脉络宁注射液与激素对脊神经根炎所致脊髓损伤保护作用的比较

目的:比较脉络宁注射液和激素治疗对脊神经根炎大鼠所致脊髓损伤的保护作用,为脉络宁注射液在临床上代替激素治疗腰腿疼痛提供相关依据。方法:雄性Wistar大鼠30只,随机分为5组,正常组、假手术组、模型组、脉络宁组、康宁克通(激素)组。造模成功后脉络宁组按120 g·kg-1剂量硬膜外腔注射给予脉络宁注射液,康宁克通组按240 mg·kg-1剂量硬膜外腔注射给予康宁克通注射液,其他组分别予等量生理盐水,6 mL·kg-1,4 d/次,共4次。采用滤纸片法制备大鼠脊神经根炎模型,放射免疫法检测血液中血栓素B2(TXB2)、白细胞介素8(IL-8)的含量,Nissl氏染色观察各组脊髓中神经细胞变化,免疫组化法观察各组神经元Bcl-2与Bax的表达。结果:模型组脊髓中神经细胞变性坏死增多,血液中TXB2,IL-8含量显著增高(P<0.01),Bax阳性细胞的平均吸光度(A)明显上调,与正常组比较具有显著差异性(P<0.05);与模型组比较,脉络宁组和康宁克通(激素)组神经细胞变性坏死减少,血液中TXB2,IL-8含量降低(P<0.01),Bax表达显著下调(P<0.01),Bcl-2表达明显上调(P<0.01),Bax/Bcl-2降低(P<0.01)。结论:硬膜外腔注射脉络宁注射液可以改善脊神经根炎大鼠炎性反应,通过调节炎症反应而抑制大鼠脊髓神经炎所致的脊髓神经细胞的凋亡,与康宁克通组无显著差别,这可能是其临床治疗腰腿痛并可以替代激素治疗的依据之一。

Comparison of Mailuoning Injection and Hormone on Protective Effect of Spinal Cord Damage Caused by Radiculitis

Objective: To explore the protective effect of Mailuoning injection and hormone on spinal cord damage in radiculitis rats and to investigate the underlying mechanism as well as the evidence for substituting Mailuoning injection for hormone. Method: Wistar rats were divided into five groups randomly:normal group, sham group, model group, Mailuoning-treated group and Kangning Ketong-treated group. Filter paper placement was adopted as model method. Radioimmunologic technique was employed for blood interleukin8(IL-8) and thromboxane B₂(TXB₂) detetion, Nissl's staining method was used for neurons observation and immunohistochemical technique was used to examine the expression of Bax and Bcl-2 in spinal cord. Result: Compared with normal group, neurons degeneration and necrosis were normally observed in model group. Meanwhile, blood concentration of TXB₂ and IL-8 was significantly increased (P<0.01), and Bax expression was obviously up-regulated (P<0.05) in model group. Compared with model group, neurons degeneration and necrosis were greatly decreased in Mailuoning-and Kangningketong-treated group, and at the same time, IL-8 and TXB₂ concentration as well as Bax-positive expression were decreased, while Bcl-2 protein was remarkably up-regulated, then ratio of Bax/Bcl-2 was obviously decreased (P<0.01). Furthermore, there was no significant difference between the above two groups. Conclusion: The experiment implied that Mailuoning injection could relieve inflammation of spinal cord in radiculit rats and protect spinal cord neurons from apoptosis, which may be one of the mechanisms of Mailuoning injection on reliving lumbocrural pain through replacing hormone in clinical practice.