按法对大鼠脑卒中后肌痉挛的影响及其机理研究

目的:观察按法干预后脑卒中后肌痉挛大鼠血浆及脊髓L1-L3节段灰质前角组织中γ-氨基丁酸(GABA)和甘氛酸(Gly)含量的变化,探讨按法缓解脑卒中后肌痉挛的作用机制。方法:健康成年雄性Sprague-DawIey(SD)大鼠80只,随机抽取10只为空白组,其余70只造模。采用左颈外动脉插入线栓法建立大鼠大脑中动脉局灶性脑缺血(MCAO)模型。Longa神经功能评定为2-3分,且改良Ashworth肌张力评分评定为;1+、1+及2级的30只大鼠纳入实验。用随机数字表法将30只造模成功的大鼠随机分为模型组、按肌腱组和按肌腹组。造模成功2 d后,按肌腱组及按肌腹组大鼠分别接受大鼠按法橾作治疗仪按股四头肌肌腱和按股四头肌肌腹治疗,压力控制在(350±50)g,按压频率为5s/次,每次15 min,每日1次,连续治疗5d。各组于治疗第5次后,采用改良Ashworth#挛评定标准对大鼠股四头肌的张力进行评定。采用酶联免疫吸附试验(ELISA)法观察大鼠血浆及脊髓L1-L3节段中Gly的含量变化,采用高效液相色谱法(HPLC)观察大鼠血浆及脊髓L1-L3节段中GABA的含量变化。结果:各组改良Ashworth量表肌张力评定中,按肌腱组大鼠肌张力下降较按肌腹组更为明显(P<0.01);按肌腱组血浆及香髓L1-L3节段组织中Gly及GABA的含量增加较按肌腹组更为明显(均P<0.01)。结论:基于腱器官“反牵张反射”理论,采用按法刺激腱器官诱发“反牵张反射”对大鼠肌痉挛状态的改善效果优于按压肌腹。大鼠血浆和脊髓L1-L3节段中Gly和GABA含量的增加,可能是按法刺激腱器官改善大鼠肌痉挛状态的作用机制之一。

Effect of An-pressing manipulation on post-stroke muscle spasticity in rats and its mechanism study

Objective:To explore the mechanism of An-pressing manipulation in improving post-stroke muscle spasticity,by observing the changes of γ-aminobutyric acid(GABA)and glycine(GIy)in plasma and gray matter of L1-L3 spinal cord anterior horn in post-stroke rats with muscle spasticity after An-pressing manipulation intervention.Methods:Ten of 80 adult male Sprague-Dawley(SD)rats were randomly selected as the blank group,and the remaining 70 were used for modeling.The middle cerebral artery occlusion(MCAO)rat model was established by insertion suture occlusion method in the left external carotid artery.Thirty rats with a Longa neurological score of 2-3 points and a modified Ashworth spasticity scale score of 1,1+,or 2 were included in the experiment.Using the random number table method,the 30 successfully modeled rats were randomly divided into a model group,an An-pressing tendon group and an An-pressing muscle belly group.Two days after modeling,rats in the An-pressing tendon group and An-pressing muscle belly group received An-pressing manipulation on the tendon and belly of quadriceps femoris muscle respectively,with the pressure of(350±50)g and the frequency of 5 s/time,15 min per session,once a day for 5 continuous days.After the 5th treatment,the tension of the rat quadriceps femoris muscle was evaluated using the modified Ashworth spasticity scale.The Gly levels in rat plasma and L1-L3 segments of spinal cord were determined by enzyme-linked immunosorbent assay(ELISA).The GABA levels in rat plasma and L1-L3 segments of spinal cord were measured by high performance liquid chromatography(HPLC).Results:The decrease in rat muscle tension scored by the modified Ashworth spasticity scale in the An-pressing tendon group was more significant than that in the An-pressing muscle belly group(P<0.01);the increases in Gly and GABA levels in the rat plasma and L1-L3Segments of spinal cord were more significant in the An-pressing tendon group than those in the An-pressing muscle belly group(all P<0.01).