內填黃耆皂苷矽膠管對截斷大鼠坐骨神經再生的影響 研究生：鄭均洹 指導教授：陳光偉 博士 共同指導教授：陳悅生 博士 中醫醫藥學院 中西醫學結合研究所 神經斷傷，間距是選擇種神經修復術最重要考慮因素。間距較大時，也就是說超過一公分以上時，考慮施行神經管接合術。神經管接合術是將神經兩斷端手術縫合於一圓管的兩端，此圓管可導引及支持再生的神經纖維修復。現在，有許多不同的生物材料用來製作神經管，矽膠管因為有諸多優點，故常被選用。此外，管內添加再生過程中所需的物質，能使管中神經在較短的時間內再生，跨過神經間距，避免神經瘤發生。 補陽還五湯(Buyang Huanwu Decoction) [19] 証明對周圍神經斷傷(neurotmesis)有明顯之療效，中醫臨床用來治療中風病患有其一定之療效，其主要成分為黃耆。故本實驗即以矽膠管內填黃耆皂苷(astragaloside)，來評估其對周圍神經生長之療效。 黃耆對於神經再生之機轉，似乎沒有直接之證據，許多報告呈現，黃耆對免疫有確定之療效，依可能之機轉為巨嗜細胞，改變神經生長所需之環境，進而間接加速神經再生，是本實驗可能之推論。 實驗結果：Collagen (control)組為0 %；Collagen+25μM astragaloside組 0%；Collagen+50μM astragaloside組 40%；Collagen+100μM astragaloside組 10%；證明黃耆皂苷於50μM時，對神經再生有最佳療效。 關鍵字：周圍神經再生，矽膠管，黃耆皂苷; Effect of astragaloside on Peripheral Nerve Regeneration Chun-Yuan Cheng, Yueh-Sheng Chena, Chien-Ju Liua, Abstract The present study provides in vivo trials of silicone rubber chambers filled with different concentrations of astragaloside (0, 25, 50, 100 μM) to bridge a 15 mm sciatic nerve defect in rats. Collagen was also filled in the chambers to prevent the astragaloside from leakage. Histological and electrophysiological techniques were used to evaluate the functional recovery of the nerve. At the conclusion of 8 weeks, animals from the group treated with the astragaloside , especially at the concentration of 50μM, had a higher rate (40%) of successful regeneration across the wide gap and a significantly larger number of myelinated axons. However, the high dose astragaloside (100 μM) completely reversed this positive effect of growth-promoting capability and inhibited nerve regeneration. Only 10% of the animals treated with the high dose astragaloside had regenerated cables within the silicone rubber chambers. The low dose astragalosie (25μM) and control groups are no growth. These results indicated that astragaloside could be involved in both positive and negative effects on regenerating nerves. Therefore, whether a proper dosage of astragaloside is used or not plays a critical factor in deciding if it can sustain nerve regeneration over long gaps. We used this Astragalus membranaceusn(AM) as the material of this study is according to the Buyang Huanwu Decoction, the component Astragalus membranaceusn (AM).is around 40%. (19) Review the literatures of astragaloside on peripheral nerve regeneration no direct evidence on this issue. The possible mechanism macrophage played the role. Macrophage induced degeneration process of the injuried nerve, the cytokine and some growth factor also recruit for the regeneration procedure. Key words: astragaloside ; Silicone rubber chamber; Peripheral nerve, silicone tube, astragaloside
