摘要
目的探讨"三法三穴"推拿手法对坐骨神经损伤大鼠运动功能恢复、坐骨神经损伤点和L4-6脊髓中神经调节蛋白(NRG) 1及其受体人类表皮生长因子受体(ErbB) 2表达以及坐骨神经损伤点处髓鞘形态变化的影响。方法 76只雄性Sprague-Dawley大鼠随机分为正常组、假手术组、模型组和推拿组,每组19只。模型组和推拿组夹持右侧坐骨神经造模;假手术组仅分离后暴露坐骨神经,不夹持。术后7 d,推拿组以按摩推拿手法模拟仪模拟点法、拨法、揉法,作用于殷门、承山、阳陵泉,分别于造模前、术后7 d、28 d行斜板测试,于术后3 d、7 d、28 d,采用Western blotting检测坐骨神经损伤点和L4-6脊髓NRG1、ErbB2蛋白表达,术后28 d透射电镜观察坐骨神经损伤点处髓鞘的变化。结果术后7 d和28 d,模型组和推拿组斜板测试角度低于正常组和假手术组(P <0.05);术后28 d,推拿组评分高于模型组(P <0.05)。坐骨神经损伤点中,术后3 d,模型组和推拿组NRG1、ErbB2表达高于正常组和假手术组(P <0.05);术后7 d和28 d,各组NRG1表达无显著性差异(P> 0.05);术后28 d,模型组和推拿组ErbB2表达高于正常组和假手术组(P <0.05)。L4-6脊髓中,术后3 d,模型组和推拿组NRG1、ErbB2表达高于正常组和假手术组(P <0.05);术后7 d,模型组和推拿组NRG1表达高于假手术组(P <0.05),模型组和推拿组ErbB2表达高于正常组和假手术组(P <0.05);术后28 d,推拿组NRG1表达高于模型组(P <0.05),ErbB2各组间无显著性差异(P> 0.05)。术后28 d,模型组髓鞘崩脱严重,推拿组神经损伤点超微结构明显改善,神经纤维髓鞘保留较完整;模型组g-ratio值低于假手术组(P <0.05),推拿组高于模型组(P <0.05),且与假手术组比较无显著性差异(P> 0.05)。结论 "三法三穴"推拿手法能改善坐骨神经损伤大鼠后肢运动功能。推拿干预周围神经损伤起效机制与维持坐骨神经损伤点和L4-6脊髓中NRG1和ErbB2蛋白表
Objective To explore the effect of Tuina of Three Handing-Three Points on the recovery of motor function,the expression of neuregulin(NRG)1 and human epidermal growth factor receptor(ErbB)2 in the injured point of sciatic nerve and L4-6 spinal cord,and the morphological change of myelin sheath at the injured point of sciatic nerve of rats.Methods A total of 76 male Sprague-Dawley rats were randomly divided into normal group,sham operation group,model group and Tuina group with 19 rats in each group.The right side sciatic nerve was clamped to make model in the model group and Tuina group.The sham operation group exposed sciatic nerve only.Tuina group received Tuina on Yinmen(BL37),Chengshan(BL57)and Yanglingquan(GB34)with dialing,plucking and kneading using Tuina technique simulator.All of them were tested with Oblique Plate Test before modeling,seven days and 28 days after modeling.Western blotting was used to detect the protein expression of NRG1 and ErbB2 in the injured point of sciatic nerve and L4-6 spinal cord.The change of myelin sheath at the sciatic nerve injury point was observed and analyzed by transmission electron microscope.Results Seven days and 28 days after modeling,the scores of Oblique Plate Test were lower in the model group and Tuina group than in the normal group and the sham operation group(P<0.05);28 days after modeling,the scores was higher in Tuina group than in the model group(P<0.05).At the sciatic nerve injury point,three days after modeling,the expression of NRG1 and ErbB2 was higher in the model group and Tuina group than in the normal group and the sham operation group(P<0.05);seven days and 28 days after modeling,there was no significant difference in NRG1 among groups(P>0.05);28 days after modeling,the expression of ErbB2 was higher in the model group and Tuina group than in the normal group and the sham operation group(P<0.05).In L4-6 spinal cord,three days after modeling,the expression of NRG1 and ErbB2 was higher in the model group and Tuina group than in the normal group and s
作者
沈熠
莫岩君
于天源
吕桃桃
罗宇婷
张羽墨
邵帅
李易真
SHEN Yi;MO Yan-jun;YU Tian-yuan;Lü Tao-tao;LUO Yu-ting;ZHANG Yu-mo;SHAO Shuai;LI Yi-zhen(Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《中国康复理论与实践》
CSCD
北大核心
2020年第4期423-431,共9页
Chinese Journal of Rehabilitation Theory and Practice
基金
国家自然科学基金项目(No.81674094)。
