| [Objective]Peripheral nerve injury is a clinical common disease, multi-sensory and motor function disorders are the main symptoms. The use of massage therapy-related diseases in clinical achieved good results, but has not been elucidated. Recovery of neurological function is based on axonal transport function in normal, selected as the object of this study sciatic nerve clamping injury rat model to simulate the clinical peripheral nerve compression injury, timing given by massage, qualitative and quantitative intervention, behavior, morphology as efficacy evaluation indicators from the motor protein and nerve growth factor expression changes in the spinal cord, discover massage promote axonal transport functional recovery mechanism, the clinical application of massage for treatment of peripheral nerve injury diseases, improve symptoms and prognosis of the patient to provide strong scientific evidence.[Method]SD rats, carried out the sciatic nerve clamping injury model, select the ipsilateral acupuncture points-nerve-muscle area "Yin door, Chengshan, Yanglingquan hole for massage therapy, from the behavioral point of view, by its light heat pain tolerance threshold and the detection of the inclined plane test, evaluation massage therapy feeling of nerves and muscles, exercise recovery; massage from a morphological point of view, through its spinal cord, damage points nervous, muscle staining, to explore the promotion of neuronal regeneration evidence of repair; through detection of spinal cord motor protein, evaluation and massage axonal transport function power support; detect activated protein dynein in the spinal cord and nerve growth factor expression, to find massage to promote axonal transport function recovery evidence, and ultimately to further clarify the mechanism of action of the massage treatment of sciatic nerve injury and the onset of ways.[Results]1.behaviorLight and heat-resistant pain threshold results are as follows:modeling7days after the massage therapy10times,20times, left (contralateral) light and heat pain tolerance threshold between the groups, there were no differences; modeling7d right side (ipsilateral) light and heat pain tolerance threshold, the model group and normal group were significantly different (P<0.05) after sciatic nerve injury in rats sensory dysfunction, reduced sensitivity. Massage therapy10times,20times, compared to the rat right light and heat pain tolerance threshold massage treatment group and model group and med(?) control group were lower-(P<0.05), the hyperalgesia fraction massage therapy group compared with the model group significantly decreased (P<0.01), massage can promote the recovery of sensory function of the sciatic nerve injury in rats. Inclined plane test results show that the model group and normal group modeling7d significant difference (p<0.05) after sciatic nerve injury in rats motor function loss, decreased muscle strength, successful modeling.10massage therapy, massage therapy group and model group and model control group compared were significantly elevated (p<0.05), and close to the level of the normal group.20massage therapy, massage therapy group to meet or exceed the level of the normal group, and there is still a significant difference (p<0.05), massage may help improve the effectiveness of the muscle strength compared with the model group and model control group. Massage can effectively promote the recovery of the sciatic nerve injury in rats motor function and lower extremity muscle strength.2.MorphologyGastrocnemius wet weight results are as follows:7d modeling, massage therapy10times,20times, the rats left gastrocnemius muscle wet weight There were no differences. Modeling7d, sham-operated group and model group were ipsilateral gastrocnemius wet weight have a certain degree of reduction is more obvious, and the model group, model group and the normal group and sham operation group, the gastrocnemius muscle wet weight and gastrocnemius The recovery rate was significantly decreased (P<0.05), stripped of pure muscle of the sham-operated group had a definite impact on muscle.10massage therapy, massage therapy group rat gastrocnemius muscle wet weight and the gastrocnemius muscle recovery rate increased, and significant difference (P<0.05) with the model group and model control group, but the gastrocnemius wet weight of the rats in each group and the recovery rate and the normal group, there is still a difference (P<0.05).20massage therapy, massage therapy group gastrocnemius wet weight and the recovery rate is still higher than the model group and model control group, but still a gap compared with the normal group (P<0.05).Model7d, the diameter of the gastrocnemius muscle cells of the right side of the model group was significantly less than the normal group and sham operation group, the difference was statistically significant (P<0.05).10massage therapy, massage therapy group the right side of the rat gastrocnemius muscle cell diameter increased to a certain extent, and there is a significant difference compared with the model group and model control group (P<0.05), but is still low compared with the normal group (P<0.05). Massage therapy for20rats in each group the right gastrocnemius muscle cell diameter are gradually increased, and massage treatment group was significantly better than the model group and model control group (P <0.05), but has not yet reached the level of the normal group.HE staining in the spinal cord:Under normal circumstances, the ventral horn of the spinal cord neurons arranged in neat rows, the nucleus is located in the center of the cell, the nucleolus is clear, evenly distributed Nissl bodies; model of spinal cord ventral horn neurons irregular arrangement, reducing the number of cell swelling degeneration phenomenon, lighter staining nucleus toward the edge of Nissl bodies dissolved disappear; after massage therapy, spinal cord ventral horn neuronal degeneration, damage to a lesser extent, arranged in a more regular part of the nucleus toward the edge, we can see a small amount of reproducing the nucleus.The sciatic nerve HE staining:Under normal circumstances, the axons and Schwann cells arranged in neat rows; model group, part of the axon and Schwann cells arranged in irregular, swelling, ulceration, or even crack, and macrophages glial cells significantly hyperplasia; Schwann cells and axons normal after massage therapy.The gastrocnemius HE staining results:Under normal circumstances, the gastrocnemius muscle in the same size, arranged in neat rows, clear nucleus and cytoplasm uniform moderate muscle fiber gap; diameter of the gastrocnemius muscle cells of the model group was significantly reduced, the uneven distribution of the nucleus is clear, but the number is significantly increased, increased muscle fiber gap shrank phenomenon; uniform diameter of the gastrocnemius muscle cells after massage therapy, clear nucleus, to a lesser extent of muscle fiber atrophy.3. MechanismNormal group and sham-operated rats motor protein (dynein Dynein, Kinesin Kinesin, dynein activator protein Dynactin), NGF in the spinal cord have a small amount of expression of positive neurons in the nucleus was blue, the cytoplasm tan; modeling7d, more than model group research indicators expression in the spinal cord compared with the normal group and sham operation group deeper staining, immunohistochemistry average optical density also increased, with statistical significance (P<0.05); massage10after treatment, the model group, model control group and the massage therapy group rat spinal cord Dynein, Kinesin, Dynactin, NGF immunohistochemistry average optical density compared with the normal group was significantly higher, and the the dyeing range and extent of the massage therapy group was significantly better than the model group, and the remaining four groups were statistically significant; massage therapy after20, the motor protein of the massage therapy group and the expression of NGF in the spinal cord and the remaining four groups comparison there is still a significant difference, and Dynactin massage Reverse axonal transport group expression at a higher level, but the expression in the model group was reduced to with the normal group there was no significant difference in the level, combined with the performance of the model group behavior, the inference model rats barrier function, NGF high expression, it can not be transported to the neuronal cell bodies in a timely manner, resulting in peripheral nerve damage has not been repaired in time. Taking into account the treatment time constraints, according to the experimental results, continue treatment, when damaged nerve recovery to a certain extent, the Kinesin and Dynein expression, will gradually reduce to normal. Expression in the model group, too, but the massage group of axonal transport function will be improved. Thus in the final comparison, although the Kinesin and Dynein expression, in the massage with the model group no significant difference, but the behavior of the rats learn to appear quite different, namely, the massage group was significantly better than the model group. Massage, thanks to improved spinal cord motor protein, promote axonal transport functional recovery.[Conclusion]1massage can improve the the gastroenemius muscle recovery rate of sciatic nerve injury in rats as well as muscle strength, and can enhance the degree of hyperalgesia in rats, thus contributing to the recovery of the sciatic nerve injury in rat motor and sensory function;2massage can improve the sciatic nerve motor protein expression in the spinal cord injury in rats, the axis the slurry transport functional recovery provided the impetus foundation, nutrition pathway between neurons and target organ;3massage can improve the sciatic nerve the dynein activation of protein in the spinal cord injury in rats with nerve growth factor expression, neuronal survival and regeneration, impaired axonal sprouting and growth nutrition security.4from motor protein power level to promote axonal transport occurrence and improve axonai transport of neurotrophic substances pass level, should be one of the massage therapy onset mechanism of peripheral nerve injury. |
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