点刺“委中”放血治疗腰椎间盘突出症机制的探讨

目的：通过观察实验性腰椎间盘突出症（LIDP）家免坐骨神经传导速度（SNCV）和髓核组织中白细胞介素-1α（interleukin-1α，IL-1α）、磷脂酶A2（PLA2）及PGE2（前列腺素E2）水平变化，探讨点刺“委中”放血治疗LIDP的机制。方法：40只健康新西兰家免随机分为4组，即空白组、LIDP模型组、点刺委中组和点刺非穴对照点组。自制的LIDP动物病理模型造模器造实验性LIDP病理模型，三棱针点刺“委中”或对照点放血治疗7天。采用BL-410生理信号记录系统记录SNCV，酶联免疫吸附法和放射免疫等方法测定腰椎间盘髓核组织中IL-la、PLA2，和血浆中的PGE2的含量。结果：点刺委中组治疗后SNCV显著高于治疗前（P〈0．01），其治疗前后SNCV的差值显著高于模型组和非穴对照组（P〈0．05）；点刺“委中”放血可降低LIDP家兔髓核组织中IL-1α、PLA2，和血浆中的PGE2含量、与模型组和非穴对照组比较差异有显著性或非常显著性意义（P〈0．01或0．05）。结论：点刺“委中”穴可明显增快LIDP家兔的SNCV，减少IL-1α、PLA2，和PGE2等炎症因子含量，提示减轻损伤局部炎症反应可能是点刺“委中”放血治疗LIDP的机制之一。

DISCUSSION OF MECHANISM ON LUMBAR DISC HERNIATION TREATED WITH BLOODLETTING ON W(E)IZH(O)NG(委中 BL40)

Objective To observe the changes of sciatic nerve conduction velocity （SNCV） and interleukin-1α （IL-1α）, phospholipase A2 （PLA2） and prostaglandin E2 （PGE2） in neucleus pulposus tissue in experimental rabbits with lumbar disc herniation （LDH） ; and discuss the mechanism of LDH treated with bloodletting on Wěizhōng （委中 BL40）. Methods 40 normal named control group, LDH model group, BL40 group New Zealand rabbits were randomized into 4 groups, and comparative point group. The experimental LDH model was prepared by the self-made LDH animal pathological modeling device. Bloodletting on BL40 or on comparative point was applied for 7 days. BL-410 physiological signal recorder was used to record SNCV. Enzyme-linked immunosorbent assay （ELISA） and radioimmunology methods were used to determine the contents of IL-1α and PLA2 in neucleus pulposus tissue and PGE2 in serum. Results In BL40 group, SNCV was significantly increased after treatment comparing with that before treatment （P〈0. 01 ）, and the difference in SNCV value before and after treatment was significantly bigger than that in model group and comparative point group （P〈0.05）. Bloodletting on BL40 reduced the contents of IL-1α and PLA2 in neucleus pulposus tissue and serum PGE2 in LDH rabbits, which indicated significant difference or very significant results in the comparison with model and comparative point groups （P〈0.01 or 0. 05）. Conclusion Bloodletting speeded up rapidly SNCV and reduced the contents of inflammatory factors, i.e. IL-1α, PLA2 and serum PGE2 in LDH rabbits, which indicated that alleviation of local inflammatory reaction is probably one of the mechanisms on LDH treated by bloodletting on BL40.