Empirical Study On Jiawei Huangqi Guizhi Wuwu Decoction In Treating Thoracicolumbar Spinal Cord Injury And Its Mechanism

Objective:To investigate the clinical efficacy of Huangqi Guizhi Wuwu decoction in thoracolumbar fracture with spinal cord injury and to explore the mechanism with experimental study that advantage of the traditional Chinese medicine in treating spinal cord injury can be further incarnated.Methods:Part I:A total of 82 consecutive patients were contacted and encouraged to visit our hospital and to participate in our study between October 2013 and July 2014.In total, 54 patients were available for clinical follow-up.They were divided into two groups:control group (26 cases) and trial group (28 cases).Scores of ASIA scales of pre-treatment and the last follow-up were carried out to evaluate neurological function changes in two groups.Part â…¡: Sixty female SD rats were randomly divided into 3 groups:the sham-operated group, spinal cord injury group, and injury with Jiawei Huangqi Guizhi Wuwu decoction treated group.A spinal cord injury was induced at T10 levels of rat spinal cord using a vascular clip. Jiawei Huangqi Guizhi Wuwu decoction was administrated via intragastric i.g. after 12h of SCI. The morphological changes, the IOD of GFAP and NG2, tissue integrity and scar formation were evaluated until 4 weeks after SCI using histological and immunohistochemical analyses.Results:Part I:The superficial sense of patients improved significantly in both groups at the last follow-up and the difference showed no significant(P>0.05).The motor score and ASIA grade were better enhanced in trial group(P>0.05).Part â…¡:BBB score results of three groups showed that the motor functional improvements of three groups maintained with the time going after operation.At Id,3d and 7d, it shows no significance in the difference between control group and trial group (P>0.05). Over time, motor function of the posterior limbs of rats showed different degrees of recovery. At 14d and 28d, trial group showed higher degree of recovery than the control group(P<0.05).The administration of Jiawei Huangqi Guizhi Wuwu decoction via intragastric i.g. treatment significantly reduced the cavity size and glial scar formation at 7d and 28d after SCI. Jiawei Huangqi Guizhi Wuwu decoction also reduced the expression of core proteins of glialfibriallary acidic protein (GFAP) and NG2.Fast blue (LFB) showed that Jiawei Huangqi Guizhi Wuwu decoction preserved well protecting neuron from apoptosis.Conclusion:1.SCI in the thoracolumbar spine would benefit from Jiawei Huangqi Guizhi Wuwu decoction with an average improvement in motor score, while superficial sense is not better.Overall, the ASIA grade could be improved with the treatment of Jiawei Huangqi Guizhi Wuwu decoction;2. Experimental results suggest that Jiawei Huangqi Guizhi Wuwu decoction could enhance long-term recovery from SCI by suppressing the glial scar formation by means of inhibiting the expression levels of GFAP/NG2 proteins and enhancing the integrity of axonal structure.