[物理治疗对坐骨神经损伤再生的实验研究]

Zhao Juan, Yu Hong, Xu Yiming, Bai Yuehong

Department of Rehabilitation, the Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, 200233, P.R. China.

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Jan;25(1):107-11.

OBJECTIVE

Peripheral nerve injury is a common clinical disease, to study the effects of the physical therapy on the regeneration of the injured sciatic nerve, and provide a reference for clinical treatment.

METHODS

Sixty-four female adult Wistar rats (weighing 252-365 g) were chosen and randomly divided into 4 groups (n = 16): group A, group B, group C, and group D. The experimental model of sciatic nerve defect was established by crushing the right sciatic nerve in groups B, C, and D; group A served as the control group without crushing. At 2 days after injury, no treatment was given in group B, electrical stimulation in group C, and combined physical therapies (decimeter and infrared ray) in group D. At 0, 7, 14, and 30 days after treatment, the sciatic nerve function index (SFI) and the motor nerve conduction velocity (MNCV) were measured, and morphological and transmission electron microscopy (TEM) examinations were done; at 30 days after treatment, the morphological evaluation analysis of axons was performed.

RESULTS

At 0 and 7 days after treatment, the SFI values of groups B, C, and D were significantly higher than that of group A (P < 0.05); at 14 and 30 days after treatment, the SFI value of group D decreased significantly, no significant difference was observed between group D and group A (P > 0.05) at 30 days; whereas the SFI values of groups B and C decreased, showing significant difference when compared with the value of group A (P < 0.05). At 0, 7, and 14 days after treatment, the MNCV values of groups B, C, and D were significantly lower than that of group A (P < 0.05), and there were significantly differences between group B and groups C, D (P < 0.05); at 14 days, the MNCV value of group D was significantly higher than that of group C (P < 0.05); and at 30 days, the MNCV values of groups B and C were significantly lower than that of group A (P < 0.05), but there was no significant difference between group D and group A (P > 0.05). At 0 and 7 days, only collagen and lipid were observed by TEM; at 14 and 30 days, many Schwann cells and perineurial cells in regeneration axon were observed in groups B, C, and D, especially in group D. Automated image analysis of axons showed that there was no significant difference in the number of myelinated nerve fibers, axon diameter, and myelin sheath thickness between group D and group A (P > 0.05), and the number of myelinated nerve fibers and axon diameter of group D were significantly higher than those of groups B and C (P < 0.05).

CONCLUSION

Physical therapy can improve the regeneration of the injured sciatic nerve of rats.

目的

周围神经损伤是一种常见的临床疾病，研究物理治疗对损伤坐骨神经再生的影响，为临床治疗提供参考。

方法

选取64只成年雌性Wistar大鼠（体重252 - 365 g），随机分为4组（n = 16）：A组、B组、C组和D组。B组、C组和D组通过挤压右侧坐骨神经建立坐骨神经缺损实验模型；A组作为未挤压的对照组。损伤后2天，B组不进行治疗，C组进行电刺激，D组进行综合物理治疗（分米波和红外线）。治疗后0、7、14和30天，测量坐骨神经功能指数（SFI）和运动神经传导速度（MNCV），并进行形态学和透射电子显微镜（TEM）检查；治疗后30天，进行轴突的形态学评估分析。

结果

治疗后0和7天，B组、C组和D组的SFI值显著高于A组（P < 0.05）；治疗后14和30天，D组的SFI值显著下降，30天时D组与A组之间无显著差异（P > 0.05）；而B组和C组的SFI值下降，与A组相比差异显著（P < 0.05）。治疗后0、7和14天，B组、C组和D组的MNCV值显著低于A组（P < 0.05），B组与C组、D组之间存在显著差异（P < 0.05）；14天时，D组的MNCV值显著高于C组（P < 0.05）；30天时，B组和C组的MNCV值显著低于A组（P < 0.05），但D组与A组之间无显著差异（P > 0.05）。0和7天时，TEM观察仅见胶原和脂质；14和30天时，B组、C组和D组再生轴突中有许多施万细胞和神经束膜细胞，尤其是D组。轴突的自动图像分析显示，D组与A组之间的有髓神经纤维数量、轴突直径和髓鞘厚度无显著差异（P > 0.05），D组的有髓神经纤维数量和轴突直径显著高于B组和C组（P < 0.05）。