本文選題：針刀　切入點(diǎn)：針刺　出處：《南京中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過“低頭位+風(fēng)寒濕刺激”的方法建立頸椎間盤退變動物模型,用針刀干預(yù)模型動物,從組織形態(tài)學(xué)及椎間盤細(xì)胞外基質(zhì)組分、代謝相關(guān)酶和細(xì)胞因子含量變化等方面來探討針刀療法能否通過延緩甚至修復(fù)椎間盤退變來達(dá)到治療頸椎病的目的。方法：購進(jìn)6+0.5月齡健康雄性新西蘭大白兔,將其分為空白組、模型組、針刀組和針刺組,每組6只。除對照組外其余各組均用“低頭位+風(fēng)寒濕刺激”的方法建立實(shí)驗(yàn)?zāi)Ｐ�。造模結(jié)束后,通過對比空白組兔和造模組兔頸椎X線,初步判定造模是否成功。造模成功后,模型組常規(guī)飼養(yǎng),用針刀和毫針分別對針刀組和針刺組進(jìn)行干預(yù)治療,針刀組每周干預(yù)1次,共干預(yù)4次,針刺組每周干預(yù)3次,共干預(yù)12次。干預(yù)結(jié)束后,HE染色,光鏡下觀察四組實(shí)驗(yàn)動物頸部肌肉及椎間盤的組織形態(tài)學(xué)變化。用ELISA法檢測四組實(shí)驗(yàn)動物椎間盤內(nèi)MMP-3、TGF-β1含量,Western blot法檢測椎間盤內(nèi)II型膠原、蛋白多糖的蛋白表達(dá)水平。結(jié)果：空白組動物頸椎X線顯示：頸椎生理曲度正常存在,椎間隙無增寬或狹窄,椎體排列整齊,椎體周圍光滑無骨贅形成。造模后的實(shí)驗(yàn)動物頸椎X線顯示：頸椎正常生理曲度消失,變直甚至反弓,椎間隙變窄,椎體排列不整齊,椎體邊緣毛糙有骨贅形成。針刀及針刺干預(yù)結(jié)束后,頸部肌肉HE染色光鏡下觀察顯示：空白組實(shí)驗(yàn)動物頸肌組織切片可見肌肉組織結(jié)構(gòu)清晰,肌細(xì)胞無變性水腫,無炎性細(xì)胞浸潤。模型組可見肌纖維排列不齊、斷裂。肌細(xì)胞腫脹變形,肌核分布不均,大量炎性細(xì)胞浸潤。針刀組可見肌肉組織結(jié)構(gòu)較模型組整齊,炎性細(xì)胞浸潤明顯減少,細(xì)胞核排列較前均勻整齊。針刺組可見肌纖維排列較模型組明顯整齊,肌細(xì)胞仍有輕度腫脹、扭曲,間質(zhì)內(nèi)有少量炎性細(xì)胞浸潤,但較模型組明顯減輕。椎間盤HE染色光鏡下觀察顯示：空白組髓核居中,大小正常,纖維環(huán)包繞四周,纖維排列整齊。模型組可見髓核明顯固縮,纖維排列雜亂、扭曲變形,甚至斷裂。針刀組、針刺組均仍可見髓核固縮,但較之模型組,明顯改善。周圍纖維排列較模型組明顯整齊,裂隙變小。ELISA結(jié)果：模型組兔椎間盤內(nèi)MMP-3含量較空白組明顯升高,二者有極明顯差異(P0.01)；針刺組與模型組相比明顯降低,有明顯差異(P0.05)；針刀組與模型組相比明顯降低,有極明顯差異(P0.01)；針刀組與針刺組偏低,有極顯著差異(P0.01)。模型組兔椎間盤內(nèi)TGF-β1的含量較空白組明顯降低,二者有極明顯差異(P0.01)；針刺組與模型組相比明顯升高,有明顯差異(P0.05)；針刀組與模型組相比明顯升高,有極明顯差異(P0.01)；針刀組比針刺組略升高,無統(tǒng)計(jì)學(xué)意義(P0.05)。Western blot結(jié)果：所測四組實(shí)驗(yàn)動物椎間盤中Ⅱ型膠原蛋白表達(dá)水平模型組較空白組明顯降低,二者有極明顯差異(P0.01)；針刺組與模型組相比明顯升高,有明顯差異(P0.05)：針刀組與模型組相比明顯升高,有極明顯差異(P0.01)；針刀組較針刺組偏高,有顯著差異(P0.05)。所測四組實(shí)驗(yàn)動物椎間盤中蛋白多糖蛋白表達(dá)水平較空白組明顯降低,二者有極明顯差異(P0.01)；針刺組與模型組相比明顯升高(P0.01)；針刀組與模型組相比明顯升高,有明顯差異(P0.05)；針刺組較針刀組略偏高,但無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：1.對比空白組和模型組頸椎X線、頸肌及椎間盤組織形態(tài)學(xué)變化,“低頭位+風(fēng)寒濕”刺激可成功建立椎間盤退變實(shí)驗(yàn)?zāi)Ｐ?該實(shí)驗(yàn)?zāi)Ｐ褪浅晒Φ摹?.針刀及針刺干預(yù)均能使椎間盤中蛋白多糖和II型膠原蛋白表達(dá)升高,使MMP-3含量降低、TGF-β1含量升高,說明針刀及針刺干預(yù)治療頸椎病可能是通過對椎間盤內(nèi)細(xì)胞因子及相關(guān)代謝酶的良性調(diào)節(jié),抑制細(xì)胞外基質(zhì)的降解,緩解甚至修復(fù)椎間盤的退變。3.從頸肌、椎間盤組織形態(tài)及椎間盤微量物質(zhì)的對比,總體來講,針刀療效略優(yōu)于針刺。
[Abstract]:Objective: to establish the model of cervical intervertebral disc degeneration animal by means of "bow + cold wet stimulation, the animal model with Acupotomy intervention from histomorphology and disc extracellular matrix components, metabolism related enzymes and cytokines content, to explore whether by acupotomy therapy can delay or even repair of intervertebral disc degeneration to achieve the treatment of cervical spondylosis. Methods: the purchase of 6+0.5 month old male New Zealand rabbits were divided into blank group, model group, acupuncture group and acupuncture group, 6 rats in each group. All groups except the control group by method of" head + wind cold stimulation of the experimental model is established after the modeling. By contrast, the blank group and model group rabbit rabbit cervical X-ray, determine the initial success of modeling. After successful modeling, the model group, with the needle knife and needle of acupotomy group and acupuncture group intervention, Acupotomy group Intervention 1 times a week, a total of 4 times a week group of acupuncture intervention, intervention 3 times, a total of 12 times. The intervention after the intervention, HE staining, the morphological changes of muscle and disc four groups of experimental animal neck under light microscope. ELISA was used to detect four groups of experimental animal intervertebral disc MMP-3, TGF- beta 1 content II Western, the detection of intervertebral disc by blot collagen, the expression level of protein polysaccharide protein. Results: blank group: Animal cervical X-ray normal cervical lordosis, intervertebral broadening or stenosis, vertebral body arranged around the vertebral body smooth without osteophyte formation. Experimental animal model: cervical X-ray disappeared the normal cervical lordosis, straight and even anti bow, narrowing of intervertebral space, vertebral malalignment, rough edge vertebral osteophyte formation. Acupuncture and acupuncture intervention after the neck muscle HE staining light microscope observation showed that: blank group experimental animal muscle Histological sections showed the muscle tissue structure is clear, muscle cells without edema, no inflammatory cell infiltration. The model group showed that the muscle fibers were uneven fracture. Muscle cell swelling, muscle nuclear uneven distribution, a large number of inflammatory cells infiltration. Acupotomy group visible muscle tissue structure orderly compared with model group, inflammatory cell infiltration reduce nuclear arrangement was uniform. The acupuncture group showed muscle fibers were compared with the model group was neat, muscle cells still had mild swelling, distortion, interstitial infiltration of inflammatory cells, but was significantly reduced compared with model group. The intervertebral disc HE staining by light microscope observation showed that: blank group nucleus center size normally, fiber ring wrapped around arrangedregularly. Model group showed obvious nucleus pyknosis, fibers arranged disorderly, distorted, or even fracture. Acuknife group, the acupuncture group was still visible nucleus pyknosis, but significantly compared with the model group, improve the week. Wai fibers were arranged in the model group was significantly smaller in order, crack.ELISA results: in the model group, the rabbit intervertebral disc MMP-3 was significantly higher than that in blank group two there were significant differences (P0.01); acupuncture group compared with model group significantly decreased, had significant difference (P0.05); the knife needle group and the model group significantly decreased there were significant differences (P0.01); low Acupotomy group and acupuncture group, there were significant differences between the model group (P0.01). The content of the rabbit intervertebral disc TGF- beta 1 was significantly lower than those in the control group two, there were significant differences (P0.01); Acupuncture group compared with model group significantly increased, there was significant difference (P0.05); acupuncture group compared with model group increased significantly (P0.01); acupuncture group than in acupuncture group increased slightly, no statistical significance (P0.05).Western blot results: the measured four groups of experimental animal intervertebral discs of type II collagen expression in model group than in the blank group Significantly, the two have very significant difference (P0.01); acupuncture group compared with model group increased significantly, there was significant difference (P0.05): acupuncture group compared with model group increased significantly (P0.01); Acupotomy group than in the acupuncture group, there was significant difference (P0.05). The four group the experimental animal intervertebral disc proteoglycan expression levels were significantly lower than those in the control group two, there were significant differences (P0.01); acupuncture group and model group were significantly higher than (P0.01); acupuncture group compared with model group increased significantly and had significant difference (P0.05); acupuncture group compared with Acupotomy group is slightly higher, but no statistical significance (P0.05). Conclusion: 1. compared with the blank group and the model group of cervical intervertebral disc and cervical X-ray, histological changes, "bow + cold wet" stimulation of intervertebral disc degeneration can be successfully established the experimental model, the experimental model is.2. and the needle acupuncture intervention can work The intervertebral disc proteoglycan and type II collagen expression increased, and decreased MMP-3 contents, increased TGF- beta 1 content, indicating needle knife and acupuncture intervention for the treatment of cervical spondylosis may be through regulating on intradiscal cytokines and related metabolic enzymes, inhibition of extracellular matrix degradation, alleviate or even repair the degeneration of intervertebral disc.3. from the neck, contrast, intervertebral discs and disc trace substances in general, Acupotomy is better than acupuncture.

【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R245;R-332

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