| Objective: To observe the curative effect of Zhi Nong Huo Xue Tong YuCapsule on nerve root compression type and the non-compression type lumbardisc disease, to discuss the action mechanism and the correlativity between thedifferent lumbar intervertebral disc protrusion and the level of PLA2in rats, andfurther to explore the mechanism of pain in lumbar disc prolapse.Methods:140SD rats aged12months (70male rats and70female rats) werebought for the experiment.130SD rats were divided into13groups (a, b, c, d, e,f, a1, b1, c1, d1, e1, f1、blank group) randomly,10rats in each group werenumbered from1to10, and the rest10rats were taken as the standby group.Group a, b, c, d, and f were made into model of L5,6on the left side of thespinal nerve root compression type of protrusion of lumbar intervertebral discwhile group al, bl, cl, dl and fl were made into model of L5,6on the left side ofthe spinal nerve root non-compression type. From the14day after the operation,the model group a, a1, b, b1, c, c1were given a gavage of Zhi Nong Huo XueTong Yu Capsule with high dose(1.6g/kg/d/a), middle dose(0.8g/kg/d/a) andlow dose(0.4g/kg/d/a) in order for fourteen days. Meanwhile group d and dlwere given a gavage of normal saline (0.8g/kg/d/a). Group e and el were shamoperation group in which the rats’ nerve root were exposed and then sutured and were given a gavage of normal saline with the same dose as group d and dl.Group f and fl were model groups without gavage. Observation target:1. groupf and fl: the CT detection and the pain thresholds of the left hind leg’s shrinkageclaw with mechanical stimulation were observed and recorded for three daysbefore model-made,7days and14days after model-made.2,①Rats killed:five rats in group blank; f and fl were killed in order respectively at the seventhand the fourteenth day to extract the nucleus pulposus in lumbar at differenttimes and nerve root to get staining images and the amount of PLA2of nucleuspulposus with ELISA method.②The pain thresholds of the left hind leg’sshrinkage claw with mechanical stimulation were observed and recorded at the7and the14days after the gavages, furthermore killed in order respectively atthe seventh and the fourteenth day to extract the nucleus pulposus in lumbar atdifferent times and nerve root to get staining images and the amount of PLA2ofnucleus pulposus with ELISA method.Results:1, Behavior changes after model-made:①, the rats of nerve rootcompression type consumed a normal diet, appeared mild drag with limping,avoided weighting on the left hind leg when walking, without incontinence andbiting, but became irritable on the seventh day after model-made, but on thefourteenth day, they appeared significant drag and limped, avoided weightingcompletely on the left hind leg when walking. The rats of non-compression typeconsumed a normal diet, appeared significant drag and limped, avoidedweighting on the left hind leg when walking, without incontinence and biting, and became irritable on the7days after model-made, as well as the14days aftermodel-made;②, Before the operation, the pain thresholds of the left hind leg’sshrinkage claw with mechanical stimulation of the rats with nerve rootcompression type were69-91mmhg, on the seventh(P<0.01, the lowest) as wellas the fourteenth day(P>0.05), pain thresholds decreased significantly. The painthresholds of the non-compression type were70-89mmhg, the lowest(P<0.01)was on the seventh day after the operation, and the pain thresholds on thefourteenth day (P>0.05) was recovered than that but lower than thenormal(P<0.01);③the change of PLA2: compression type groups got thehighest at the seventh day after model-made comparing the normal (P<0.01)before the model-made, as well as that at the fourteenth day, meanwhile thenon-compression type groups also got the highest one at the7days aftermodel-made comparing the normal (P<0.01) before the model-made, but at the14days after model-made, PLA2decreased(P>0.05), but still higher than thenormal.2, Behavior changes when given gavages:①the compression typegroups at the7days after gavages: group a: drag on the left hind legs disappear,mild residual claudicating; group b: a mild drag on the left legs and limp didn’tdisappear; group c: a drag on the left legs and limp didn’t disappear, but it’sbetter than preoperative, so in a word, total effective rate was100%; group d:the rats’ activity function of left hind leg was recovered poorly with significantdrag and limping and avoided weighting on the left hind leg when walking,without incontinence; group e: no change on the left hind leg before and after gavages, in addition, about group a, b and c, there were no changes at thefourteenth day than seven days ago. The non-compression type groups at theseventh day after gavages: group a1: dragging on the left hind leg disappearedwith mild residual claudicating, group b1: a mild drag on the left hind leg andthe claudication did not disappear, group c1: significant drag, limping didn’tdisappear, the left hind leg could load when walking, it was much better thanpreoperative, in a word, total effective rate was100%; group d1: the rats hadmild recovery on activity function of left hind legs, appeared significant dragand limping without incontinence and avoided weighting on the left whenwalking completely, group e1: there were no abnormal changes on activityfunction of left hind legs before and after gavages.14days after gavages: groupa1: rats didn’t drag and the limp disappeared completely; group b1: dragging onthe left hind leg disappeared with mild residual claudicating; group c1: amoderate drag on the left hind leg and limping didn’t disappear; group d1: aswell as the seventh day.②Pain thresholds of the left hind leg’s shrinkage clawwith mechanical stimulation of the rats: The compression type groups: gavagesafter7days, high dose groups had the fastest rising threshold which wasbetween (66-83mmhg); middle dose group was in between (60-65mmhg), andthe two groups’ thresholds increased than saline model groups, P<0.01. highand middle dose groups compared with P<0.01and the difference wasstatistically significant. The threshold of saline model groups didn’t change andhad no significant difference compared with surgery model of7days after operation (P>0.05). Sham operation group didn’t change significantly as normalrats before and after gavages.14days after gavages, thresholds of rats in high,medium and low dose groups didn’t rise obviously (P>0.05) comparing withthat7days ago. The non-compression type groups: gavages after7days, highdose groups had the fastest rising threshold which was between (63-73mmhg);middle dose group was in between (59-68mmhg). The thresholds of two groupsincreased (P<0.01) than saline model group. The high dose group comparedwith the middle dose group P<0.01and the difference was statisticallysignificant. The threshold of saline model groups didn’t change and had nosignificant difference compared with surgery model of7days after operation(P>0.05). Sham operation group didn’t change significantly as normal ratsbefore and after gavages.14days after gavages: the high dose group comparedwith7days gavages group (P<0.01) and sham operation group (P>0.05) had nosignificant difference. Comparison before and after gavages were not significantcompared with middle and low dose groups.③Changes of PLA2after gavages:the compression type groups: PLA2of high dose group decreased fastest7daysafter gavages, which was different significantly with the saline modelgroup(P<0.01), and PLA2of middle dose group decreased more slowly incomparison with high dose group (P<0.01)with significant differences; PLA2oflow dose group decreased the most slowly, compared with the saline modelgroup (P>0.05), no significant differences. Sham operation group didn’t changeas normal rats before and after gavages. The comparison between7days and14 days after gavages: there were no significant difference among high dose,middle dose and low dose groups (P>0.05), but there was significant differencebetween high dose group and sham operation group (P<0.01). Non-compressiontype groups: PLA2of high dose group decreased fastest7days after gavagesand there was significant difference with saline model group (P<0.01). PLA2ofmiddle dose group decreased more slowly in comparison with high dose group(P<0.01) with significant differences; PLA2of low dose group decreased themost slowly, compared with the saline model group (P>0.05), no significant.Sham operation group didn’t change as normal rats before and after gavages.The comparison between7days and14days after gavages: high dose group hadsignificant difference(P<0.01), didn’t have significant difference with the lowdose group P>0.05, and there was no significant difference between high dosegroup and sham operation group.Conclusion:1, According to the experiment, it’s feasible to make the nerve rootcompression type and the non-compression type lumbar disc disease model onrats.2, Zhi Nong Huo Xue Tong Yu Capsule can improve neurologicalsymptoms obviously caused by protrusion of lumbar intervertebral disc andrelieve pain. Its mechanism may be associated with decreasing nflammatorymediator, PLA2.3, Both mechanical compression and inflammatory mediator arethe cause of the pain caused by protrusion of lumbar intervertebral disc. Inflammatory mediator plays a main role at the early stage because ofoppressive nerve in nucleus pulposus, but the late pain are maily caused bymechanical compression. So early disc treatment should be given to inhibitinflammation of nerve root, but late surgery should be given prior to resolvemechanical compression. |
PDF Full Text Request