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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:

第26卷

期數(shù):

2014年06期

頁(yè)碼:

10-14

欄目:

基礎(chǔ)研究

出版日期:

2014-06-30

文章信息/Info

Title:

Effect of oral application of JIAWEI HUANGQI GUIZHI WUWU decoction and mecobalamin on peripheral nerve injuries

作者:

程真真; 唐洪濤; 程春生

河南省洛陽(yáng)正骨醫(yī)院,河南 洛陽(yáng) 471002

Author(s):

Cheng Zhenzhen^*; Tang Hongtao; Cheng Chunsheng.^*

Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China

關(guān)鍵詞:

周圍神經(jīng)損傷 黃芪桂枝五物湯 甲鈷胺 動(dòng)物實(shí)驗(yàn)

Keywords:

Peripheral nerve injuries;  HUANGQI GUIZHI WUWU decoction;  Mecobalamin;  Animal experimentation

摘要:

目的:探討加味黃芪桂枝五物湯聯(lián)合甲鈷胺治療周圍神經(jīng)損傷的療效。方法:將54只SD大鼠隨機(jī)分為3組,每組18只,均采用左側(cè)坐骨神經(jīng)切斷縫合建立坐骨神經(jīng)損傷模型。造模后第3天,A組大鼠按1 mL·100 g^-1以加味黃芪桂枝五物湯灌胃,每天1次,連續(xù)4周; 同時(shí)按1 mL·100 g^-1以甲鈷胺和生理鹽水制成的混懸液(0.05 mg·mL^-1)灌胃,每天1次,連續(xù)4周。B組以甲鈷胺和生理鹽水制成的混懸液灌胃,用法、用量同A組。C組按1 mL·100 g^-1以生理鹽水灌胃,每天1次,連續(xù)4周。觀察各組大鼠的一般狀態(tài),并測(cè)定坐骨神經(jīng)功能指數(shù)、神經(jīng)傳導(dǎo)速度恢復(fù)率、復(fù)合肌肉誘發(fā)電位振幅恢復(fù)率、小腿三頭肌濕重恢復(fù)率及神經(jīng)軸突恢復(fù)率。結(jié)果:①一般狀態(tài)。造模后1 d所有大鼠均蜷縮傷肢,3 d后跛行,切口均無(wú)感染。藥物干預(yù)后第2周,3組大鼠左后小腿肌肉均有不同程度的萎縮,C組較A、B組更為明顯,且C組部分大鼠出現(xiàn)跗關(guān)節(jié)腫脹和皮膚潰瘍,多在第4周左右自行愈合。自藥物干預(yù)后第4周開始,大鼠跛行逐漸改善,A組大鼠毛發(fā)光亮,運(yùn)動(dòng)靈活,爬行速度快; B組大鼠毛發(fā)較暗,運(yùn)動(dòng)較靈活,爬行速度較快; C組毛發(fā)暗淡,活動(dòng)較差,反應(yīng)較遲鈍。②坐骨神經(jīng)功能指數(shù)。藥物干預(yù)后第1周、第2周、第3周及第4周坐骨神經(jīng)功能指數(shù)的差異有統(tǒng)計(jì)學(xué)意義,即存在時(shí)間效應(yīng)[(-75.61±8.20),(-62.89±7.36),(-30.89±6.14),(-18.33±6.88);(-75.39±7.70),(-60.67±7.53),(-33.11±6.43),(-24.11±7.32);(-80.33±6.78),(-65.67±7.88),(-55.22±7.26),(-29.56±7.88); F=2.015,P=0.000]。3組大鼠坐骨神經(jīng)功能指數(shù)的組間差異總體上有統(tǒng)計(jì)學(xué)意義,即存在分組效應(yīng)(F=82.434,P=0.000); 藥物干預(yù)后第3周和第4周A組的坐骨神經(jīng)功能指數(shù)均高于B組和C組(P=0.004,P=0.000; P=0.023,P=0.000)。時(shí)間因素和分組因素之間存在交互效應(yīng)(F=10.928,P=0.000)。③神經(jīng)傳導(dǎo)速度恢復(fù)率。3組大鼠神經(jīng)傳導(dǎo)速度恢復(fù)率比較,差異有統(tǒng)計(jì)學(xué)意義[(66.39±11.77)%,(53.72±14.40)%,(44.72±11.21)%,F=13.569,P=0.000]。A組大鼠神經(jīng)傳導(dǎo)速度恢復(fù)率高于B組和C組(P=0.004,P=0.000); B組高于C組(P=0.036)。④復(fù)合肌肉誘發(fā)電位振幅恢復(fù)率。3組大鼠復(fù)合肌肉誘發(fā)電位振幅恢復(fù)率比較,差異有統(tǒng)計(jì)學(xué)意義[(63.22±14.29)%,(45.06±11.72)%,(32.44±7.82)%,F=32.117,P=0.000]。A組復(fù)合肌肉動(dòng)作電位振幅恢復(fù)率高于B組和C組(P=0.000,P=0.000); B組優(yōu)高于C組(P=0.002)。⑤小腿三頭肌濕重恢復(fù)率。3組大鼠小腿三頭肌濕重恢復(fù)率比較,差異有統(tǒng)計(jì)學(xué)意義[(78.56±7.01)%,(65.78±8.19)%,(58.28±10.84)%,F=29.940,P=0.000]。A組高于B組和C組(P=0.000,P=0.000),B組高于C組(P=0.013)。⑥神經(jīng)軸突恢復(fù)率。3組大鼠神經(jīng)軸突恢復(fù)率比較,差異有統(tǒng)計(jì)學(xué)意義[(78.28±7.91)%,(69.89±8.08)%,(62.94±10.66)%,F=13.889,P=0.000]。A組高于B組和C組(P=0.006,P=0.000),B組高于C組(P=0.021)。結(jié)論:加味黃芪桂枝五物湯聯(lián)合甲鈷胺可有效促進(jìn)受損周圍神經(jīng)的修復(fù)和再生。

Abstract:

Objective:To explore the curative effect of oral application of JIAWEI HUANGQI GUIZHI WUWU decoction and mecobalamin on peripheral nerve injuries.Methods:Fifty-four SD rats were randomly divided into 3 groups,18 rats in each group.The sciatic nerve injuries models were created through transecting and suturing the sciatic nerve at the left hind legs of rats.The rats in group A were intragastric administrated with JIAWEI HUANGQI GUIZHI WUWU decoction(1 mL/100 g)on the 3rd day after modeling,once per day for 4 consecutive weeks.Meanwhile,the rats in group A were intragastric administrated with the mecobalamin solution(0.05 mg/mL,1 mL/100 g),once per day for 4 consecutive weeks.The rats in group B were intragastric administrated with the mecobalamin solution(0.05 mg/mL),which usage and dosage were same as that of group A.The rats in group C were intragastric administrated with normal saline(1 mL/100 once per day for 4 consecutive weeks.After that,the general status of rats in each group were observed,and the sciatic nerve function index(SFI),nerve conduction velocity(NCV)recovery rate,compound muscle evoked potential amplitude recovery rate,wet weight of triceps muscle(WWT)recovery rate and nerve axons recovery rate were all determined.Results:All rats curled their injured legs one day after modeling and claudication were found 3 days after modeling,and no incision infection were found.The various degrees of muscle wasting were found in the left hind legs of the rats in 3 groups on the 2nd week after the beginning of drug intervention.Compared with group A and group B,muscle wasting were more significant in group C.Meanwhile,the hock joints swelling and skin ulcers were found in several rats of group C,and most skin ulcers healed naturally on the 4th week after the beginning of drug intervention.The claudication of rats were improved gradually since the 4th week after the beginning of drug intervention.The rats in group A presented with vivid hair,swift action and fast crawling speed; and the rats in group B presented with dark hair,relative swift action and relative fast crawling; while the rats in group C presented with dim hair and sluggish action.There was statistical difference in SFI between different time points after the beginning of the drug intervention,in other words,there was time effect(-75.61+/-8.20,-62.89+/-7.36,-30.89+/-6.14,-18.33+/-6.88; -75.39+/-7.70,-60.67+/-7.53,-33.11+/-6.43,-24.11+/-7.32; -80.33+/-6.78,-65.67+/-7.88,-55.22+/-7.26,-29.56+/-7.88; F=2.015,P=0.000).There was statistical difference in SFI between the 3 groups in general,in other words,there was grouping effect(F=82.434,P=0.000).The SFI of group A was higher than that of group B and group C on the 3rd and 4th week after the beginning of the drug intervention(P=0.004,P=0.000; P=0.023,P=0.000).There was interaction between time factor and grouping factor(F=10.928,P=0.000).There was statistical difference in NCV recovery rate between the 3 groups(66.39+/-11.77%,53.72+/-14.40%,44.72+/-11.21%,F=13.569,P=0.000).The NCV recovery rate of group A was higher than that of group B and group C(P=0.004,P=0.000),and group B surpassed group C(P=0.036).There was statistical difference in the compound muscle evoked potential amplitude recovery rate between the 3 groups(63.22+/-14.29%,45.06+/-11.72%,32.44+/-7.82%,F=32.117,P=0.000),and group A surpassed group B and group C(P=0.000,P=0.000)and group B surpassed group C(P=0.002).There was statistical difference in the WWT recovery rate between the 3 groups(78.56+/-7.01%,65.78+/-8.19%,58.28+/-10.84%,F=29.940,P=0.000),and group A surpassed group B and group C(P=0.000,P=0.000)and group B surpassed group C(P=0.013).There was statistical difference in the nerve axons recovery rate between the 3 groups(78.28+/-7.91%,69.89+/-8.08%,62.94+/-10.66%,F=13.889,P=0.000),and group A surpassed group B and group C(P=0.006,P=0.000)and group B surpassed group C(P=0.021).Conclusion:The therapy of oral application of JIAWEI HUANGQI GUIZHI WUWU decoction and mecobalamin can effectively promote the recovery and regeneration of injured peripheral nerves.

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更新日期/Last Update: 1900-01-01