Laboratory Study And Clinical Application Of Modified Tao Hong Si Wu Tang On The Treatment Of Acute Spinal Cord Injury

Part I Laboratory Study of Modified Tao Hong Si Wu Tang on the Treatment of Acute Spinal Cord Injury in RatsObjectiveTo investigate the treatment effect of Modified Tao Hong Si Wu Tang on neural morpholo-gical repairing and fuctional recovery after acute spinal cord injury(ASCI) in rats. To provide theoretical guidance for treatment of spinal cord injury.MethodsOne hundred and four female SD rats were randomly divided into A group (Modified Tao Hong Si Wu Tang group, n=32), B group(Tao Hong Si Wu Tang group, n=32), C group(ASCI control group, n=32), D group(normal control group, n=8). The ASCI models of rats were established by the modified Allen’s method to injury the12th thoracic vertebra of animals. After operation, A group received Modified Tao Hong Si Wu Tang, and B group received Tao Hong Si Wu Tang, and C group subject to identified quantity of normal saline, and D group did not make any processing. Every group was scored the nerve function by BBB scale(The Basso, Beattie&Bresnahan Locomotor Rating Scale, BBB scale) at Id,3d,7d,14d and28d after surgery. Before and after operation(1d,14d,28d), somatosensory evoked potential(SEP) was used to assess neurologic recovery of A, B and C group. Blood specimens were collected for determination of platelect activating factor(PAF) and fibrinogen(FIB) at Id,3d,7d and14d after surgery. Specimens from injury sites were obtained at Id,3d,14d and28d after injury. Histological changes of injury sites were observed with light microscope and electon microscope after HE(hematoxylin-eosin, HE) saining, and immunohistochemisty staining of GFAP(Glial Fibrillary Acidic Protein, GFAP), Bcl-2(B-cell lymphoma/leukemia-2, Bcl-2), and AQP-4(aquaporin-4, AQP-4), and further to observe pathological changes of SCI. The data were analyzed using statistical software SPSS16.0. Results1.BBB scale:On the spinal cord injury day, the hindlimbs BBB scale of A, B and C groups was0, that was no significant difference between three groups(p>0.05). Along with the time, motor function of the posterior limbs of rats showed different degrees of recovery. At3d,7d,14d and28d after surgery, A group and B group showed higher degree of recovery than C group(P<0.05), and A group also showed higher degree than B group(P<0.05).2.SEP:The latatencies of SEP were prolonged and amplitudes were decreased after ASCI. Over time the latatencies and amplitudes showed different degrees of recovery. At28d after surgery, A group showed higher degree than B group and C group(P<0.05).3.PAF, FIB:After ASCI, the levels of PAF and FIB significantly increased. Over time the levels of PAF and FIB showed different degrees of recovery. Modified Tao Hong Si Wu Tang down-regulated the levels of PAF and FIB significantly(P<0.05).4.Pathohistology(1)Measurement of Glial fibrillary acidic protein(GFAP)The level of expression of GFAP significantly increased after spinal cord injury. Modified Tao Hong Si Wu Tang down-regulated expression of GFAP(P<0.05), and reduced the formation of glial scar.(2) Measurement of Bcl-2After SCI, the expression of protein of Bcl-2began to increase. The state continued to rise, reached a peak at the3th day, and then began to decline to normal level after28days later. Both Modified Tao Hong Si Wu Tang and Tao Hong Si Wu Tang could promote the expression of Bcl-2protein(P<0.05), but Modified Tao Hong Si Wu Tang is better than Tao Hong Si Wu Tang(P<0.05).(3) Measurement of AQP-4After SCI, the expression of protein of AQP-4began to increase. The state continued to rise, reached a peak at the3th day, and then began to decline to normal levels after28days later. Both Modified Tao Hong Si Wu Tang and Tao Hong Si Wu Tang down-regulated the expression of AQP-4protein(P<0.05), but Modified Tao Hong Si Wu Tang is better than Tao Hong Si Wu Tang (P<0.05).ConclusionBoth Modified Tao Hong Si Wu Tang and Tao Hong Si Wu Tang can improve hindlimb motor function, and reduce plasma fibrinogen level and platelect activating factor level, and eliminate spinal cord edema, and reduce the formation of glial scar and restrain the apoptosis of neurocyte. But the efficacy of Modified Tao Hong Si Wu Tang is better than Tao Hong Si Wu Tang.Part II Clinical Application of Modified Tao Hong Si Wu Tang with an-terior Decompression for Thoracolumbar Fracture Complicated with Incomplete ParalysisObjectiveTo observe the effect of Modified Tao Hong Si Wu Tang with anterior decompression for thoracolumbar fracture complicated with incomplete paralysis.MethodsForty-eight patients with thoracolumbar fractures complicated with incomplete paralysis between March2010to September2011were strictly selected. In accordance with the order of admission, patients were randomly divided into treatment group(A group, n=23) and contral group(B group, n=23). Two groups were all treated with anterior decompression and internal fixation of thoracolumbar fracture complicated with incomplete paralysis. The patients of contral group were treated with routine therapy of hormone dehydration drug. The patients of treatment group were treated with Modified Tao Hong Si Wu Tang on the basis of routine therapy. The two groups were evaluated by ASIA score before and after treatment. The data were analyzed using statistical software SPSS16.0.ResultsThe marks of touch feeling,pain feeling, movement,and the Neurological Classiffication of Spinal Cord Injury(ASIA) of two groups showed different degrees of recovery.28days after treatment, A group showed higher degree than B group(P<0.05) in movement and ASIA classification.ConclusionModified Tao Hong Si Wu Tang is conducive to neural function recovery after surgical treatment of thoracolumbar fracture complicated with incomplete paralysis.