電針刺激對於可降解導管中坐骨神經再生之影響

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题名:	電針刺激對於可降解導管中坐骨神經再生之影響 Effect of electroacupuncture on regeneration of sciatic nerve assisted by a biodegradable nerve conduit
作者:	許偉宸;Wei-Cheng Hsu
贡献者:	針灸研究所碩士班
关键词:	周邊神經再生;電針刺激;可降解神經導管;Peripheral nerve regeneration;electroacupuncture;biodegradable nerve conduit
日期:	2019-07-04
上传时间:	2019-11-11
出版者:	中國醫藥大學
摘要:	目的：探討可降解神經導管( gelatin-BVSM )在使用針刺與1mA電針刺激在20Hz與200Hz不同頻率下對於神經再生的影響。方法：本研究應用可降解神經導管( gelatin-BVSM )，接合被截斷的SD大鼠右側坐骨?經，術後一星期開始，以針刺組作為對照組，施予1mA在20Hz與200Hz不同頻率電針，在斷傷兩端給予電刺激，將陰極置於遠端(陽陵泉)，陽極置於近端(環跳)，每兩天一次，連續電針三星期，術後四星期評估電針效果。從形態學，電生?和組織學功能的角?，對於坐骨?經再生成功率的影響進?評估。結果：發現使用 1mA 20Hz 電針刺激有較高的坐骨神經再生成功率。但是在，熒光金逆行標記與組織學量化結果顯示成功再生的組織中，雖然gelatin-BVSM +1mA 20Hz組別數量較多，熒光金逆行標記細胞密度增加較多，且有較多髓鞘化的軸突，成熟度看似較好，但皆未達顯著差異。電生理檢測，在振幅與波下面積20 Hz與200 Hz組顯著有較大振幅、較大動作電位波形總面積，在神經傳導速度及潛值則無統計顯著意義。免疫組織化學染色在腰椎I-II 背角CGRP各組間也無顯著差異；在巨噬細胞密度則可看到gelatin-BVSM +1mA 20Hz 與針刺組有顯著差異。結論：gelatin-BVSM神經導管在經由電針與高頻率電刺激並無加速崩解，可提供神經再生良善環境。使用1mA 20Hz再生成功率較高，可以相對穩定發炎反應，且適當頻率可延緩神經退化及受損區域發炎及水腫產生，再者產生促進神經再生因子，促進神經再生。 Background: To investigate the effect of biodegradable nerve conduit (gelatin-BVSM) on the regeneration of sciatic nerve using acupuncture and electroacupuncture at a current intensity of 1 mA and different frequencies of 20 Hz and 200 Hz. Methods: In this study, a biodegradable nerve conduit (gelatin-BVSM) was used to join the truncated right sciatic nerve of SD rats. The acupuncture group was used as the control group; the two groups of electroacupuncture groups were given the same current intensity of 1 mA but different frequencies of 20 Hz and 200 Hz. Starting 1 week after transection, stimulation was applied between the cathode placed at the distal stump (GB34) and the anode at the proximal stump (GB30) every other day for 3 weeks. From the perspective of morphology, electrophysiological and histological features, impact on the success rate of sciatic nerve regeneration was evaluated. Results: At 4 weeks after surgery,it found that the use 1mA 20Hz EA has a higher success rate of sciatic nerve regeneration. The results of histological quantification and retrograde labeling of Fluorogold showed that although gelatin-BVSM with 1 mA 20Hz was more abundant, the Fluorogold retrograde marker cell density increased more, and there were more myelinated axons, better mature degree,but, there was no significant difference between the three groups. In terms of amplitude and MAP area, gelatin-BVSM with 20 Hz has a larger amplitude and a larger MAP area than gelatin-BVSM with 200 Hz. There are statistically significant differences. There was no statistical significance in nerve conduction velocity and Latency. Immunohistochemical staining showed that expression of I-II region of calcitonin gene-related peptide in the dorsal horn had no significant difference. At macrophage density, gelatin-BVSM with 1 mA 20 Hz was significantly different from the acupuncture group. Conclusions: The gelatin-BVSM nerve conduit does not accelerate disintegration via electroacupuncture and high frequency electrical stimulation, providing a good environment for nerve regeneration. The gelatin-BVSM with 1mA 20Hz has a higher success rate of sciatic nerve regeneration. It can stabilize the inflammatory response, and the appropriate frequency can delay the neurodegeneration and inflammation and edema in the damaged area, and then guide the generation of nerve regeneration factors and promote nerve regeneration.
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