宋子贤等,腰椎旁经椎间孔硬膜外腔注药治疗腰椎间盘突出症的研究,中国疼痛医学杂志,1998,4(3):148—153;
48.吴兴杰张灵邓庆芝,脊痛舒治疗腰椎间盘突出症的实验研究,中国正骨,1997,9(6):3—5;
49.张伟国等,甲基强地松龙局部浸润对脊神经根炎性损伤后影响的实验研究,中国临床药理学与治疗学,2001,6(1):28—30;
50.沈霖高兰谢晶等,鹿丹通督片对大鼠实验性腰神经根炎的影响,中国正骨,2000,12(3):3—6;
51.张军孙树椿,中药对模拟颈神经炎大鼠血浆前列腺素E2作用的放免测定观察,中国骨伤,2000,13(5):273—275;
52.佐藤二郎,硬膜透过い关する研究,麻醉,1986,25(6):917;
53.新树敦,硬膜外モネ注入关する研究,麻醉,1984,33(1):2;
54.孙锦年,硬膜外腔注射地塞米松引起精神障碍2例报道,颈腰痛杂志,1987, 18(1):72;
55.Ishikawa H, Nohara Y, Miyanti S. action of chondroitinase ABC on eqidurally transplanted nucleus pulposus in the tabbit〔J〕. Spine ,199924:﹙15﹚.