针药结合对EAN家兔周围神经病理及电生理功能影响的研究
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摘要
目的:通过针药结合对格林-巴利综合征经典动物模型——实验性变态反应性神经炎(EAN)家兔周围神经病理形态学及神经电生理功能影响的研究,揭示了针药结合的切入点及对格林-巴利综合征的治疗作用及干预机制。
方法:取12ml提取的牛髓鞘碱性蛋白II(P2)与等量的完全弗氏佐剂(CFA)充分混合后免疫家兔制备EAN动物模型。16只正常健康家兔作为正常组,正常组以12ml生理盐水代替牛P2与等量的CFA进行免疫作为对照,另外取造模成功的64只EAN家兔随机分为模型组、通经益髓方组、针药结合组、免疫球蛋白组,每组各16只。通经益髓方组给予通经益髓方鼻饲治疗;针药结合是电针五脏俞与通经益髓方合用;免疫球蛋白组给予免疫球蛋白400mg/(kg·d)腹腔注射治疗。分别于发病后的第7天及第14天检测各组实验动物坐骨神经运动传导速度和F波出现频率,并对实验动物取材,应用电镜观察坐骨神经病理形态学超微结构的变化,及光镜结果。
结果:1本实验成功的复制了EAN家兔模型,无论从病理、神经电生理都与相关报道相一致,证明了本实验研究中的动物模型制备是成功的。
2针药结合组能很有效地改善有髓神经纤维有空化、粗大迂曲及线粒体肿大,使脱髓鞘改变不明显,鞘层清晰程度增强。光镜下见炎细胞浸润减少。
3神经电生理方面,针药结合组能使运动神经传导速度明显增快,F波的异常率明显减少,明显改善神经传导阻滞现象。
结论:1针药结合可以明显改善有髓神经脱髓鞘改变及炎细胞浸润现象;
2针药结合可以增加运动神经的传导速度,改善传导阻止现象;
3针药结合是以经髓理论为指导,寻求治痿的最佳切入点。
Purpose: Through needle medicine combined on the Guillain-Barre syndrome classic animal model - experimental allergic neuritis (EAN) in rabbit peripheral nerves and nerve pathomorphology electrophysiological function study.
Method: 12ml extract of bovine myelin basic protein II (P2) with the contour of complete Freund's adjuvant (CFA) to fully prepare a mixture of immune rabbit animal model of EAN. 16 normal, healthy rabbits as a normal group, normal group to 12ml with normal saline in place of P2 with the cow equivalent CFA immunization as a control, another successful model from 64 EAN rabbits were randomly divided into normal group, model group, Tongjing Yisui side group, needle medicine combined group immunoglobulin group, 16 in each group. Tongjing Yisui side group Tongjing Yisui side nasal feeding treatment; needle medicine combined pass through electric acupuncture to Shu-points of the five-organs and Tongjing Yisui side;immune globulin group immunoglobulin 40mg / (kg ? d) treatment by intraperitoneal injection. In the 7th days and the 14th days we separately examined each group of experimental animal sciatic nerve movement conduction velocity and the F wave appearance frequency, and selected the material from the experimental animal, and used the electricity to observe the change of the peripheral nerve pathology morphology ultrastructure, application of electron microscopy the ultrastructure of sciatic nerve pathological changes, and optical microscopy.
Result: 1 The success of this experiment replicated EAN rabbit model, in terms of pathology, neuro-electrophysiology is consistent with the relevant reports to prove that this experimental study in the animal model is successful.
2 Needle medicine combined group can improve very effectively has the marrow nerve fiber to have the cavitation, the thick in and out and the line plastochondria is tumescent, causes to escape the myelinic membrane change not to be obvious, sheath level readability enhancement. Under the light microscope sees the phlogocyte infiltration to reduce.
3 In neural electrophysiological, the needle medicine combined group can motor nerve conduction velocity increased significantly faster, F-wave abnormalities were significantly reduced, significant improvement in nerve conduction block phenomenon.
Conclusion: 1 Needle medicine combined can significantly improve the myelinated nerve demyelination and inflammatory cell infiltration.
2 It can increase the motor nerve conduction velocity to improve the conduction block phenomenon after needle medicine combined.
3 Needle medicine combined is based on combining the theory as a guide through the pulp, the best starting point for governance atrophy.
方法:取12ml提取的牛髓鞘碱性蛋白II(P2)与等量的完全弗氏佐剂(CFA)充分混合后免疫家兔制备EAN动物模型。16只正常健康家兔作为正常组,正常组以12ml生理盐水代替牛P2与等量的CFA进行免疫作为对照,另外取造模成功的64只EAN家兔随机分为模型组、通经益髓方组、针药结合组、免疫球蛋白组,每组各16只。通经益髓方组给予通经益髓方鼻饲治疗;针药结合是电针五脏俞与通经益髓方合用;免疫球蛋白组给予免疫球蛋白400mg/(kg·d)腹腔注射治疗。分别于发病后的第7天及第14天检测各组实验动物坐骨神经运动传导速度和F波出现频率,并对实验动物取材,应用电镜观察坐骨神经病理形态学超微结构的变化,及光镜结果。
结果:1本实验成功的复制了EAN家兔模型,无论从病理、神经电生理都与相关报道相一致,证明了本实验研究中的动物模型制备是成功的。
2针药结合组能很有效地改善有髓神经纤维有空化、粗大迂曲及线粒体肿大,使脱髓鞘改变不明显,鞘层清晰程度增强。光镜下见炎细胞浸润减少。
3神经电生理方面,针药结合组能使运动神经传导速度明显增快,F波的异常率明显减少,明显改善神经传导阻滞现象。
结论:1针药结合可以明显改善有髓神经脱髓鞘改变及炎细胞浸润现象;
2针药结合可以增加运动神经的传导速度,改善传导阻止现象;
3针药结合是以经髓理论为指导,寻求治痿的最佳切入点。
Purpose: Through needle medicine combined on the Guillain-Barre syndrome classic animal model - experimental allergic neuritis (EAN) in rabbit peripheral nerves and nerve pathomorphology electrophysiological function study.
Method: 12ml extract of bovine myelin basic protein II (P2) with the contour of complete Freund's adjuvant (CFA) to fully prepare a mixture of immune rabbit animal model of EAN. 16 normal, healthy rabbits as a normal group, normal group to 12ml with normal saline in place of P2 with the cow equivalent CFA immunization as a control, another successful model from 64 EAN rabbits were randomly divided into normal group, model group, Tongjing Yisui side group, needle medicine combined group immunoglobulin group, 16 in each group. Tongjing Yisui side group Tongjing Yisui side nasal feeding treatment; needle medicine combined pass through electric acupuncture to Shu-points of the five-organs and Tongjing Yisui side;immune globulin group immunoglobulin 40mg / (kg ? d) treatment by intraperitoneal injection. In the 7th days and the 14th days we separately examined each group of experimental animal sciatic nerve movement conduction velocity and the F wave appearance frequency, and selected the material from the experimental animal, and used the electricity to observe the change of the peripheral nerve pathology morphology ultrastructure, application of electron microscopy the ultrastructure of sciatic nerve pathological changes, and optical microscopy.
Result: 1 The success of this experiment replicated EAN rabbit model, in terms of pathology, neuro-electrophysiology is consistent with the relevant reports to prove that this experimental study in the animal model is successful.
2 Needle medicine combined group can improve very effectively has the marrow nerve fiber to have the cavitation, the thick in and out and the line plastochondria is tumescent, causes to escape the myelinic membrane change not to be obvious, sheath level readability enhancement. Under the light microscope sees the phlogocyte infiltration to reduce.
3 In neural electrophysiological, the needle medicine combined group can motor nerve conduction velocity increased significantly faster, F-wave abnormalities were significantly reduced, significant improvement in nerve conduction block phenomenon.
Conclusion: 1 Needle medicine combined can significantly improve the myelinated nerve demyelination and inflammatory cell infiltration.
2 It can increase the motor nerve conduction velocity to improve the conduction block phenomenon after needle medicine combined.
3 Needle medicine combined is based on combining the theory as a guide through the pulp, the best starting point for governance atrophy.
引文
[1]刘振拴.痿证明清诸家论治心要.陕西中医函授,1999,4:4-5
[2]陈金亮,杨晓黎,郭双庚.论中医屡病学说的形成及发展.中国中医药信息杂志,1997,4(3):9-11
[3]高彩林,王洪典,王津存,等. 225例格林-巴利综合征临床流行病学分析.青海医药杂志,1998,28(2):1-2
[4]洪霞,张振馨,王建明,等.北京和河北城乡格林-巴利综合征的流行病学特征.中国医学科学院学报.2000,4,22(2):115-119
[5] Jiang GX, Cheng Q, Lint H,et al. Epidemiological features of Guillain-Bar résyndrome in Sweden, 1978-1993. J Neurol Neurosurg Psychiatry, 1997, 62:447-453
[6] Rees JH, Thompson RD, Smeeton NC,et al.Epidemiological study of Guill ain-Bar résyndrome in southeast England. J Neurol Neurosurg Psychiatry,1998, 64:7 4-77
[7]王德生,韩辉,张艳,等.哈尔滨市1997~1999年吉兰-巴雷综合征的流行病学调查.中华神经科杂志,2003,4,36(2):133-137
[8]肖雷,袁锦楣,刘向志,等.格林-巴利综合征病因学的研究.锦州医学院学报,1996,17(6):40-44
[9]李冰,杨立彬,杨亚平,等. 31例格林-巴利综合征病因学研究.实用儿科临床杂志,2001,16,(6):420-421
[10]王强,孟威宏,王虹蛟,等.急性运动性轴索型GBS的免疫发病机制研究进展.神经疾病与精神卫生,2001,1,(3):53-54
[11]王国平,李淮玉,陈柯,等.亚急性炎性脱髓鞘性多发性神经根神经病的临床和病理研究.临床神经病学杂志,2002,15(3):53-54
[12]王强,王虹蛟,张海.急性运动性轴索型格林巴利综合征的病理学研究.国外医学.老年医学分册,2000,6:269
[13]祝善尧,徐劲,鲍青松,等. 30例格林巴利综合征的临床和神经电生理分析.中国社区医师,2008,6:17
[14]党静霞,李汉玲,石小磊. Guillain-Barre综合征早期电生理变化及分型再认识.西安医科大学学报,1997,6,18(2):255-257
[15]张晓君.格林-巴利综合征的电诊断新进展.临床脑电学杂志, 1997,9,(3):188-191
[16]黄盘冰.格林一巴利综合征诊断与治疗进展.医学综述,16-18
[17]周钦.吉兰-巴雷综合征的诊断标准与治疗研究进展.医学综述,2001,7(6):378-380
[18]魏世超,徐丽君,张秀桥.马钱子总生物碱对大鼠佐剂性关节炎的作用。中国药理学通报,2001,17(4) :479-480
[19]朱建伟,武继彪,李成韶等.马钱子碱镇痛作用及其药效动力学研究.中国中医药科技,2005,12(3):166-167
[20]赵红卫,翁世艾,朱燕娜,等.马钱子碱对小鼠淋巴细胞功能的影响.中国药理学通报,1999,15(4):354-356
[21]张蕻,李燕玲,任连生,等.马钱子天南星对小鼠移植性肿瘤的抑瘤作用.中国药物与临床,2005 , 5(4):272
[22]周建英,卞慧敏,马骋,等.马钱子碱和马钱子碱氮氧化物抗血小板聚集及抗血栓形成作用的研究.江苏中医,1998 ,19(4):41-43
[23]吴抒见,陈娟,朱高发,等.豚鼠实验性变态反应性神经炎模型的建立及电生理、免疫等指标的观察[J].中华神经精神科杂志,1995,30(6):198.
[24]刑国利.针灸治疗痿症的研究进展.针灸临床杂志[J],2004,20(5):70-71
[25]胡金凤.从五脏藏神的理论内涵探讨五脏俞治疗失眠症.中国针灸,2006,1,26(1):69-71
[26]许凤华.张锡纯治痿特色初探.中医药临床杂志,2006,l 0, l 8(5 ):433-435
[2]陈金亮,杨晓黎,郭双庚.论中医屡病学说的形成及发展.中国中医药信息杂志,1997,4(3):9-11
[3]高彩林,王洪典,王津存,等. 225例格林-巴利综合征临床流行病学分析.青海医药杂志,1998,28(2):1-2
[4]洪霞,张振馨,王建明,等.北京和河北城乡格林-巴利综合征的流行病学特征.中国医学科学院学报.2000,4,22(2):115-119
[5] Jiang GX, Cheng Q, Lint H,et al. Epidemiological features of Guillain-Bar résyndrome in Sweden, 1978-1993. J Neurol Neurosurg Psychiatry, 1997, 62:447-453
[6] Rees JH, Thompson RD, Smeeton NC,et al.Epidemiological study of Guill ain-Bar résyndrome in southeast England. J Neurol Neurosurg Psychiatry,1998, 64:7 4-77
[7]王德生,韩辉,张艳,等.哈尔滨市1997~1999年吉兰-巴雷综合征的流行病学调查.中华神经科杂志,2003,4,36(2):133-137
[8]肖雷,袁锦楣,刘向志,等.格林-巴利综合征病因学的研究.锦州医学院学报,1996,17(6):40-44
[9]李冰,杨立彬,杨亚平,等. 31例格林-巴利综合征病因学研究.实用儿科临床杂志,2001,16,(6):420-421
[10]王强,孟威宏,王虹蛟,等.急性运动性轴索型GBS的免疫发病机制研究进展.神经疾病与精神卫生,2001,1,(3):53-54
[11]王国平,李淮玉,陈柯,等.亚急性炎性脱髓鞘性多发性神经根神经病的临床和病理研究.临床神经病学杂志,2002,15(3):53-54
[12]王强,王虹蛟,张海.急性运动性轴索型格林巴利综合征的病理学研究.国外医学.老年医学分册,2000,6:269
[13]祝善尧,徐劲,鲍青松,等. 30例格林巴利综合征的临床和神经电生理分析.中国社区医师,2008,6:17
[14]党静霞,李汉玲,石小磊. Guillain-Barre综合征早期电生理变化及分型再认识.西安医科大学学报,1997,6,18(2):255-257
[15]张晓君.格林-巴利综合征的电诊断新进展.临床脑电学杂志, 1997,9,(3):188-191
[16]黄盘冰.格林一巴利综合征诊断与治疗进展.医学综述,16-18
[17]周钦.吉兰-巴雷综合征的诊断标准与治疗研究进展.医学综述,2001,7(6):378-380
[18]魏世超,徐丽君,张秀桥.马钱子总生物碱对大鼠佐剂性关节炎的作用。中国药理学通报,2001,17(4) :479-480
[19]朱建伟,武继彪,李成韶等.马钱子碱镇痛作用及其药效动力学研究.中国中医药科技,2005,12(3):166-167
[20]赵红卫,翁世艾,朱燕娜,等.马钱子碱对小鼠淋巴细胞功能的影响.中国药理学通报,1999,15(4):354-356
[21]张蕻,李燕玲,任连生,等.马钱子天南星对小鼠移植性肿瘤的抑瘤作用.中国药物与临床,2005 , 5(4):272
[22]周建英,卞慧敏,马骋,等.马钱子碱和马钱子碱氮氧化物抗血小板聚集及抗血栓形成作用的研究.江苏中医,1998 ,19(4):41-43
[23]吴抒见,陈娟,朱高发,等.豚鼠实验性变态反应性神经炎模型的建立及电生理、免疫等指标的观察[J].中华神经精神科杂志,1995,30(6):198.
[24]刑国利.针灸治疗痿症的研究进展.针灸临床杂志[J],2004,20(5):70-71
[25]胡金凤.从五脏藏神的理论内涵探讨五脏俞治疗失眠症.中国针灸,2006,1,26(1):69-71
[26]许凤华.张锡纯治痿特色初探.中医药临床杂志,2006,l 0, l 8(5 ):433-435