电针对兔面神经损伤的超微结构影响
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摘要
目的:对比电针与手针对面神经损伤兔面神经雪旺细胞、髓鞘及线粒体等结构形态学影响,探索电针治疗面神经损伤的机制。方法:新西兰兔随机分为正常组、假手术组、模型组、手针组、电针组,每组10只。经面神经压榨复制面神经损伤模型。电针组取"地仓""下关""太阳""阳白"进行电针治疗,每次30min;手针组选穴同电针组,每10min平补平泻捻转手法行针1次,留针30min。两组均每日治疗1次,共治疗28d。每7d进行1次面肌运动评分,28d后电镜观察各组面神经超微结构。结果:治疗后,假手术组与正常组比较各项结果未见明显变化(P>0.05)。模型组在面肌运动评分、超微结构形态学变化以及单位面积轴突数目、髓鞘厚度、轴突面积等方面均差于正常组(P<0.05);两治疗组面肌运动评分、超微结构形态学变化以及单位面积轴突数目、髓鞘厚度、轴突面积均好于模型组(P<0.05);电针组各项结果均好于手针组(P<0.05)。结论:在面神经损伤的治疗中,电针比手针更能促进轴浆线粒体增殖、髓鞘恢复以及轴索再生,这可能是电针治疗面神经损伤效果优于手针的机制之一。
Objective To observe the effect of manual acupuncture and electroacupuncture(EA)on ultrastructure of facial nerve Schwann cells,myelin sheath and mitochondria in facial nerve injury rabbits,so as to explore its mechanism underlying improving facial palsy.Methods A total of 50 New Zealand rabbits were randomly divided into normal,sham-operation,model,MA and EA groups(n=10 in each group).Facial nerve injury model was made by clamping the facial nerve for 5 min using apair of forceps.Manual needle stimulation(mild reinforcing-reducing)or EA(continuous wave,20 Hz)was applied to"Dicang"(ST 4),"Xiaguan"(ST 7),"Taiyang"(EX-HN 5)and "Yangbai"(GB 14)on the injured sides for 4 weeks,30 min each day.The facial nerve motion score was performed every 7 days.The ultrastructure of facial nerve was observed by electron microscope after 28 days' treatment.Results There were no significant differences in behavioral score and ultrastructure in normal and sham-operation groups(P>0.05).Compared with the normal group,facial nerve motion scores,ultrastructural morphological changes and the number of axons per unit area,myelin sheath thickness and axon area were worse in the model group(P<0.05).After treatment,facial nerve motion scores,ultrastructural morphological changes and the number of axons per unit area,myelin sheath thickness and axon area in the two treatment groups were better than those in the model group(P<0.05),and EA worked better than MA(P <0.05).Conclusion In the treatment of facial nerve injury,EA can promote axoplasmic mitochondrial proliferation,myelin sheath recovery and axonal regeneration more effectively than MA,which may be one of the mechanisms that EA therapy is superior to MA.
Objective To observe the effect of manual acupuncture and electroacupuncture(EA)on ultrastructure of facial nerve Schwann cells,myelin sheath and mitochondria in facial nerve injury rabbits,so as to explore its mechanism underlying improving facial palsy.Methods A total of 50 New Zealand rabbits were randomly divided into normal,sham-operation,model,MA and EA groups(n=10 in each group).Facial nerve injury model was made by clamping the facial nerve for 5 min using apair of forceps.Manual needle stimulation(mild reinforcing-reducing)or EA(continuous wave,20 Hz)was applied to"Dicang"(ST 4),"Xiaguan"(ST 7),"Taiyang"(EX-HN 5)and "Yangbai"(GB 14)on the injured sides for 4 weeks,30 min each day.The facial nerve motion score was performed every 7 days.The ultrastructure of facial nerve was observed by electron microscope after 28 days' treatment.Results There were no significant differences in behavioral score and ultrastructure in normal and sham-operation groups(P>0.05).Compared with the normal group,facial nerve motion scores,ultrastructural morphological changes and the number of axons per unit area,myelin sheath thickness and axon area were worse in the model group(P<0.05).After treatment,facial nerve motion scores,ultrastructural morphological changes and the number of axons per unit area,myelin sheath thickness and axon area in the two treatment groups were better than those in the model group(P<0.05),and EA worked better than MA(P <0.05).Conclusion In the treatment of facial nerve injury,EA can promote axoplasmic mitochondrial proliferation,myelin sheath recovery and axonal regeneration more effectively than MA,which may be one of the mechanisms that EA therapy is superior to MA.
引文
[1]桑久华,陶海琦,孙丽艳,等.电针治疗急性期周围型面瘫研究进展[J].河南中医,2013,33(12):2213-2215.
[2]李金存,高李,蒋振亚.特发性面神经麻痹急性期电针治疗的可行性探讨[J].针刺研究,2006,31(4):249-251.
[3]彭晓红,李蓉,龚可,等.平补平泻针刺法与电针疗法治疗周围性面瘫60例对比观察[J].四川中医,2011,29(4):109-110.
[4]刘立安,朱在波,戚其华,等.周围性面瘫急性期不同干预方法疗效比较[J].中国针灸,2010,30(12):989-992.
[5]刘百生,夏义仁,危志龙.电针治疗面瘫临床疗效观察[J].中国医学工程,2012,20(1):144-147.
[6]姜喜凤,王健,王军.探讨针刺结合电针治疗周围性面瘫恢复期临床效果[J].中国卫生标准管理,2016,7(8):141-142.
[7]牙祖蒙,王建华,李忠禹,等.穴位针刺对面神经再生影响的实验研究[J].针刺研究,1999,24(2):111-115.
[8]牙组蒙,肖道宏,王建华,等.面神经损伤后穴位针刺对NGF mRNA表达的影响[J].针刺研究,2000,25(2):96-99.
[9]吴滨,何竟,高炳庆,等.电针对面神经再生逆行轴突转运神经营养因子的影响[J].针刺研究,2002,27(2):108-111.
[10]惠莲,刘凤啸,袁婧,等.FK 506对大鼠面神经损伤后面运动神经元凋亡及bcl-2,bax表达的影响[J].中国医科大学学报,2013,42(7):608-611.
[11]孙运花,李瑛,张薇,等.压榨性面神经损伤模型在电针机理研究中的应用[J].辽宁中医杂志,2012,39(1):141-143.
[12]邱辉,张志光,张洪来,等.针刺治疗面神经损伤的动物模型制作[J].广东牙病防治,2002,10(3):169-170.
[13]彭成.中医药动物实验方法[M].北京:人民卫生出版社,2008:1313-1314.
[14]牙祖蒙,王建华,周渝.穴位针刺对面神经再生影响的动物模型制作[J].实验动物科学与管理,1999,16(1):15-17.
[15]左文静.不同病因周围性面瘫临床特点相关分析[D].福州:福建医科大学,2014.
[16]佟帅.针刺治疗周围神经损伤机理的实验研究[D].哈尔滨:黑龙江中医药大学,2002.
[17]顾丹丹,张沛云.许旺细胞对周围神经再生的促进效应[J].中国组织工程研究与临床康复,2008,12(25):4921-4926.
[18]位孟元,宫子超.针刺治疗面瘫的体会[J].山东中医杂志,1997,16(8):58.
[19]刘立安,朱在波,戚其华,等.周围性面瘫急性期不同干预方法疗效比较[J].中国针灸,2010,30(12):989-992.
[20]张立宁,王兴林.电刺激对周围神经再生的影响[J].中国康复理论与实践,2006,12(7):588-590.
[21]张微,孙运花,彭晓华,等.面神经损伤实验动物模型的自愈性研究[J].中国神经免疫学和神经病学杂志,2012,19(1):49-52.
[22]张微.电针对面神经损伤修复的雪旺细胞形态学及CNTF表达影响的研究[D].成都:成都中医药大学,2012.
[23]陈志宏,马泉,谢利德,等.面神经局部缺血对面神经及面神经核的影响[J].中国临床解剖学杂志,2010,28(3):317-320.
[24]王长黎.面神经损伤后面神经核中E-cadherin和Calmodulin mRNA的相对表达量及电针对其表达的影响[D].成都:四川医科大学,2015.
[25]孙忠人,卫彦,姜国华,等.穴位电针刺激对周围性面神经损伤兔面神经核中BDNF mRNA表达的影响[J].针刺研究,2006,31(4):204-207.
[2]李金存,高李,蒋振亚.特发性面神经麻痹急性期电针治疗的可行性探讨[J].针刺研究,2006,31(4):249-251.
[3]彭晓红,李蓉,龚可,等.平补平泻针刺法与电针疗法治疗周围性面瘫60例对比观察[J].四川中医,2011,29(4):109-110.
[4]刘立安,朱在波,戚其华,等.周围性面瘫急性期不同干预方法疗效比较[J].中国针灸,2010,30(12):989-992.
[5]刘百生,夏义仁,危志龙.电针治疗面瘫临床疗效观察[J].中国医学工程,2012,20(1):144-147.
[6]姜喜凤,王健,王军.探讨针刺结合电针治疗周围性面瘫恢复期临床效果[J].中国卫生标准管理,2016,7(8):141-142.
[7]牙祖蒙,王建华,李忠禹,等.穴位针刺对面神经再生影响的实验研究[J].针刺研究,1999,24(2):111-115.
[8]牙组蒙,肖道宏,王建华,等.面神经损伤后穴位针刺对NGF mRNA表达的影响[J].针刺研究,2000,25(2):96-99.
[9]吴滨,何竟,高炳庆,等.电针对面神经再生逆行轴突转运神经营养因子的影响[J].针刺研究,2002,27(2):108-111.
[10]惠莲,刘凤啸,袁婧,等.FK 506对大鼠面神经损伤后面运动神经元凋亡及bcl-2,bax表达的影响[J].中国医科大学学报,2013,42(7):608-611.
[11]孙运花,李瑛,张薇,等.压榨性面神经损伤模型在电针机理研究中的应用[J].辽宁中医杂志,2012,39(1):141-143.
[12]邱辉,张志光,张洪来,等.针刺治疗面神经损伤的动物模型制作[J].广东牙病防治,2002,10(3):169-170.
[13]彭成.中医药动物实验方法[M].北京:人民卫生出版社,2008:1313-1314.
[14]牙祖蒙,王建华,周渝.穴位针刺对面神经再生影响的动物模型制作[J].实验动物科学与管理,1999,16(1):15-17.
[15]左文静.不同病因周围性面瘫临床特点相关分析[D].福州:福建医科大学,2014.
[16]佟帅.针刺治疗周围神经损伤机理的实验研究[D].哈尔滨:黑龙江中医药大学,2002.
[17]顾丹丹,张沛云.许旺细胞对周围神经再生的促进效应[J].中国组织工程研究与临床康复,2008,12(25):4921-4926.
[18]位孟元,宫子超.针刺治疗面瘫的体会[J].山东中医杂志,1997,16(8):58.
[19]刘立安,朱在波,戚其华,等.周围性面瘫急性期不同干预方法疗效比较[J].中国针灸,2010,30(12):989-992.
[20]张立宁,王兴林.电刺激对周围神经再生的影响[J].中国康复理论与实践,2006,12(7):588-590.
[21]张微,孙运花,彭晓华,等.面神经损伤实验动物模型的自愈性研究[J].中国神经免疫学和神经病学杂志,2012,19(1):49-52.
[22]张微.电针对面神经损伤修复的雪旺细胞形态学及CNTF表达影响的研究[D].成都:成都中医药大学,2012.
[23]陈志宏,马泉,谢利德,等.面神经局部缺血对面神经及面神经核的影响[J].中国临床解剖学杂志,2010,28(3):317-320.
[24]王长黎.面神经损伤后面神经核中E-cadherin和Calmodulin mRNA的相对表达量及电针对其表达的影响[D].成都:四川医科大学,2015.
[25]孙忠人,卫彦,姜国华,等.穴位电针刺激对周围性面神经损伤兔面神经核中BDNF mRNA表达的影响[J].针刺研究,2006,31(4):204-207.