| Objective:: To evaluate the effect of co-application of ATP and Mecobalamine on promoting peripheral nerve collateral growth and nerve regeneration after terminolateral neurorrhaphy(TLN); To identify the effect that two drugs were allied to use through comparing with single drug. Method: sixty female SD rats were weighed from 190 to 210 grams. They were randomly divided into five groups by different drugs they were administrated, group A: the ATP combined mecobalamine group (combined group); group B: Sodium Chloride (SC) group; group C: ATP group; group D: Mecobalamine (CH3-B12) group; group E: Nerve Growth Factor (NGF) group. every group was subdivided into two groups respectively, combinde six weeks and twelve weeks group, SC six weeks and twelve weeks group, ATP six weeks and twelve weeks group, CH3-B12 six weeks and twelve weeks group, NGF six weeks and twelve weeks group. There were six subjects in every subgroup. In every group, peripheral nerve was performed end-to-side anastomosis. The left peroneal nerve was transected, and then a 1mm epineukral window was created on the neighbouring tibial nerve trunk. The distal end of peroneal nerve was sutured to the windowed tibial nerve by means of end-to-side attachment. The proximal end reverts 100°to embed the nearby intramusculary. At the same day after operation, per group was intraperitoneally injected the following difference drugs: group A: ATP 1mg and CH3-B12 0.01mg, group B: S C 0.5ml, group C: ATP 1mg, group D: CH3-B12 0.01mg, group E: NGF 60u. All the drugs were injected continually for four weeks. Gait analyses, Electrophysiological, histolgicial, morphological examinations were measured at 6 and 12 week after the operation. Results: Regeneration of peroneal nerve occurred in every groups. All the data were analysed by analysis of variance. Compared with the group B, group C and group D, the quality of regeneration of peroneal of group A is better, but compared with group E, that of the group A is worse. And the difference is significant. In the experiment, the peroneal function index (PFI), motor nerve conduction velocity, Histolgicial analysis, axon number and cross area of regenerated myelinated nerve fibres of peroneal nerve in group A were significantly difference compared with those control groups at week 6, which shows the conduction of motor nerve and the degree of maturity of myelin sheath in group A were better than group C and group D, but worse than group E in earlier period. Furthermore, with transmission electron microscope, in group A and group E , schwann cells proliferation are more activity, organelle in cytoplasm are abundant, myelin sheath are maturation, auxiliary fibers regenerate significantly. But in group B , group C and group D, auxiliary fibers are fairly pachy and myelin sheath are fairly thin and folding and pucker, axolemma is separated from the inner most layer of the myelin sheath layers. Conclusion: The co-application of ATP and mecobalamine can promote the growth of lateral bud, regeneration and functional recovery of the distal segment nerve. Furthermore, the effect of co-application of two drugs surpasses to that of single drug, but inferior to the effect of NGF.
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