OBJECTIVE:To probe into peripheral nervous mechanisms of analgesic effect of electroacupuncture (EA) at Hegu (LI 4) and Neiguan (PC 6) on cervical region.METHODS:Twenty cases of thyroid disease who wished to receive acupuncture anesthesia, were stimulated with electroacupuncture at bilateral Hegu (LI 4), Neiguan (PC 6) in continued wave, intensity of 6-8 V, frequency of 10-20 Hz. After stimulation for 40 min, the operation was made. Before EA stimulation, 10 min, 20 min and 30 min after EA stimulation, changes of the physiologi cal functions including latent period, conduction velocity, wave peak amplitude of great auricular nerve were monitored and changes of pain sense were detected.RESULTS:After EA given at Hegu (LI 4) and Neiguan (PC 6) for 10 min, 20 min and 30 min, the pain sense significantly decreased (P<0.01), the latent period of great auricular nerve was shortened, and the conduction velocity was fastened and the wave peak amplitude raised with significant changes as compared with those before EA stimulation (P<0.01).CONCLUSION:EA at Hegu (LI 4) and Neiguan (PC 6) can produce a better analgesic effect on cervical region; EA at Hegu (LI 4) and Neiguan (PC 6) induces electro-physio logic changes of the nerve innervating the cervical region, showing increase of excitability; the nerves innervating Hegu (LI 4) and Neiguan (PC 6) and the nerves of cervical region possibly are homologous nerves.

Objective To observe whether or not nimodipine injection can improve the peripheral neuropathy in diabetic patients.Methods 115 diabetic patients complicated with peripheral neuropathy were divided randomly into two groups:1)Treated group(n=62): Nimodipine 20 mg was given intravenously with normal 1 000 ml per day for 14 days.2)Control group(n=53): Radix salviae miltiorrhiza 20ml was administrated intravenously in normal saline 500 ml also for 14 days. The symptoms and signs were observed and recorded, and the nerve conducting velocity(NCV), latencies and wave amplitudes of median nerve, tibial nerve, peroneal nerve and sural nerve of the lower limbs were measured before and afteries treatment in the two groups using electromyograph (Denmark). The fasting and postprandial plasma glucose levels, serum insulin and C-peptide were measured; HbA1c and the lipoprotein profile were determined before and after the treatment also; the modified index of HOMA insulin-resistance (HOMA-IR)was calculated basing on the fasting levels of glucose and insulin, the whole blood and the plasma viscosities were measured correspondingly.Results All 62 diabetic patients completed the course of 14-day treatment. In the treated group, the numbness, pain and abnormal sensitivity decreased obviously more than those in the control patients, and the decreased knee jerk and superficial sensation recovered; and the pulse of pedisdorsalis became stronger. The NCV of tibial nerve ,peroneal nerve and sural nerve after 14 days of nimodipine administration were faster, more significantly than those of the control group (P0.05) The plasma and whole blood viscosities decreased significantly in treated patients, and the deformed ability of red blood cell increased, but the aggregation index decreased more significantly than that before treatment. The high-density lipoprotein cholesterol(HDL-C) level of treated group increased significantly, there was no significant difference in TC and LDL-C levels between the two groups, the HOMA-IR index reduced obviously(P0.01).Conclusion Nimodipine improves the diabetic peripheral neuropathy with the probable mechanism dilatation for nutrient vessels in the nerve tissue improving local ischemia and hypoxia together with decreasing insulin-resistance and blood viscosity.

Objective: To investigate whether hyperbaric oxygen therapy(HBOT) can improve the peripheral neuropathy in streptozotocin-induced diabetic rats, and to study its possible mechanisms. Method: The diabetic rat model was induced by injection intraperitonally of streptozotocin. Rats were randomly divided into two groups:①HBOT group(n=31): inhale oxygen(concentration97%) in animal chamber 1h per day at the pressure of 0.15MPa for 1 to 20 days.②Diabetic control group(DM,n=32): 32 diabetic rats complicated peripheral neuropathy without any treatment.③Normal group(NC,n=20). At the 10th and 20th day of oxygenation, the NCV, latency and wave amplitude of tibial nerve and sural nerve of rats right-behind limbs were measured in the three groups using the electromyograph and the arterial blood was collected from bilateral femoral artery and serum levels of IGF, NGF, NO and MMP-1 were measured. Result: Before treatment,the NCV of diabetic rats was slower than normal rats. At 10 days after HBOT, the NCV of tibial nerve and sural nerve of the right-behind limbs of treatment group was faster significantly than DM group(P0.05), but they were still slower than normal group. The serum levels of NGF and NO increased slightly but without statistical meaning. At 20 days after oxygenation, NCV of the tibial nerve and sural nerve increased significantly than DM group timely and treatment group 10-days before, but there was no significant difference of the NCV between HBOT group and normal group at this time. The abnormal ultrastructure of DM group was improved in treatment group, like the decreasing of axon,and denaturation and incrassation of myelin, and the number of Schwann cell increased significantly than DM group.The levels of NGF,IGF-1 and NO in HBO group were higher than DM group, and its MMP-1 level decreased significantly compared with DM group and baseline.Conclusion:The hyperbaric oxygen therapy improves the peripheral neuropathy in STZ-diabetic rats, its mechanism may be related to induce the synthesis of NGF,IGF-1 and NO, and inhibiting the MMP-1.

目的:研究高压氧治疗是否可改善链脲佐菌素(streptozocin,STZ)糖尿病大鼠的周围神经病变并探讨其机制.方法:SD大鼠83只,用STZ制造糖尿病模型成功60 d、肌电图和电镜证实有周围神经病变后,随机分为3组:①高压氧组(n=31):每天接受0.15 MPa、高压氧1 h,连续20 d.②糖尿病对照组(n=32):不做治疗.③正常对照组(n=20):腹腔注射生理盐水的无糖尿病的正常STZ大鼠.分别在疗程5,10,20 d时测定右后肢胫神经、腓神经的传导速度(nerve conduction velocity,NCV)和H反射后处死治疗组及同期对照组大鼠,取坐骨神经进行苏木精-伊红染色病理学观察,同时进行电镜观察.结果:治疗前糖尿病大鼠的胫神经(28.56±6.99)mm/s、腓神经(28.92±7.37)mm/s的NCV明显低于正常组[分别为(48.29±8.04)mm/s,(51.93±8.50)mm/s],而H反射的潜伏期延长,波幅变小.高压氧治疗10d后,治疗组后肢胫神经(45.17±9.80)mm/s和腓神经的传导速度(43.81±7.05)mm/s明显高于同期糖尿病对照组,但低于正常对照组;治疗组H反射的潜伏期(7.27±0.76)ms较糖尿病对照组(7.49±1.26)ms缩短,波幅增大[(1.09±0.39)mV,(0.57±0.30)mV,P＜0.05];病理学变化不明显,但电镜观察显示治疗组的许旺细胞数较糖尿病对照组增多,髓鞘结构有所改善;氧疗20 d后,治疗组后肢胫神经[(46.56±9.72),(36.75±4.29)mm/s]和腓神经[(44.43±11.23),(30.74±6.03)mm/s]的传导速度明显高于糖尿病对照组(P＜0.01),而与正常对照组间无明显差异[分别为(56.6±9.72)mm/s和(45.07±4.08)mm/s,P＞0.05],H反射的潜伏期(7.01±1.14)ms较糖尿病对照组(7.74±0.86)ms进一步缩短(P＜0.05),但波幅变化不明显;病理观察显示此时神经髓鞘和神经纤维结构明显好转;电镜下也观察到许旺细胞增生、有髓神经结构好转、轴突增大等改变.结论:高压氧可改善STZ糖尿病大鼠周围神经病变.

Purpose In order to investigate whether hyperbaric oxygen therapy (HBOT) could improve the peripheral neuropathy in streptozocin (STZ)-induced diabetic rats and its influence on transforming growth factor-β1 (TGF-β1). Methods Diabetic animal model was induced by injection intraperitonally of STZ,and blood glucose were controlled using injection of regular insulin and protamine zine insulin.After 2 months of diabetes onset,the neuropathy was diagnosed through observing the ultrastructure under electron-microscope,and rats were divided randomized into three groups:① Hyperbaric oxygen treatment (HBOT) group(n=31):inhale oxygen (concentration 97%) in animal chamber 1 hour per day at the pressure of 0.15 MPa for 1 to 20 days.② Diabetic model (DM,n=32) group:diabetic rats diagnosed neurepathy without any treatment.③ Normal control (NC,n=20) group:rats were injected normal solution intraperitonally and with normal blood glucose.At the 10 th and 20 th day of oxygenation,the rats in three groups were killed randomized after measuring the nerve conducting velocity(NCV),and the arterial blood were collected from bilateral femoral artery,and the nerve of hind-limb was taken immediately.The glucose levels of nail vein were measured using glucometer before death,and the serum TGF-β1 levels were measured using EIA method.At the same time,the pathological change of nerve tissue was observed using HE staining,and the TGF-β1 immunostaining in peripheral nerve was observed using DAB two-step method.The ultrastructure of them was also observed under electron-microscope. Results Except 1 rat died of anaethesation,30 rats completed the oxygenation in HBOT group.In DM group, excluded 2 died of hypoglycemic coma,data of 30 rats were collected.After 10 days treatment,the serum TGF-β1 levels in HBOT group decreased slightly but significantly than DC group,and they were still higher than NC group.But no obvious neural pathological change was observed in HBOT group,and the improvement of nerve ultrastructure was discovered,like the improvement of myelination and neuraxon and the increasing number of Schwann cells. At 20th day after oxygenation,serum TGF-β1 levels[(121.68±20.01)ng/mL] decreased significantly than that of DM group [(154.71±18.79) ng/mL].There was no significant difference between treatment group and NC group[(125.4±38.38) ng/mL].The improvement of nerve ultrastructure was observed in oxygenation rats but not in DM rats,and the immunostaining of TGF-β1 in nerve axon and compartments beside it was reduced obviously in HBOT group. Conclusions Hyperbaric oxygen therapy improved the peripheral neuropathy in STZ-diabetic rats,and its mechanism may be related to inhibiting the circulation TGF-β1 and its expression in nerve tissue.