电针对糖尿病周围神经病变模型大鼠外周血流灌注量及其坐骨神经NGF受体表达的影响
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摘要
目的:通过腹腔注射链脲佐菌素(Streptozocin,STZ)建立痛性糖尿病周围神经病变(Painful Diabetic Neuropathy,PDN)模型,探讨电针对PDN的治疗作用机制。方法:采用PDN组大鼠腹腔注射STZ建立糖尿病模型,观察各组大鼠的行为反应,各大鼠的一般情况、血糖、痛阈,处死前检测大鼠周围血流灌注量,于处死后采用免疫组化法检测大鼠坐骨神经神经生长因子(Nerve Growth Factor,NGF)受体的表达,进而初步探讨电针治疗PDN大鼠的部分机制。结果:与空白组比较,模型组大鼠周围血流灌注量、NGF受体的表达明显降低,电针组大鼠血流灌注量、NGF受体的表达增加,并且电针2组较电针1组血流灌注量、NGF受体的表达增加较多。结论:电针可以提高PDN模型大鼠的痛阈,增加大鼠周围血流灌注量,电针可以增加PDN模型大鼠坐骨神经NGF受体的表达,从而对损伤的坐骨神经起到修复的作用,电针能够改善PDN模型大鼠坐骨神经的病理形态和超微结构,对神经具有保护作用。
Objective: To build the Painful Diabetic Neuropathy( PDN) model by intraperitoneal injection of Streptozocin( STZ),to discuss treatment mechanism of PDN by electric acupuncture( EA) and provide theoretical basis for clinical promotion. Methods: The PDN group was intraperitoneal injected STZ to build PDN model for observing behavior reaction of each groups and general state,blood glucose and pain threshold of all rats. Before death,peripheral blood perfusion was measured. After death,expression of receptor expression of Sciatic Nerve growth factor( NGF) was detected by immunohistochemistry. Moreover,it was to investigate the mechanism of electroacupuncture in the treatment of painful diabetic peripheral neuropathy in rats. Results: After building model,blood glucose of model group is increased significantly,pain threshold was declined gradually. After treatment of EA,blood glucose was not significant changed,and pain threshold was rising after treatment for 4 weeks. 8-week-treatment pain threshold was rising more than 4-weeks-treatment group. Conclusion: The treatment of EA can improve the pain threshold of PDN model rats for increasing the peripheral blood perfusion and microcirculation,can improve the expression of NGF receptors in the sciatic nerve of the PDN model rats for repairing the injured sciatic nerve,can improve the Sciatic pathological morphology and ultrastructure of PDN model rats for protecting the nerves.
Objective: To build the Painful Diabetic Neuropathy( PDN) model by intraperitoneal injection of Streptozocin( STZ),to discuss treatment mechanism of PDN by electric acupuncture( EA) and provide theoretical basis for clinical promotion. Methods: The PDN group was intraperitoneal injected STZ to build PDN model for observing behavior reaction of each groups and general state,blood glucose and pain threshold of all rats. Before death,peripheral blood perfusion was measured. After death,expression of receptor expression of Sciatic Nerve growth factor( NGF) was detected by immunohistochemistry. Moreover,it was to investigate the mechanism of electroacupuncture in the treatment of painful diabetic peripheral neuropathy in rats. Results: After building model,blood glucose of model group is increased significantly,pain threshold was declined gradually. After treatment of EA,blood glucose was not significant changed,and pain threshold was rising after treatment for 4 weeks. 8-week-treatment pain threshold was rising more than 4-weeks-treatment group. Conclusion: The treatment of EA can improve the pain threshold of PDN model rats for increasing the peripheral blood perfusion and microcirculation,can improve the expression of NGF receptors in the sciatic nerve of the PDN model rats for repairing the injured sciatic nerve,can improve the Sciatic pathological morphology and ultrastructure of PDN model rats for protecting the nerves.
引文
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[14]Chung SS,Ho EC,Lam KS,et al.Contribution of polyol pathway to diabetes-induced oxidative stress[J].J Am Soc Nephrol,2003,14(8Suppl 3):S233-236.
[15]伍绍铮,曹仁贤.糖尿病周围神经病变发病机制研究进展[J].中国医药指南,2012,10(10):467-468.
[16]钟美蓉,付秀美,付文亮,等.糖尿病周围神经病变发病机制及中医药治疗研究进展[J].承德医学院学报,2009,26(4):438-440.
[17]Vinik AI.Diabetic neuropathy:pathogenesis and therapy[J].Am JMed,1999,107(2B):17S-26S.
[18]King RHM.The role of glucution in the pathogenesis of diabetic polyneuropathy[J].Clim Pathol Mol Pathol,2001,54(6):400-408.
[19]Yangihashi S.Pathology of diabetic neuropathy.A review from the updated literature of last10year[J].Nippon Rinsho,2002,60(10):204.
[20]叶成夫,卢学勉,陈良苗.2型糖尿病患者血浆同型半胱氨酸水平与糖尿病周围神经病变的关系[J].临床医学,2005,25(9):29-31.
[21]余俊先,张银娣.糖尿病周围神经病变的发病机制及药物治疗[J].中国医刊,2007,42(9):66-69.
[2]Marchettini P,Teloni L,Formaglio F,et al.Pain in diabetic neuropathy case study:whole patient management[J].Eur J Neurol,2004,11(1):12-21.
[3]张子谦,姚红,陈建雄,等.电针治疗糖尿病周围神经病92例临床观察[J].广州医学院学报,2006,34(5):45-47.
[4]李永方,孙辉臣,郭秀英,等.电针对糖尿病大鼠坐骨神经传导速度和神经超微结构的影响[J].针刺研究,2004,29(3):192-196.
[5]Kessels J,Tarantola A,Salahuddin N,et al.Rabies post-exposure prophylaxis:A systematic review on abridged vaccination schedules and the effect of changing administration routes during a single course[J].Vaccine,2010,23(5):77-79.
[6]Craner MJ,Klein JP,Black JA,et al.Preferential expression of IGF-Iin small DRG neurons and down-regulation following injury[J].Neuroreport,2002,13(13):1649-1652.
[7]Leinninger GM,Vincent AM,Feldman EL.The role of growth factors in diabetic peripheral neuropathy[J].J Peripher Nerv Syst,2004,9(1):26-53.
[8]Pieron CR,Murakawa Y,Zhang W,et al.Impaired glucose tolerance and insulin open in the GE-rat causes peripheral neuropathy[J].Diabetes Matab Res Rev,2001,18(8):33-34.
[9]刘俊岭,陈淑萍,高永辉,等.不同强度、不同频度电针对慢性痛大鼠镇痛作用的比较[J].针刺研究,2006,31(5):280-285.
[10]Brewster WJ,Fernyhough P,Diemel LT,et al.Diabetic neuropathy,nerve growth factor and other neurotrophic factors[J].Trends Neurosci,1994,17(8):321-325.
[11]Provenzano MJ,Xu N,Ver MMR,et al.p75NTR and sortilin increase after facial nerve injury[J].Laryngoscope,2008,118(1):87-93.
[12]贾建平.神经病学[M].北京:人民卫生出版社,2009:419-421.
[13]Delva P,Pastori C,Montesi G,et al.Intralymphocyte free magnesium and calcium and insulin tolerance test in a group of essential hypertensive patients[J].Life Sci,1998,63(16):1405-1415.
[14]Chung SS,Ho EC,Lam KS,et al.Contribution of polyol pathway to diabetes-induced oxidative stress[J].J Am Soc Nephrol,2003,14(8Suppl 3):S233-236.
[15]伍绍铮,曹仁贤.糖尿病周围神经病变发病机制研究进展[J].中国医药指南,2012,10(10):467-468.
[16]钟美蓉,付秀美,付文亮,等.糖尿病周围神经病变发病机制及中医药治疗研究进展[J].承德医学院学报,2009,26(4):438-440.
[17]Vinik AI.Diabetic neuropathy:pathogenesis and therapy[J].Am JMed,1999,107(2B):17S-26S.
[18]King RHM.The role of glucution in the pathogenesis of diabetic polyneuropathy[J].Clim Pathol Mol Pathol,2001,54(6):400-408.
[19]Yangihashi S.Pathology of diabetic neuropathy.A review from the updated literature of last10year[J].Nippon Rinsho,2002,60(10):204.
[20]叶成夫,卢学勉,陈良苗.2型糖尿病患者血浆同型半胱氨酸水平与糖尿病周围神经病变的关系[J].临床医学,2005,25(9):29-31.
[21]余俊先,张银娣.糖尿病周围神经病变的发病机制及药物治疗[J].中国医刊,2007,42(9):66-69.