摘要
目的:观察电针对实验性糖尿病周围神经病变大鼠坐骨神经传导速度及神经纤维超微结构的影响。方法:实验于2005-01/12在上海中医药大学附属岳阳中西医结合医院中心实验室完成。选用清洁级雄性Wistar大鼠100只,按随机数字表法选取15只作为正常对照组。在链脲佐菌素制备实验性糖尿病大鼠(n=85)基础上制备实验性糖尿病周围神经病变大鼠模型,以空腹血糖≥15mmol/L,坐骨神经感觉神经传导速度,运动神经传导速度明显减慢、摆尾温度阈值升高及坐骨神经有髓纤维形态学改变为造模成功的标准。在确认实验性糖尿病周围神经病变大鼠模型成功的基础上,采用随机数字表法抽取60只大鼠,分为3组,即电针经(组、电针非经(组、模型对照组,每组20只。①电针经(组:取肾俞(双)、足三里(双)(,将大鼠固定,针刺0.5cm,并接电针治疗仪,连续波,频率2Hz,20min/次,隔日1次,共治疗12次。②电针非经(组:将大鼠尾尖作为刺激点,具体方法和治疗次数同上。③模型对照组:不作任何治疗,只作与电针经(组相同的固定。④正常对照组:作与电针经(组相同的固定。造模后4周,以神经电生理法测试各组大鼠的运动神经、感觉神经传导速度;造模后8周,应用透射电镜观察各组大鼠的坐骨神经组织超微结构。结果:实验过程中模型对照组、电针非经(组及电针经(组大鼠分别死亡5,4,1只,因此进入结果分析每组分别抽取15只进行指标检测。①各组大鼠造模4周时的坐骨神经传导速度比较:模型对照组的运动神经传导速度、感觉神经传导速度显著低于正常对照组(31.37±3.70,18.17±9.54;41.30±1.15,44.22±8.80)m/s(P<0.01)。电针经(组经治疗后运动神经传导速度、感觉神经传导速度显著高于模型对照组(38.04±2.01,37.98±5.10)m/s(P<0.01),但未达到正常对照组水平(P<0.05);电针非经(组大鼠的运动神经传导速度、感觉神经传导速度与模型对照组差异无显著性意义(32.74±5.42,21.39±5.61)m/s(P>0.05)。②各组大鼠造模8周时的坐骨神经超微结构比较:模型对照组大鼠坐骨神经有髓神经纤维髓鞘结构模糊、松散、排列紊乱,出现空泡状缺损。电针非经(组大鼠坐骨神经有髓神经纤维髓鞘结构松散、排列紊乱,出现断裂或空泡状缺损。电针经(组大鼠坐骨神经髓纤维髓鞘结构损伤脱失的程度较模型对照组有所减轻,但未达到正常对照组水平。结论:电针对糖尿病周围神经病变具有一定的防治作用,其作用可能是通过改善糖尿病周围神经病变大鼠周围神经有髓纤维的形态及功能而实现的。
AIM： To observe the influence of electroacupuncture on the conduction velocity and microstructure of sciatic nerve in rats with experimental diabetic peripheral neuropathy.
METHODS： The experiment was conducted in the central laboratory of Yueyang Hospital of Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine from January to December 2005. Among 100 clean grade male Wistar rats, 15 were randomly selected as normal control group. The rat models of experimental diabetic peripheral neuropathy were established based on streptozotocin-induced experimental diabetic rats （n =85）. The successful modeling was identified by fasting serum glucose ≥ 15 mmol/L, obvious decrease in sensory nerve conduction velocity （SNCV） and motor nerve conduction velocity （MNCV） of sciatic nerve, advances of the threshold of wave tail temperature and morphological changes in the myelinated fibre of sciatic nerve. Then sixty rats were randomly selected and divided into three groups including electroacupuncture （EA） acupoints group, EA un-acupoints group and model group with 20 rats in each group. （1）EA acupoints group was acupunctured Shenshu and Zusanli at 0.5 cm combined with EA therapy device of continuous wave at 2 Hz, 20 minutes every time, once every other day for 12 times. （2）EA un-acupoints group was acupunctured the tip of rat tail with the previous methods and times. （3）The model group was not given any treatment, only the same fixation as the EA acupoints group. （4）The normal group was given the same fixation as the EA acupoints group. Four weeks after modeling, the SNCV and MNCV of rats in each group were measured with electrophysiological method; eight weeks after modeling, the microstructural changes of the nerve fibers were observed with transmission electron microscope.
RESULTS： During the experiment, 5 rats in the model group, 4 in the EA un-acupoints group and 1 in the EA acupoints group died, finally, 15 rats of each group were selected and involved in the result analysis. （1）Comparison of conduction velocity at four weeks after modeling： MNCV and SNCV of the sciatic nerve in the model group were significantly lower than the normal control group （31.37±3.70, 18.17±9.54; 41.30±1.15, 44.22±8.80） m/s, （P 〈 0.01）. MNCV and SNCV of the EA acupoints group after treatment were obviously higher than the model group （38.04±2.01, 37.98±5.10） m/s, （P 〈 0.01）, but still lower than the normal control group （P 〈 0.05）; there were no significant differences in MNCV and SNCV among the EA un-acupoints group and model group （32.74±5.42, 21.39±5.61） m/s, （P 〉 0.05）. （2）Comparison of the microstructure of sciatic nerve at eight weeks after modeling： The microstructure of myelinated fibre of the model group was vague, loose, and arranged irregularly with vacuolus defects. The microstructure of the EA un-acupoints group was also loose, and arragned irregularly with breakage or vacuolus defects. The demyelination ratio and lesion of the myelinated nerve fibers in the EA acupoints group were ameliorated compared with the model group, but still not reached the normal group level.
CONCLUSION： EA displays a preventive effect on the diabetic peripheral neuropathy by improving the morphology and function of the myelinated fibre of sciatic nerve in rats with diabetic peripheral neuropathy.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第16期3069-3073,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
国家自然科学基金资助项目(30372888)
上海市重点学科建设项目资助(T0302)~~
