中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2018, Vol. 13 ›› Issue (7): 1241-1246.doi: 10.4103/1673-5374.235062

• 原著:脊髓损伤修复保护与再生 • 上一篇    下一篇

不同时期脊髓减压联合督脉电针修复大鼠急性上颈髓损伤是否有更好的效果？

  

  • 收稿日期:2018-05-06 出版日期:2018-07-15 发布日期:2018-07-15
  • 基金资助:

    北京市科技计划“首都特色临床应用研究项目”的资助（Z16110000516009）

Effects of decompression joint Governor Vessel electro-acupuncture on rats with acute upper cervical spinal cord injury

Yan-Lei Wang1, Ying-Na Qi1, Wei Wang1, Chun-Ke Dong1, Ping Yi2, Feng Yang2, Xiang-Sheng Tang2, Ming-Sheng Tan2   

  1. 1 Beijing University of Chinese Medicine, Beijing, China
    2 Department of Spine Surgery, China-Japan Friendship Hospital, Beijing, China
  • Received:2018-05-06 Online:2018-07-15 Published:2018-07-15
  • Contact: Ming-Sheng Tan,1030721955@qq.com
  • Supported by:

    This study was supported by the Capital Characteristic Clinical Application Research Projects of Beijing Municipal Science and Technology Plan of China, No. Z16110000516009.

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摘要：

脊髓减压是急性脊髓损伤的主要治疗策略，但脊髓减压时间窗一直存在争议，超过时间窗的减压能否抑制或逆转继发性脊髓损伤？有研究证实，督脉电针可以通过抑制细胞凋亡和改善脊髓损伤的微环境来改善脊髓损伤的症状。督脉电针联合不同时间脊髓减压治疗脊髓损伤。实验设计以改良经寰枕间隙置入球囊导管造成上颈髓损伤构建模型大鼠，分别压迫上颈髓12 h和48 h，进行球囊导管减压，并给与其督脉电针大椎(GV14)和百会穴(GV 20)(2 Hz，15 min) 干预，每日1次，连续干预14 d后发现，与单纯脊髓减压相比，脊髓压迫12，48 h后减压并经督脉电针治疗大鼠的后肢运动功能恢复较好，但脊髓压迫12 h后减压的大鼠治疗后14 d后肢运动功能恢复情况差异无显著性意义；督脉电针组脊髓组织继发性损伤主要相关因子-血小板活化因子水平及促凋亡蛋白-caspase 9蛋白表达较单纯减压组均降低明显。上述结果说明，与单纯脊髓减压相比，督脉电针联合大鼠晚期(48 h)脊髓减压对于上颈段脊髓损伤的治疗更加有效，督脉电针联合大鼠早期(12 h)脊髓减压具有加速上颈段脊髓损伤大鼠的神经运动恢复的作用，但是最终能否取得较单纯早期减压治疗更大的收益，仍需进行进一步的研究。

orcid:0000-0001-7738-4768(Ming-Sheng Tan)

关键词: 急性脊髓损伤, 脊髓减压, 电针总督血管, 血小板活化因子, 凋亡, 甲基强的松龙, Caspase家族, 上颈椎, 动物模型, BBB评分, 神经再生

Abstract:

Decompression is the major therapeutic strategy for acute spinal cord injury, but there is some debate about the time window for decompression following spinal cord injury. An important goal and challenge in the treatment of spinal cord injury is inhibiting or reversing secondary injury. Governor Vessel electroacupuncture can improve symptoms of spinal cord injury by inhibiting cell apoptosis and improving the microenvironment of the injured spinal cord. In this study, Governor Vessel electroacupuncture combined with decompression at different time points was used to treat acute spinal cord injury. The rat models were established by inserting a balloon catheter into the atlanto-occipital space. The upper cervical spinal cord was compressed for 12 or 48 hours prior to decompression. Electroacupuncture was conducted at the acupoints Dazhui (GV14) and Baihui (GV 20) (2 Hz, 15 minutes) once a day for 14 consecutive days.Compared with decompression alone, hind limb motor function recovery was superior after decompression for 12 and 48 hours combined with electroacupuncture. However, the recovery of motor function was not significantly different at 14 days after treatment in rats receiving decompression for 12 hours. Platelet-activating factor levels and caspase-9 protein expression were significantly reduced in rats receiving electroacupuncture compared with decompression alone. These findings indicate that compared with decompression alone,Governor Vessel electroacupuncture combined with delayed decompression (48 hours) is more effective in the treatment of upper cervical spinal cord injury. Governor Vessel electroacupuncture combined with early decompression (12 hours) can accelerate the recovery of nerve movement in rats with upper cervical spinal cord injury. Nevertheless, further studies are necessary to confirm whether it is possible to obtain additional benefit compared with early decompression alone

Key words: nerve regeneration, acute spinal cord injury, decompression, Governor Vessel electroacupuncture, platelet-activating factor, apoptosis, methylprednisolone, caspase family, upper cervical spine, animal model, Basso, Beattie and Bresnahan locomotor scale, neural regeneration