夹脊电针联合甲基强的松龙(MP)对ASCI大鼠脊髓组织病理形态学影响的时效关系实验研究

摘要

目的 探寻夹脊电针联合甲基强的松龙(MP)治疗对大鼠急性脊髓损伤(ASCI)后组织的病理学改变影响的时效关系.方法 将72只大鼠雌性Wistar大鼠按随机数字表法平均分为Sham组、ASCI组、EA+MP组,每组又分为1 d、3 d、7 d、14 d 4个亚组.采用BBB评分观察不同治疗方法在不同时间点对ASCI大鼠肢体运动功能的影响;采用HE染色观察在各个时间点对ASCI大鼠脊髓组织病理学影响;比较Sham组、ASCI组、EA+MP组在不同的时间点治疗效果,筛选最佳治疗方案.结果BBB评分结果显示,术后3 d、7 d、14 d,与ASCI组比较,EA+MP组大鼠肢体运动功能评分升高(P<0.05),EA+MP组组间比较,14 d组明显优于3 d组;HE染色结果显示ASCI组大鼠1 d时出血明显,可见大量凋亡神经细胞;3 d时细胞破坏最明显,7 d时神经细胞凋亡有所减轻,神经细胞坏死,4 d时凋亡已不明显,可见空泡存在,治疗组神经细胞损伤情况较ASCI组明显减轻,神经细胞保存较完好.结论 夹脊电针联合MP能改善ASCI大鼠运动功能评分,同时减少细胞凋亡,减轻脊髓病理学形态改变,并随着时间延长效果愈加明显.%Objective: To study time-effect relationship of Jiaji electroacupuncture and MP (Methylpred-nisolone) on pathomorphology change of spinal cord tissue in ASCI rats. Methods: 72 female Wister rats were randomly divided into sham operation group,ASCI group,and EA+MP group,and each group was divided into four subgroups:1 d,3 d,7 d and 14 d. BBB scores were observed to find the effects of different treatments on limb movement function of ASCI rats at different time points;HE staining was used to observe the pathological changes of spinal cord of ASCI rats at different time points;treatment effects at different time points in different groups were compared to select the best treatment plan. Results: BBB scores showed that on 3 d,7 d,14 d after opera-tion,compared with the ASCI groups,limb movement function score increases in EA+MP groups (P< 0.05). 14 d group was better than 3 d group in EA+MP groups. HE staining results showed that on 1st day,ASCI groups had significant bleeding,and a large number of apoptotic neurons appeared;on 3rd day,there was the most obvious cell destruction;on 7th day,the apoptosis of nerve cells was decreased and the nerve cells were necrotic;on 14th day,apoptosis was not obvious,and there physalides existed. The injury of nerve cells in the treatment groups was significantly lower than that in ASCI groups,and the nerve cells were well preserved. Conclusion: Jiaji elec-troacupuncture and MP can improve the movement function scores of ASCI rats,meanwhile,reduce the apoptosis, and relieve spinal pathology morphological changes,and the effects are more obvious with the extension of time.