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吴珍元,黄英如,冼 华,邓 熊,高伟峰,米庆高,张 军,孙永博.电针对失神经骨骼肌萎缩及纤维化的影响[J].中国康复医学杂志,2016,(2):177~182
电针对失神经骨骼肌萎缩及纤维化的影响    点此下载全文
吴珍元  黄英如  冼 华  邓 熊  高伟峰  米庆高  张 军  孙永博
重庆医科大学中医药学院骨科教研室,重庆,400016
基金项目:国家自然科学基金面上项目(81373668);重庆市渝中区科技计划项目(20120219);重庆市九龙坡区科技项目(2010-43;2010-44;2011-62)
DOI:
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摘要:
      摘要 目的:观察不同强度电针对失神经支配骨骼肌萎缩及肌纤维化的影响。 方法:32只SD大鼠随机等分为4组(n=8):A组(模型组)、B组(0.5mA电针组)、C组(1.0mA电针组)、D组(1.5mA电针组)。切断坐骨神经干造成失神经支配腓肠肌模型,术后1天,B、C、D组术侧分别给予相应强度电针(针刺“足三里”和“承山”)治疗,每次治疗10min,隔天1次,每周3次,共治疗4周,A组不行治疗。术后8周,测定术侧腓肠肌湿重比,Masson染色测定腓肠肌结缔组织截面积率、肌纤维直径和截面积,Western blot检测转化生长因子β1(transforming growth factor β1, TGF-β1)、结缔组织生长因子(connective tissue growth factor, CTGF)、Bcl-2和Bax表达,透射电镜观察腓肠肌超微结构。 结果:A组与B、C、D组间,D组与B、C组间腓肠肌湿重比差异均有显著性意义(P<0.05),但B、C组间差异无显著性意义(P>0.05)。A组与B、C、D组间,以及D组与B、C组间结缔组织截面积率差异均有显著性意义(P<0.05),但B、C组间差异无显著性意义(P>0.05)。A组与B、C、D组间,以及B、C、D组间肌纤维直径和截面积差异均有显著性意义(P<0.01)。A组最高、D组最低,A组与B、C、D组间,以及B、C、D组间TGF-β1、CTGF蛋白表达差异均有显著性意义(P<0.01)。Bcl-2蛋白表达,A组最低、D组最高,而Bax蛋白表达,A组最高、D组最低;Bcl-2/Bax比值A组最低,B、C、D组依次升高,且A组与C、D组间,以及B、C、D组间差异均有显著性意义(P<0.01)。透射电镜显示,A组肌丝排列紊乱、溶解严重,Z线断裂,线粒体空泡化;B、C、D组肌丝排列基本整齐,肌丝溶解、Z线断裂较轻,B组可见线粒体肿胀、空泡化,但轻于A组。 结论:电针可减轻失神经骨骼肌萎缩程度,其机制可能与抑制靶肌肉结缔组织增生,调节Bcl-2、Bax蛋白表达有关。
关键词:失神经骨骼肌萎缩  电针  结缔组织增生  细胞凋亡
Effects of electroacupuncture on denervated skeletal muscle atrophy and muscle fibrosis    Download Fulltext
Chongqing Medical University, 400016
Fund Project:
Abstract:
      Abstract Objective: To observe the effect of different intensity electroacupuncture on denervated skeletal muscle atrophy and muscle fibrosis. Method: Thirty-two SD rats were randomly divided into four groups (each group contains 8 rats): group A was model group, groups B, C and D were treated with 0.5mA, 1.0mA, 1.5mA electroacupuncture respectively. The sciatic nerve of rats were transected to establish the model of denervated skeletal muscle. 1 day after surgery, groups B, C and D were treated with the corresponding intensity of electroacupuncture last 10 minutes, and 3 times weekly for 4 weeks, group A wasn't given any treatment. The wet weight ratio of gastrocnemius muscle were measured 8 weeks after operation. The ratio of cross sectional area of connective tissue, muscle fiber diameter and cross-sectional area were measured using Masson staining method. The expression of transforming growth factor β1(TGF-β1), connective tissue growth factor(CTGF), Bcl-2 and Bax were detected by Western blot. The ultrastructure of gastrocnemius muscles were observed with transmission electron microscope. Result: The wet weight ratio of gastrocnemius muscle in group A was lower than that in groups B, C and D, and in groups B and C lower than that in group D (P<0.05), but there was no significant difference between group B and group C (P>0.05). The ratio of cross sectional area of connective tissue in group A was higher than that in groups B, C and D, and in groups B and C higher than that in group D (P<0.05), but there was no significant difference between group B and group C (P>0.05). There was significant difference in the muscle fiber diameter and cross-sectional area between different groups (P<0.01), and in the expression of TGF-β1 and CTGF between different groups (P<0.01). The expression of Bcl-2 in group A was the lowest, and that in group D was the highest, on the contrary, the expression of Bax in group A was the highest, and that in group D was the lowest. The ratio of Bcl-2 / Bax increased gradually in groups A, B, C and D, there was significant difference between group A and groups C and D, and among groups B, C and D (P<0.01). Transmission electron microscopy results showed that disorder-arranged myofilament, broken Z line, and mitochondrial vacuole in group A were seen, while these degeneration in groups B, C and D were lighter than those of group A. Conclusion: Electroacupuncture could retard the process of denervated skeletal muscle atrophy, its mechanism might be related to the inhibition of hyperplasia in the skeletal muscles connective tissue and the regulation of expression of the Bcl-2 and Bax.
Keywords:denervated skeletal muscle atrophy  electroacupuncture  connective tissue hyperplasia  cell apoptosis
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