中药熏洗促进大鼠失神经支配骨骼肌损伤修复的实验研究
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摘要
目的研究熏洗一号方促进失神经支配骨骼肌损伤修复的机理。方法120只雄性SD大鼠,随机取90只大鼠造模成功后,随机分为熏洗一号方组、丹参组和模型组,剩余30只设为空白对照组,不做处理。各组实验动物分别在术后7天、14天和21天处死,股直肌肌腹组织块取材,常规HE染色,分别观察失神经支配后骨骼肌结构,乙酰胆碱酯酶活性,NGF、bFGF免疫组织化学染色和骨骼肌匀浆液Na~+-K~+-ATP酶改变。结果1.HE染色结果:术后7天:失神经早期骨骼肌中绝大多数肌丝肌节排列尚规则,可见到着色变浅。熏洗一号方组,肌纤维未见明显改变,部分肌纤维充血或坏死,但形态完整,有血管内皮充血。丹参组肌纤维水肿,肌纤维排列紊乱。术后14天:熏洗一号方组,肌纤维周围无明显增生的胶原纤维。丹参组肌纤维坏死或变性。模型组肌纤维增生显著,深入肌梭,代替肌肉组织,肌纤维排列紊乱。术后21天:熏洗一号方组,肌纤维排列尚整齐,极少有胶原纤维组织长入肌组织。丹参组肌细胞皱缩,纤维组织增生明显。模型组肌丝排列明显紊乱,大量纤维组织增生。2.乙酰胆碱酯酶活性:术后7天:各组乙酰胆碱酯酶活性较弱,丹参组和模型组与空白对照组相比(P＜0.05),熏洗一号方组与空白组相比(P＞0.05)。术后14天:熏洗一号方组乙酰胆碱酯酶活性增强,但与空白组相比(P＞0.05),丹参组分别与模型组和空白对照组相比(P＜0.01)。术后21天:熏洗一号方组乙酰胆碱酯酶活性强,接近于正常,染色均匀,运动终板结构规则,呈椭圆形或卵圆形花纹状结构,与空白组相比(P＞0.05);模型组和丹参组乙酰胆碱酯酶活性弱,与空白对照组相比(P＜0.01)。3.免疫组织化学染色观察:(1)NGF表达:术后7天:熏洗一号方组,肌梭梭内纤维肌细胞染色阳性,成纤维细胞、血管内皮细胞染色较弱。丹参组肌梭肌细胞染色弱阳性。模型组肌梭变小,未见明显染色。术后14天:熏洗一号方组,增生的胶原纤维染色阳性,血管内皮细胞染色阳性,肌梭未见明显染色。丹参组丹参组成纤维细胞染色阳性。模型组肌梭萎缩,肌细胞染色阴性。术后21天:熏洗一号方组,增生的胶原纤维组织染色弱阳性。丹参组纤维组织未见染色。(2)bFGF表达:术后7天:熏洗一号方组肌细胞和成纤维细胞染色阳性。丹参组成纤维细胞染色阳性。模型组成纤维细胞染色阳性。术后14天:熏洗一号方组骨骼肌基底膜染色强阳性,成纤维细胞染色阳性,肌梭内有少量肌细胞染色阳性。丹参组核肌梭内成纤维细胞染色阳性。模型组肌梭内细胞染色很浅。术后21天:熏洗一号方组肌梭肌细胞染色阳性,神经末梢处成纤维细胞染色强阳性。丹参组血管内皮细胞有散在阳性细胞。模型组未见染色,肌纤维边缘不规则相对大于正常。4.骨骼肌匀浆液Na~+-K~+-ATP结果:术后7天各组Na~+-K~+-ATP酶组间比较没有统计学意义(P＞0.05)。术后14天熏洗一号方组与空白对照组对比(P＜0.05)。术后21天,熏洗一号方组与空白对照组对比(P＜0.01),且熏洗一号方组Na~+-K~+-ATP酶含量最高。结论1.失神经支配骨骼肌损伤的修复与NGF和bFGF的变化有关,骨骼肌失去神经营养因子(NGF)的营养发生萎缩。bFGF能促进运动神经纤维的再生,对神经肌肉接头的形成具有重要作用,能促进神经损伤后肌肉功能的恢复。2.熏洗一号方能延缓神经肌肉运动终板(Motor endplate,MEP)与效应器的变性。3.熏洗一号方能改善失神经支配骨骼肌的营养供应、延缓骨骼肌的萎缩。
Objective:To study the mechanism of Xun xi yi haofang on the recovery of denervated skeletal muscle.Methods:90 male SD rats,10%Chloral Hydrate abdominal anesthesia,adopt emoribus internus incision,in the right femoribus internus severed femoral nerve.These rats were randomly divided into the following four groups after modeling successed and each group have 30 rats:Xun xi yi haofang group,Salvia miltiorrhiza group and model group.30 rats in control group.Experimental animals in each group after 7 days,14 days and 21 days were killed,to draw the materials from rectus femoris venter musculi tissue, conventional HE staining,to observe ultrastructural of denervated skeletal muscle ultramicrostructure with transmission electron microscopy after changes.NGF and bFGF immunohistochemical staining,and skeletal muscle homogenates of Na ~+-K~+ -ATP changes.Results:1.HE staining Results:After one week,early denervated skeletal muscle in majority of myofilament inocomma were still rules, can be seen staining weaken.Xun xi yi haofang group morphological integrity.Salvia miltiorrhiza group myocyte membrane shrinkage.After two weeks,surround of muscle fibers without proliferation of collagen fibers.Salvia miltiorrhiza group myocyte invaginated.Model group and the control group muscle spindle atrophy.After three weeks,Xun xi yi haofang group,myocyte thiner,model group myofilament fragmentation and derangemenin,the volum of cellular radually shrinked,stain deepened.Control group myocyte shrinkage,irregular margins relatively larger than control group,surrounding of muscle fibers appeared more fibroblast and the proliferation of collagen fibers.2.Acetylcholine activity:After one week,acetylcholine activity in every group is weak,Salvia miltiorrhiza group and model group compared to control group(P＜0.05)Xun xi yi haofang group compared to control group(P＞0.05).After two week,acetylcholine activity in Xun xi yi haofang group increased,but compared with the control group was not significant(P＞0.05),model group and Salvia miltiorrhiza group staining weaken, compared to control group(P＜0.01).After the 3 week,Xun xiyi haofang group acetylcholinesterase activity strong,and closer to normal,stained uniform, myoceptor structure rules,Similar in elliptical,or oval-shaped structure,compared to control group(P＞0.05);Model group and Salvia miltiorrhiza group acetylcholinesterase activity weak,compared to control group(P＜0.01).3.Immunohistochemical staining:(1)The expression of NGF:After seven days,Xun xi yi haofang group,muscle spindle myocyte staining positive, fibroblasts,vascular endothelial cells were weak,Salvia miltiorrhiza group muscle spindle myocyte were weakly positive.Model group muscle spindle smaller,there was no obvious staining.After 14 days,Xun xi yi haofang group,myocyte cellular nucleus not smooth,staining positive,fibroblast proliferation and staining positive strongly,vascular endothelial cells positive staining,muscle spindle no obvious staining,Salvia miltiorrhiza group myocyte cellular nucleus invagination,positive staining and fibroblasts positive staining.Model group and control group muscle spindle atrophy,negative staining.After 21 days,Xun xiyi haofang group,staining thin,endocytoplasmic reticulum expansion and weak positive,Salvia miltiorrhiza group myocyte cytolemma shrinkage and no staining.(2)expression of bFGF: After seven days,Xun xi yi haofang group myocyte staining positive,Salvia miltiorrhiza group and model group fibroblast positive staining.After 14 days,Xun xi yi haofang group skeletal muscle basilemma staining strong positive,fibroblast cells staining positive,a small amount of myocyte staining positive in muscle spindle,Salvia miltiorrhiza group nucleolemma staining was positive,fibroblasts stained positive in muscle spindle,model group positive weak.After 21 days,Xun xi yi haofang group skeletal muscle basilemma staining positive,fibroblasts staining strongly positive in the nerve endings,Salvia miltiorrhiza group with mitochondrial vacuolization positive cells scattered,endotheliocyte positive staining in muscle spindle,model group and control group not.5.Skeletal muscle homogenates Na~+-K~+-ATP results:After seven days,Na~+-K~+-ATP in all group there were no statistically significant(P＞0.05)compared with each other.After 14 days Xun xi yi haofang group compared with the control group(P＜0.05).After 21 days,Xun xi yi haofang group compared with control group(P＜0.01),and the content of Na~+-K~+-ATP enzyme in Xun xi yi haofang group was the highest.Conclusion:1.The repair ofdenervated skeletal muscle injury related to the changes of NGF and bFGF,skeletal muscle will atrophy if loss the nutrition of neurotrophic factor(NGF),bFGF can promote regeneration of the motorius neurofibra,plays an important role to the formation of neuromuscular junction,can promote recovery of muscle function after nerve injury.2.Xun xi yi haofang can delay degeneration of neuromuscular motor endplates(Motor endplate,MEP)and the effector.3.Xun xi yi haofang can improve denervated skeletal muscle nutrition supply and delayed skeletal muscle atrophy.
Objective:To study the mechanism of Xun xi yi haofang on the recovery of denervated skeletal muscle.Methods:90 male SD rats,10%Chloral Hydrate abdominal anesthesia,adopt emoribus internus incision,in the right femoribus internus severed femoral nerve.These rats were randomly divided into the following four groups after modeling successed and each group have 30 rats:Xun xi yi haofang group,Salvia miltiorrhiza group and model group.30 rats in control group.Experimental animals in each group after 7 days,14 days and 21 days were killed,to draw the materials from rectus femoris venter musculi tissue, conventional HE staining,to observe ultrastructural of denervated skeletal muscle ultramicrostructure with transmission electron microscopy after changes.NGF and bFGF immunohistochemical staining,and skeletal muscle homogenates of Na ~+-K~+ -ATP changes.Results:1.HE staining Results:After one week,early denervated skeletal muscle in majority of myofilament inocomma were still rules, can be seen staining weaken.Xun xi yi haofang group morphological integrity.Salvia miltiorrhiza group myocyte membrane shrinkage.After two weeks,surround of muscle fibers without proliferation of collagen fibers.Salvia miltiorrhiza group myocyte invaginated.Model group and the control group muscle spindle atrophy.After three weeks,Xun xi yi haofang group,myocyte thiner,model group myofilament fragmentation and derangemenin,the volum of cellular radually shrinked,stain deepened.Control group myocyte shrinkage,irregular margins relatively larger than control group,surrounding of muscle fibers appeared more fibroblast and the proliferation of collagen fibers.2.Acetylcholine activity:After one week,acetylcholine activity in every group is weak,Salvia miltiorrhiza group and model group compared to control group(P＜0.05)Xun xi yi haofang group compared to control group(P＞0.05).After two week,acetylcholine activity in Xun xi yi haofang group increased,but compared with the control group was not significant(P＞0.05),model group and Salvia miltiorrhiza group staining weaken, compared to control group(P＜0.01).After the 3 week,Xun xiyi haofang group acetylcholinesterase activity strong,and closer to normal,stained uniform, myoceptor structure rules,Similar in elliptical,or oval-shaped structure,compared to control group(P＞0.05);Model group and Salvia miltiorrhiza group acetylcholinesterase activity weak,compared to control group(P＜0.01).3.Immunohistochemical staining:(1)The expression of NGF:After seven days,Xun xi yi haofang group,muscle spindle myocyte staining positive, fibroblasts,vascular endothelial cells were weak,Salvia miltiorrhiza group muscle spindle myocyte were weakly positive.Model group muscle spindle smaller,there was no obvious staining.After 14 days,Xun xi yi haofang group,myocyte cellular nucleus not smooth,staining positive,fibroblast proliferation and staining positive strongly,vascular endothelial cells positive staining,muscle spindle no obvious staining,Salvia miltiorrhiza group myocyte cellular nucleus invagination,positive staining and fibroblasts positive staining.Model group and control group muscle spindle atrophy,negative staining.After 21 days,Xun xiyi haofang group,staining thin,endocytoplasmic reticulum expansion and weak positive,Salvia miltiorrhiza group myocyte cytolemma shrinkage and no staining.(2)expression of bFGF: After seven days,Xun xi yi haofang group myocyte staining positive,Salvia miltiorrhiza group and model group fibroblast positive staining.After 14 days,Xun xi yi haofang group skeletal muscle basilemma staining strong positive,fibroblast cells staining positive,a small amount of myocyte staining positive in muscle spindle,Salvia miltiorrhiza group nucleolemma staining was positive,fibroblasts stained positive in muscle spindle,model group positive weak.After 21 days,Xun xi yi haofang group skeletal muscle basilemma staining positive,fibroblasts staining strongly positive in the nerve endings,Salvia miltiorrhiza group with mitochondrial vacuolization positive cells scattered,endotheliocyte positive staining in muscle spindle,model group and control group not.5.Skeletal muscle homogenates Na~+-K~+-ATP results:After seven days,Na~+-K~+-ATP in all group there were no statistically significant(P＞0.05)compared with each other.After 14 days Xun xi yi haofang group compared with the control group(P＜0.05).After 21 days,Xun xi yi haofang group compared with control group(P＜0.01),and the content of Na~+-K~+-ATP enzyme in Xun xi yi haofang group was the highest.Conclusion:1.The repair ofdenervated skeletal muscle injury related to the changes of NGF and bFGF,skeletal muscle will atrophy if loss the nutrition of neurotrophic factor(NGF),bFGF can promote regeneration of the motorius neurofibra,plays an important role to the formation of neuromuscular junction,can promote recovery of muscle function after nerve injury.2.Xun xi yi haofang can delay degeneration of neuromuscular motor endplates(Motor endplate,MEP)and the effector.3.Xun xi yi haofang can improve denervated skeletal muscle nutrition supply and delayed skeletal muscle atrophy.
引文
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[1]周重建,施杞,王拥军,等.腰神经根损伤后神经肌肉接头施旺细胞的作用和表现[J].安徽医科大学学报,2001,36(4):271-275.
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[1]陈哓东,顾玉东,杨毅.电针对神经损伤后神经生长因子mRNA及胰岛素样生长因子-1mRNA表达的影响[J].中国修复重建外科杂志,2000,14(6):330-331.
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[8]龙在云,陈恒胜,曾琳等.神经生长因子对失神经肌肉及其运动终板的作用[J].中国临床康复,2002,6(19):2855.
[9]赵志强,刘强,李钢.骨骼肌卫星细胞移植对延缓失神经肌肉萎缩的作用[J].中华骨科杂志,2006,26(1):51.
[10]庞水发,汪华侨,卢晓林,等.胚胎运动神经元移植对失神经肌肉影响的实验研究[J].中华显微外科杂志,2001,24(4):285.
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[13]王爱国,其木格,李昶.带神经肌束分点植入对大鼠失神经肌肉的影响-超微结构观察[J].电子显微学报,2004,23(4):317.
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[17]王栓科,洪光祥,王同光.细胞外ATP防治失神经肌肉萎缩的实验研究[J].中华手外科杂志,2002,18(1):44.