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Objective:To observe the effects of acupuncture at Houxi(SI3)and Huantiao(GB30)on the expression levels of nuclear factor kappa B(NF-κB),inducible nitric oxide synthase(iNOS),and nitric oxide(NO)of NF-κB inflammatory signaling pathway in L5 spinal nerve root of lumbar disc herniation(LDH)model rats and explore the mechanism of acupuncture in LDH treatment.Methods:Forty specific-pathogen-free healthy male Sprague-Dawley rats were randomly divided into a sham operation group,a model group,acupuncture group 1,and acupuncture group 2,with 10 rats in each group.The non-compression nucleus protrusion model was made by puncturing L4-L5 spinous process space and injecting autologous nucleus suspension.Acupuncture at bilateral Shenshu(BL23),Dachangshu(BL25),and Weizhong(BL40)was carried out in acupuncture group 1,and acupuncture at bilateral Houxi(SI3)and Huantiao(GB30)in acupuncture group 2.All rats were treated with balanced reinforcing and reducing needling manipulations,and the needles were retained for 30 min/time with one episode of needling manipulation every 10 min,once a day,14 times in total.The threshold value of paw withdrawal pain was measured by a thermal stimulation pain instrument;the serum NF-κB,iNOS,and NO levels were measured by enzyme-linked immunosorbent assay.The pathomorphological changes of spinal nerve roots were observed by hematoxylin-eosin(HE)staining;quantitative reverse transcription polymerase chain reaction was used to detect iNOS mRNA expression in spinal nerve roots;the NF-κB and iNOS protein expression in spinal nerve roots was detected by the immunofluorescence method.Results:Compared with the sham operation group,the threshold of paw withdrawal pain in the model group was decreased,and the expression levels of serum NF-κB,iNOS,and NO were increased;HE staining showed many degenerated and dissolved Schwann cells in spinal nerve roots with vacuolar changes;meanwhile,the expression levels of NF-κB and iNOS proteins,and the iNOS mRNA in spinal nerve roots were increased.Compared with the model group,the paw withdrawal pain thresholds in acupuncture group 1 and acupuncture group 2 were increased,and the increase in acupuncture group 2 was greater(P<0.05);the expression levels of serum NF-κB,iNOS,and NO in acupuncture group 1 and acupuncture group 2 were decreased,especially in acupuncture group 2(P<0.01);the vacuolar changes of spinal nerve roots,and the degeneration and lysis of Schwann cells in acupuncture group 1 and acupuncture group 2 were decreased,which were more obvious in acupuncture group 2;the NF-κB and iNOS protein expression and the iNOS mRNA expression levels in spinal nerve roots of acupuncture group 1 and acupuncture group 2 were decreased,especially in acupuncture group 2(P<0.01).Conclusion:Acupuncture at Houxi(SI3)and Huantiao(GB30)can improve the morphology of spinal nerve roots,inhibit the NF-κB and iNOS protein expression levels in spinal nerve roots and the serum NO level,and relieve the pain caused by inflammation of spinal nerve roots,which may be one of the mechanisms of acupuncture in LDH treatment.
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OBJECTIVE: To observe the effect of different frequencies (2 Hz, 100 Hz) of electroacupuncture (EA) on limb locomotion and the expression of inflammatory factors IL-1β, IL-6, TNF-α in sciatic nerve, and nuclear factor kappa B (NF-κB) in lumber(L)4-L5of spinal cord in rats with sciatic nerve injury (SNI), so as to reveal its mechanisms underlying improvement of SNI. METHODS: A total of 48 SD rats (half male and half female) were equally divided into blank control, model, low frequency (2 Hz) EA and high frequency (100 Hz) EA groups. The SNI model was established by clamping the spinal nerve. EA intervention (2 Hz, 100 Hz, 1 mA), starting on the 8th day after modeling, was applied to "Huantiao" (GB30) on the injured side for 15 min, once daily for 14 consecutive days. The sciatic function index (SFI) was calculated to assess the injured hindlimb recovery with reference to BAIN's and colleagues' methods. Histopathological changes of the sciatic nerve were displayed by H.E. staining. The expressions of IL-1β, IL-6 and TNF-α in the sciatic nerve tissue were detected by immunohistochemistry, and the expression of NF-κB in the spinal cord was detected by using Western blot. RESULTS: After modeling, the SFI level on day 8 was significantly decreased in the model group (P0.05). Following the treatment (at the 22nd day), the SFI values of both low frequency EA and high frequency EA groups were significantly increased (P<0.01), suggesting an improvement of the limb motor function, and the SFI of the low frequency EA group was notably higher than that of the high frequency EA group (P<0.01). In comparison with the blank control group, the expression levels of IL-1β, IL-6, TNF-α in the sciatic nerve and NF-κB protein in the spinal cord were significantly up-regulated (P<0.05). Following EA intervention, the increased expression levels of IL-1β, IL-6, TNF-α and NF-κB proteins were significantly down-regulated in both low frequency EA and high frequency EA groups (P<0.05), and the therapeutic effect of low frequency EA was markedly superior to that of high frequency EA in down-regulating the expression levels of IL-1β, IL-6, TNF-α and NF-κB protein (P<0.05). H.E. staining showed increase of Schwann cells in number, cellular swelling, and disintegration of the axons and myelin sheath, and appearance of vacuolar degeneration in the model group, which was relatively milder in both low frequency EA and high frequency EA groups, particularly in the low frequency EA group. CONCLUSION: EA of GB30 at 2 Hz and 100 Hz can promote the recovery of hindlimb motor function in SNI rats, which is probably related to its function in inhibiting the inflammatory response, and facilitating the repair of the damaged sciatic nerve. 2 Hz EA is better than 100 Hz EA in the therapeutic effect.
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OBJECTIVE: To observe the effect of deep electroacupuncture (EA) stimulation at "Huantiao"(GB30) on hindlimb motor function and expression of p38 mitogen-activated protein kinase (p38 MAPK ) and p53 proteins in dorsal root ganglia (DRG) in rats with chronic constrictive injury (CCI) of sciatic nerve. METHODS: Forty-eight SD rats (half male and half female) were randomly divided into control, model, shallow EA (SEA) stimulation and deep EA (DEA) stimulation groups (n=12 in each group). The CCI model was constructed by implanting a silicone tube close to the sciatic nerve of the left hind limb. For DEA group and SEA group, filiform acupuncture needles were inserted into GB30 about 12-14 mm deep and 5-8 mm deep (monitored by using a high-frequency ultrasound device), respectively, followed by electrical stimulation (2 Hz/100 Hz, 1 mA) using an EA stimulator. The intervention was conducted for 15 min every time, once daily for 14 days. The sciatic nerve function index (SFI) calculated to assess the motor function status. Histopathological changes of the sciatic nerve were displayed by H.E. staining. The expression levels of phosphorylated-p38 MAPK (p-p38) and phosphorylated-tumor protein p53 (p-p53) in DRGs of L4-L5 on the affected side were observed by immunohistochemical staining. RESULTS: Following modeling, the SFI were significantly decreased (P<0.01), and the expression levels of p-p38 and p-p53 proteins of L4-L5 DRGs were considerably increased in the model group (P<0.05). After the intervention, the SFI were obviously increased, and the expression levels of p-p38 and p-p53 proteins notably down-regulated in both DEA and SEA groups relevant to the model group (P<0.01, P<0.05). The therapeutic effect of DEA was significantly superior to that of SEA in raising SFI and down-regulating expression le-vels of p-p38 and p-p53 proteins (P<0.01, P<0.05). H.E. staining showed disordered arrangement of the sciatic nerve fibers and myelin, disaggregation of the myelin and axons with deformity and vacuolation in some of them and with an increase of Schwann cells in the model group, which was relatively milder in both DEA and SEA groups. CONCLUSION: Both DEA and SEA at GB30 can obviously improve the motor function in CCI rats, which may be associated with its function in down-regulating the expression of p-p38 and p-p53 proteins in L4-L5 DRGs, restraining p38 MAPK signaling. The therapeutic effect of DEA is evidently better than that of SEA.
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Objective: To observe the effect of electroacupuncture (EA) at Huantiao (GB 30) and Weizhong (BL 40) on thigmesthesia, gait function, and expression levels of serum immunoglobulin G (IgG) and immunoglobulin M (IgM) in rabbits with lumbar intervertebral disc herniation (LIDH). Methods: Forty healthy New Zealand rabbits were randomly divided into a blank control group, a model group, an EA at acupoint group and an EA at non-acupoint group, with 10 rabbits in each group. The LIDH pathological model of rabbit was established using the self-made LIDH model maker. The thigmesthesia and gait function of rabbits were recorded by Siegal method. The serum IgG and IgM expression levels were detected by enzyme-linked immunosorbent assay. Results: EA at Huantiao (GB 30) and Weizhong (BL 40) could improve the clinical symptoms of thigmesthesia and gait function, and inhibit the expressions of serum IgG and IgM in the LIDH rabbits, which were significantly different compared with those in the model group and EA at non-acupoint group. Conclusion: EA at Huantiao (GB 30) and Weizhong (BL 40) can improve the clinical symptoms of LIDH rabbits, which is associated with inhibition of the serum IgG and IgM expressions and reduction of the immunoinflammatory factor release. This may be one of the mechanisms of EA at Huantiao (GB 30) and Weizhong (BL 40) in the treatment of LIDH.
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Objective To investigate the feasibility of short-segment percutaneous pedicle screw non-fusion fixation plus electro-acupuncture for the treatment of single thoracolumbar fracture.Methods Forty-three patients with single thoracolumbar fracture were treated with short-segment percutaneous pedicle screw fixation without fusion,and then were given electro-acupuncture on points such as Jiaji (EX-B2),Huantiao (GB30),and Zhibian (BL54) after the operation.Before and after operation and during the follow-up,X-ray images of the spine at positive position and lateral position were taken for the measurement of vertebral anterior and posterior diameter ratio and the vetebral kyphosis Cobb's angle.Lumbago visual analogue scale (VAS) scores and Oswestry scores for lumbago function disorder were used for the evaluation of clinical efficacy.Results (1) All of the 43 patients were followed-up,and the follow-up period lasted for 10-27 months.(2) After the operation and at the end of follow-up,vertebral anterior and posterior diameter ratio and Cobb's angle were much improved (P ＜ 0.01compared with those before the operation),and the two indexes at the end of follow-up were improved as compared with those after the operation (P ＜ 0.05).(3) One week after the operation and at the end of follow-up,VAS scores and Oswestry scores were obviously improved as compared with those before treatment (P ＜ 0.01),and the two kinds of scores at the end of follow-up were also improved as compared with those after the operation (P ＜0.01).Conclusion Short-segment percutaneous pedicle screw fixation without fusion plus electro-acupuncture at points such as Jiaji is effective for the treatment of single thoracolumbar fracture by relieving pain in the waist and back,which ensures the satisfactory effect of operation.
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ObjectiveTo investigate the clinical efficacy of points injection of mouse nerve growth factor in treating sciatic nerve injury.MethodAcupuncture point injection of injectable mouse nerve growth factorwas performed in 60 patients with sciatic nerve injury. Points Huantiao(GB30)and Zusanli(ST36)were selected. Treatment was given once daily, for a total of 30 times. Sensory and motor functions were assessed (MS and SS) and electromyography (EMG) was performed before and after treatment to compare motor nerve conduction velocities (MCV) and sensory nerve conduction velocities (SCV) in the injured nerves and EMG changes in the musclescontrolled by the injured nerves.ResultAfter treatment, nerve function was restored to more than S3M3, with an efficacy rate of 81.7%, in 49 patients. Neuro-electrophysiological study showed that regenerative potentials occurred, accounting for 71.7%,in43patients. Denervated potentials were fewer after treatment than before; there was a significant difference (P<0.05). The mean MCV value increased after treatment compared with before; there was a significant difference (P<0.05). ConclusionAcupuncture point injection of mouse nerve growth factor can markedly improve sensory and motor functions in the regions controlled by the injured sciatic nerve. It provides an effective way to promote the repair of sciatic nerves and the reconstruction of limb function after the nerves are injured.
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Sixty lumbar intervertebral disc herniation (LDH) cases were treated with electroacupuncture on such major points as Jiaji ( Ex-B 2) in L4, L5, and S1 and Huantiao (GB 30) as well as adjunctive corresponding points in the affected area plus short-lever micro-adjustment manipulation. Another 60 cases in the control group were treated with tra-ction. After three treatment courses, the former got the effective rate of 93.3%, while the latter only got 77.8%. The two groups have a statistical difference in therapeutic effect (P＜0.05).