CAJ | 학술논문

目的：观察脊柱关节松动术对急性根性神经痛大鼠神经生长因子（NGF）的影响，探讨脊柱手法治疗急性神经炎性疼痛的生物学机制。方法90只雄性 SD 大鼠随机分为正常组（n ＝18）、假手术组（n ＝18）、模型组（n ＝18）、模型对照组（n ＝18）、关节松动组（n ＝18）。其中正常组为无任何干预的空白对照；假手术组只在相应椎节（L5-6）左侧做局部软组织切开，未建模；其余各组均通过手术在特定椎节（L5-6）左侧建立急性 L5神经根炎模型。每组各取6只大鼠于术前1天及术后第3、5、7、12天行一般行为学观察和热辐射刺激缩爪反应潜伏期（PWL）的测定。另各取6只大鼠分别于术后第5和12天检测术侧 L5背根神经节中 NGF 的表达。结果所有大鼠均未出现运动功能明显障碍。关节松动组 PWL 在术后各观察时点比模型组、模型对照组均明显升高（P ﹤0.05）。关节松动组术侧 L5背根神经节 NGF 平均光密度在术后第5天和第12天比模型组、模型对照组明显降低（P ﹤0.05）。结论脊柱松动术治疗可以明显抑制急性坐骨神经痛大鼠 DRG 中 NGF 的过度表达，从而减轻神经急性炎症引起的强烈痛觉刺激，这可能是脊柱手法生物学起效的途径之一。
목적：관찰척주관절송동술대급성근성신경통대서신경생장인자（NGF）적영향，탐토척주수법치료급성신경염성동통적생물학궤제。방법90지웅성 SD 대서수궤분위정상조（n ＝18）、가수술조（n ＝18）、모형조（n ＝18）、모형대조조（n ＝18）、관절송동조（n ＝18）。기중정상조위무임하간예적공백대조；가수술조지재상응추절（L5-6）좌측주국부연조직절개，미건모；기여각조균통과수술재특정추절（L5-6）좌측건립급성 L5신경근염모형。매조각취6지대서우술전1천급술후제3、5、7、12천행일반행위학관찰화열복사자격축조반응잠복기（PWL）적측정。령각취6지대서분별우술후제5화12천검측술측 L5배근신경절중 NGF 적표체。결과소유대서균미출현운동공능명현장애。관절송동조 PWL 재술후각관찰시점비모형조、모형대조조균명현승고（P ﹤0.05）。관절송동조술측 L5배근신경절 NGF 평균광밀도재술후제5천화제12천비모형조、모형대조조명현강저（P ﹤0.05）。결론척주송동술치료가이명현억제급성좌골신경통대서 DRG 중 NGF 적과도표체，종이감경신경급성염증인기적강렬통각자격，저가능시척주수법생물학기효적도경지일。
Objective To observe the impacts on nerve growth factor(NGF)in the rats of acute ra-dicular neuralgia treated with spinal mobilization and explore the biological mechanism of spinal manipulation in the treatment of acute neural inflammatory pain. Methods Ninety male SD rats were randomized into a normal group(n = 18),a sham - operation group(n = 18),a model group(n = 18),a model control group(n= 18)and a mobilization group(n = 18). The normal group was the blank control group without any interven-tion adopted. In the sham - operation group,the local soft tissue was cut on the left side of L5 to L6 and the models were not prepared. In the rest groups,the model of acute radiculitis of L5 was prepared on the left of L5 to L6 . Six rats were collected from each group to observe the general behavior and determine the thermal withdrawal latency(TWL)1 day before operation and on the 3rd ,5th ,7th and 12th days after operation. The oth-er 6 rats were collected from each group to determine NGF expression on L5 dorsal root ganglion of L5 on the operation side on the 5th and 12th days after operation separately. Results The apparent motor impairment did not occur in all of the rats. TWL in the mobilization group was higher apparently in each observation point as compared with the model group and model control group(P ﹤ 0. 05). The average optical density of NGF at L5 dorsal root ganglion on the operation side on the 5th and 12th days after operation in the mobilization group was reduced apparently as compared with that in the model group and model control group(P ﹤ 0. 05). Con-clusion Spinal mobilization apparently inhibits the over - expression of NGF in dorsal root ganglion in the rats of acute sciatica and alleviates the strong pain stimulus induced by acute neural inflammation,which is possibly one of the approaches to the biological effect of spinal manipulation.