骶管注射对腰椎间盘突出症大鼠模型神经根局部炎症因子的影响

目的：研究骶管注射对腰椎间盘突出症（LDH）大鼠模型神经根局部炎症因子的作用，以明确骶管注射治疗LDH的作用机制。方法：48只雄性SD大鼠随机分为假手术组（A组），模型组（B组），中药组（C组）及西药组（D组），每组12只，均作硬膜外腔置管处理，除假手术组外，其余各组采用复合压迫与炎性刺激两种因素予以造模。各组大鼠于术后第3天开始按1mlZkg剂量标准给予硬膜外注药，A组和B组用生理盐水，C组给予2％利多卡因＋复方丹参注射液＋生理盐水（2：2：16）混合液，D组给予2％利多卡因＋醋酸曲安奈德注射液＋生理盐水（2：2：16）混合液。隔1周1次，共计3次。每注射1次1周后，各取4只大鼠处死采用酶联免疫吸附法（EuSA）检测其神经根局部肿瘤坏死因子（TNF—α）、前列腺素E2（PGE2）、白介素1（IL-1）和白介素6（IL-6）。结果：与A组比较，B组造模区神经根组织内TNF-α、PGE2、IL-1和IL-6的含量增高（P〈0．01）。C组和D组造模区神经根组织内PGE2、IL-1和IL-6的含量较B组明显减少，且D组比C组更明显（P〈0．05），各组造模区神经根组织内TNF-α变化不明显。结论：复合压迫与炎性刺激两种因素可以导致相应神经根组织内产生大量的致炎因子TNF—α、PGE2、IL-1和IL-6。骶管注射治疗通过有效减少神经根压迫区部分炎性介质PGE2、IL-1和IL-6含量而起作用，且糖皮质激素作用比复方丹参注射液明显。

Effects of sacral canal injection on nerve root local inflammatory factors in rat model with lumbar disc herniation

ABSTRACT Objective ：To explore the effects of sacral canal injection on nerve root local inflammatory factors in rat model with lumbar disc herniation,in order to identify its mechanism of treatment. Methods：Forty-eight male SD rats were randomly divided into sham operation group （group A）, model group （group B ）, Chinese medicine group （group C ） and western medicine group （group D）. There were 12 rats in each group. The model of lumbar disc herniation was established using compression and inflammatory stimulation in group B, C, D. All rats were given epidural catheterization and group A and B with physiological saline （1ml/kg）,group C with mixed liquor of 2% lidocaineand compound Dansheninjectionsandphysiologicalsaline （2：2： 16） and group D with mixed liquor of 2% lidocaine and triamcinolone aeetonide injection and physiological saline （2：2：16）, once a week for a total of three treatments. Four rats were killed every 1 week after injection for once, and the inflammatory fac- tors of tumor necrosis factor （TNF-α）, prostaglandin E2 （PGE2）, interleukin- 1 （IL- 1 ） and interleukin-6 （IL-6） were detect- ed by ELISA method. Results：The levels of TNF-α, PGE2, IL-1 and IL-6 in compressed nerve tissues in group B were in- creased than those of group A （P〈0.01）. The levels of PGE2 ,IL-1 and IL-6 in group C and D were decreased than those of group B, and group D was much less （P〈0.05）. There was no significant difference in level of TNF-α among group B, C, D （P〉 0.05 ）. Conduslon ： Compound compression with inflammatory stimulation can lead to massive release of inflammatory media- tors, such as TNF-α, PGE2, IL-1 and IL-6. Both injection with compound Danshen injections and triamcinolone acetonide in- jections by sacral canal can reduce the levels of part inflammatory mediators （PGE2, IL-1 and IL-6）, and the effect of Glueo- corticoid is better than Danshen （P〈0.05）.