目的:探讨针刀延缓椎间盘退变的作用机制。方法:建立大鼠静动力失衡性颈椎间盘退变模型

确认造模成功后

将大鼠随机分为模型组、夹脊穴组、颈周腧穴组、药物组

并设空白组

每组15只。夹脊穴组取颈2

7

椎旁夹脊穴

颈周腧穴组取颈周的双"脑空"穴、"脑户"穴、"大椎"穴、双"曲垣"穴、双"天宗"穴

每5d治疗1次

各治疗3次;药物组采用布洛芬+颈复康灌胃

每天1次

治疗10d。治疗结束继续喂养20d后运用免疫组化与定量多聚酶链反应(PCR)法对退变颈椎间盘Ⅰ、Ⅱ型胶原蛋白进行检测

并在光镜下行椎间盘组织形态学变化观察

按Miyamoto的标准做形态学评分。结果:Ⅰ型胶原的表达强度及基因表达

模型组高于空白组(P

<

0.05)

夹脊穴组、颈周腧穴组、药物组低于模型组(P

<

0.05)

夹脊穴组、颈周腧穴组低于药物组(P

<

0.05);Ⅱ型胶原的表达强度及基因表达

模型组低于空白组(P

<

0.05)

夹脊穴组、颈周腧穴组、药物组高于模型组(P

<

0.05)

夹脊穴组、颈周腧穴组高于药物组(P

<

0.05)。形态学评分

模型组高于空白组(P

<

0.05)

夹脊穴组、颈周腧穴组小于模型组和药物组(P

<

0.05);椎间盘退变程度由轻到重顺序为空白组Objective To observe the effect of acupotome relaxing at cervical acupoints on typeⅠ andⅡcollagens of degenerated cervical intervertebral discs in rats

so as to explore its potential mechanism underlying anti-degeneration of intervertebral discs.Methods Rats were randomly divided into control

model

Jiaji acupoints

cervical acupoints and medication groups(n=15in each group).The rat model of cervical intervertebral disc degeneration due to static-dynamic imbalance was made as previously specified.The Jiaji acupoints were those located along the cervical vertebra 2-7.The cervical acupoints included bilateral"Naokong"(GB 19)

"Naohu"(GV 17)

"Dazhui"(GV 14)

bilateral"Quyuan"(SI 13)and bilateral"Tianzong"(SI 11).Acupoints were treated according to the procedures of acupotome for 3times in ten days with five days' break between every two treatment sessions.Rats of the medication group were intragastrically administered with Jing Fu Kang Granules and ibuprofen daily for ten days.Twenty days after the end of treatment

all rats were sacrificed for further examination of morphological changes of the intervertebral disc tissue.Immunoactivity of protein and mRNA expression levels of collagen typeⅠ andⅡ of the intervertebral discs were measured by means of immunohistochemistry and RT-PCR

respectively.Results In comparison with the control group

the immunoactivity and mRNA expression levels of collagen typeⅠ andⅡ of the intervertebral discs were significantly elevated or reduced in rats of the model group

respectively(P

<

0.05).After acupotome intervention and medication

the increased and decreased expression levels of type Ⅰ and Ⅱ collagen proteins and genes were markedly reversed(P

<

0.05).The effects of acupotome relaxing of both cervical and Jiaji acupoints were significantly superior to those of medication in down-regulating expression of typeⅠ collagen protein and mRNA

and in up-regulating that of typeⅡ collagen protein and mRNA(P

<

0.05).No significant differences were found between the cervical acupoints and Jiaji acupoints groups in the abovementioned outcomes(P

>

0.05).The degree of severity of the degenerated intervertebral discs was the worst in the model group

followed by the medication group

then the Jiaji acupoints group and cervical acupoints group

and the control group the least.Conclusion Acupotome at neck acupoints can regulate the extracellular matrix of the intervertebral disc via inhibiting the transformation between typeⅠand typeⅡcollagens

which may contribute to its effect in delaying the degenerative process of the cervical intervertebral discs.