补肾活血中药干预下髓核移植接触神经根致大鼠诱发电位及神经显微结构的改变

目的探索补肾活血中药干预下,髓核移植接触神经根对大鼠诱发电位及神经显微结构的影响。方法 40只SD大鼠随机分成4组,A组取大鼠自体皮下筋膜脂肪无压迫下放置在L4-5神经根周围,滴加0.05ml生理盐水。B、C、D组取大鼠自体髓核组织,无压迫下放置在L4-5神经根周围,并分别滴加0.05ml生理盐水、中药(1.2g生药/ml)、地塞米松(1mg/ml)。分别在术前、术后检测大鼠术侧诱发电位。术后3d检测大鼠术侧诱发电位并处死大鼠,进行神经根的病理切片观察。结果感觉诱发电位:B、C组潜伏期延长,与A组比较有显著差异(P<0.01);D组与A组相比无显著差异。运动诱发电位:B、C组潜伏期延长,B组与A组比较有显著差异(P<0.05),C、D组与A组比较无显著差异。术前各组感觉及运动诱发电位波幅无显著差异,术后各组也无显著差异。神经显微结构观察:A、D组少量炎性细胞浸润;B组急性炎性反应,神经外膜水肿、大量炎性细胞浸润,髓鞘水肿;C组呈炎性反应,但不如B组明显。结论髓核接触神经根后可以引起急性炎症性表现,损伤神经传导功能,补肾活血中药可以抑制神经根及周围的急性炎性反应,减少神经损伤。

Changes of nerve evoked potential and microstructure in rats whose nerve roots in contact with nucleus under the intervention of Chinese medicine

Objective To explore the changes of nervous evoked potential and microstructure in rats whose nerve roots contact with nucleus under the intervention of traditional Chinese medicine.Methods Forty SD rats were randomly divided into 4 groups.The L4-5 nerve roots of group A were contacted with subcutaneous fascia and 0.05 ml saline.The L4-5 nerve roots of B,C,D group were contacted with autologous nucleus pulposus and 0.05 ml saline,traditional Chinese medicine,dexamethasone,was added respectively.Evoked potential exam was measured before and after the surgery at the operated side.The rats were sacrificed for observation of nerve root pathology 3 days after the operation.Results Spinal somatosensory evoked potential(SSEP):The latency of group B,C was significantly extended,compared with that of group A(P<0.01);There was no significant difference between group A and D.Cortical motor evoked potential(CMEP):The latency of group B,C was significantly extended,compared with that of group A(P<0.01);There was significant difference between group A and B(P<0.05),but no significant difference between group A and C,and no difference between group A and D.The amplitude of SSEP or CMEP had no significant difference before and after the surgery.Neural microstructure observation:group A,D showed a few inflammatory cell infiltration;group B showed the acute inflammatory response,epineurial edema,inflammatory cell infiltration,and myelin edema;group C showed mild inflammation.Conclusions Nerve and nucleus exposure can cause acute inflammation,and damaging nerve function.Bushenhuoxue Chinese medicine can inhibit the inflammatory response of nerve root and reduce nerve injury.