| [Objects]This thesis studies the influence of massage intervention on the sciatic nerve clamping damage behavior of rats, morphology, MAP-2, NF-M, MAG and ROCKII, and further reveals the mechanism of massage action during the repair of peripheral nerve injury.[Methods]In this experimental studies, the SD rats were randomly divided into normal group, sham operation group, model group, model control group and massage group, and further investigated the peripheral nerve injury around nervi ischiadicus. The sciatic nerve clipping injury model were prepared for the rats of model group, model control group and the massage group. The cloth binding was used for the model control group, and acupuncture points of ’yinmen’,’chengshan’ and ’yanglingquan’ were selected to intervene the massage group through the pointing, shifting and kneading methods,1times a day with each of the10times and1days of rest (a total of20therapy). In the behavior analysis, we investigated the recovery of the kinematic and sensory functions of the rats through oblique board test and thermal pain tolerance test,while in the morphology analysis, the degree of nerve regeneration, repair and recovery after massage intervention were investigated based on the HE coloration of the rat’s spinal cord and nervus ischiadicus, the recover degree of target tissue were investigated based on the gastrocnemius wet weight and the recovery rate of the gastrocnemius wet weight. Finally, we explored the regeneration mechanism of massage on peripheral nerve injury through detections of changes of MAP-2, NF-M. MAG. ROCKII in the sciatic nerve and medulla spinalis.[Results]The behavioral results show that,①oblique board test:after modeling of7days, oblique board test score of the model group is lower than that of the normal group and sham operation group with significant differences (P<0.05), illustrating that muscle of the innervation area was decreased, and the model was succeed. Oblique board test score of the massage group is higher than that of the model group and model control group with significant differences (P<0.05) after10times of massage intervention. After20times of massage intervention, oblique board test score approaches the level of normal group with insignificant differences (P>0.05), but shows a significant differences (P<0.05) in the comparison of model group and model control group, illustrating that massage has the ability to recover the muscle strength of lower limbs for the rats with neurologic damage.②Thermal pain tolerance test:thermal pain tolerance threshold of the model group is higher than that of normal group and sham operation group (P<0.05) after7days of modeling, illustrating that continuity of nerve fiber is damaged after sciatic nerve injury, and then obstructing pain transmission of the target tissue. However, thermal pain tolerance threshold of the massage group becomes lower than that of model group and model control group with significant differences (P<0.05) after10,20times of massage intervention, illustrating that massage can enhances the recovery of sensory function from neurologic damage.Morphological observation,①Sciatic nerve HE staining:the schwann cells of the normal group are regulated in good orders and integrated. The sham operation group is similar to the normal group. The Nerve fiber distribution of the model group is scattered, the axon becomes disintegrated, the myelin sheath and the axon cohere to form the egg-round body, and the schwann cells increase. The model control group is similar to the model group. The Nerve fiber of the massage group are regulated in good orders, the axon is clear and the schwann cells are normal.②Medulla spinalis HE staining:the spinal cord ventral horn neurons in nucleus are centrally located with clear nucleolus, nerve cells are arranged regularly, and nissl body is distributed uniformly; there is no significant difference between sham operation group and normal group, cell swelling and degeneration appear in the model group with the decreasing number of neuron, in irregular arrangement and with dissolved tigroid body, and the performance of model control group is similar to the model group in terms of injury. In the massage group, the most part of the neurons appear in normal shape and regular arrangement, and with lesser degenerated and injured neuron.③the gastrocnemius wet weight results:The ipsilateral gastrocnemius muscle wet weight and its recovery rate of the model group are lower than those of normal group and sham operation group (P<0.05), illustrating that the contact of the nerve fibers and gastrocnemius were damaged, and lead to the regression and shrivel of gastrocnemius. After10times of massage intervention, the ipsilateral gastrocnemius muscle wet weight and recovery rate of the massage group are changed to become higher than those of model group and model control group with significant difference (P<0.05), but has a difference when compared to the normal group (P<0.05). After20times, the ipsilateral gastrocnemius muscle wet weight and its recovery rate of the massage group still higher than the model group and model control group with significant difference (P<0.05), showing massage can promote the regeneration of injury nerve, and then prevent or even reverse, in a certain degree, the atrophy of gastrocnemius.Mechanism:①MAP-2immunohistochemistry results:after7days of modelling, the MAP-2Integral optical density in the sciatic nerve and spinal cord for the massage group are higher than that of the normal group and sham operation group (P<0.05),showing the MAP-2Stress-induced-expression during the natural recovering process from the injury of nervi ischiadicus of rats. The insignificant difference (P>0.05) between normal group and sham operation group shows that neuronal structure and function have not been damaged for sciatic nerve without injury, leading to invariance of MAP-2. After10,20times of massage intervention, MAP-2integral optical density in the sciatic nerve and spinal cord for massage group are significantly higher than the model group and model control group (P<0.05), showing that massage could be able to promote the MAP-2expression in the sciatic nerve and spinal cord; there are no significant difference between the model group and model control group (P>0.05), indicating that cloth binding have not triggered the change of MAP-2expression.②NF-M immunohistochemistry results:after7days of modeling, the NF-M integral optical density in the sciatic nerve and spinal cord for the model group are higher than that of the normal group and sham operation group (P<0.05), and there is non-obvious difference between the latter two groups(P>0.05). After10,20times of massage intervention, NF-M integral optical density in the sciatic nerve and spinal cord for massage group are significantly higher than the model group and model control group (P<0.05), showing that massage could be able to promote the NF-M expression in the sciatic nerve and spinal cord; there are no significant difference between the model group and model control group (P>0.05).③MAG immunohistochemistry results:after7days of modeling, the MAG integral optical density in the spinal cord for the model group are higher than that of the normal group and sham operation group (P<0.05), and there is non-obvious difference between the latter two groups (P>0.05). After10,20times of massage intervention, MAG integral optical density in the spinal cord for massage group are significantly lower than the model group and model control group (P<0.05), showing that massage could be able to prevent the MAG expression in the spinal cord; there are no significant difference between the model group and model control group (P>0.05).④ROCKII immunohistochemistry results:after7days of modeling, the ROCKII integral optical density in the spinal cord for the model group are higher than that of the normal group and sham operation group (P<0.05), and there is non-obvious difference between the latter two groups (P>0.05). After10,20times of massage intervention, ROCKII integral optical density in the spinal cord for massage group becomes significantly lower than the model group and model control group (P<0.05), showing that massage could be able to restrain the ROCKII expression in the spinal cord; there are no significant difference between the model group and model control group (P>0.05), showing cloth binding have no effect on the ROCKII expression of rats with sciatic nerve injury.[Conclusions]1. Massage could promote the repair of injured nervi ischiadicus of SD rats, rebuild the connection with the target tissue, increase the gastrocnemius muscle strength and its recovery rate, increase pain sensitivity, and thus promote the recovery of sensory and motor function of the rats with nerve injury.2. Massage increases the MAP-2, NF-M expression of the neuronal cytoskeleton protein in the medulla spinalis and the ischiadic nerve for the rats with injury of sciatic nerve, maintains the integrity of the neuronal cytoskeleton, restores the damaged neurons of the internal structure and function, protects the neurons, and then plays part in the axonal regeneration.3. Massage could be able to decrease the MAG, ROCKII expression in the inhibitor of axon growth of spinal cord for the rats with injured sciatic nerve, to inhibit the microtubule depolymerization and neurofilament, to maintain the neuronal cytoskeleton structure stability, to promote neuronal survival, and thereby to enhance the regeneration and repair of nerve function.4. One of the massage mechanisms for therapy of the peripheral nerve injury is based on the regulation of axon growth inhibitory factor and promotion of the synthesis of neuronal cytoskeletal proteins, leading to the protection of neurons, promote the regeneration and repair of injured nerve. |
PDF Full Text Request