Journal of Korean Medicine Rehabilitation (한방재활의학과학회지)

The society of Korean Medicine Rehabilitation (한방재활의학과학회)
권호 표지

Effects of Yanghyuljanggeungunbo-tang(Yangxuezhuangjinjianbu-tang) and Electrical Acupuncture on the Spinal Nerve Injury and the Motor Function

양혈장근건보탕(養血壯筋健步湯)과 전침의 병용치료가 손상된 척수신경 및 운동기능에 미치는 영향

  • Sul, Jae-Uk (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dong-Shin University) ;
  • Chu, Min-Kyu (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dong-Shin University) ;
  • Kim, Sun-Jong (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dong-Shin University) ;
  • Choi, Jin-Bong (Dept. of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dong-Shin University) ;
  • Shin, Mi-Suk (Dept. of Oriental Rehabilitation Medicine, School of Oriental Medicine, Pu-San National University) ;
  • Kim, Soo-Ik (Dept. of Internal Medicine, College of Oriental Medicine, Dong-Shin University)
  • 설재욱 (동신대학교 한의과대학 한방재활의학과교실) ;
  • 추민규 (동신대학교 한의과대학 한방재활의학과교실) ;
  • 김선종 (동신대학교 한의과대학 한방재활의학과교실) ;
  • 최진봉 (동신대학교 한의과대학 한방재활의학과교실) ;
  • 신미숙 (부산대학교 한의학전문대학원) ;
  • 김수익 (동신대학교 한의과대학 한방내과학교실)
  • Received : 2009.02.17
  • Accepted : 2009.04.08
  • Published : 2009.04.30

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Abstract

Objectives : The purpose of this study was to investigate the effects of Yanghyuljanggeungunbo-tang(Yangxuezhuangjinjianbu-tang, YGKT) and electrical acupuncture treatment in spinal cord injury(SCI)-induced rats. Methods : The subjects were divided into 5 groups ; Normal, Control-no treatment after SCI, Experimental I(Exp. I)-taken with YGKT 500 mg/kg $0.5m{\ell}$ daily after SCI. Experimental II(Exp. II)-taken with electrical acupuncture after SCI and Experimental III(Exp. III)-taken with YGKT 500 mg/kg $0.5m{\ell}$ and electrical acupuncture after SCI. After each operation, the present author observed cytological changes, the motor behavior recovery and nerve regeneration by analysis of the motor behavior tests, EMG, hematological(AST, ALT, WBC), histological and immunological changes. Rats were tested by Motor behavior test at 1st, 3rd, 7th, 14th and 21st day. Results : 1. All the experimental groups were improved compared with control group in the motor behavior tests including Tarlov test, Basso-Beattle-Bresnahan locomotor rating scale, modified inclined plane test, open field test, grid walk test and narrow beam test. Especially Exp. III was significantly improved among other groups. 2. In EMG test, H and M wave were significantly increased in Exp. III. 3. All the experimental groups were significantly decreased compared with control group in AST, ALT and WBC. 4. NGF, BDNF and Trk B of spinal cord gray matter in all the experimental groups were increased compared with control group. Especially, Exp. III was more effective. 5. In histological observations, muscle contraction and denaturation of gastrocnemius muscle of all the experimental groups were inhibited. Especially, those of Exp. III was more effective. On the observations of liver and kidney, cell atrophy and apoptosis of all the experimental groups were decreased compared with control group. Especially, those of Exp. III was more effective. Conclusions : It can be suggested that YGKT and electrical acupuncture may improve motor behavior, EMG, hematological, histological and immunological findings in SCI-induced rats. Especially, combination of these two treatments will be somewhat better in spinal nerve recovery and motor function improvement.

Keywords

References

  1. 장기현, 김인원, 한문희. 신경방사선과학. 서울:일조각. 2004:573.
  2. 대한정형외과학회. 정형외과학. 서울:최신의학사. 2004:675-8.
  3. Kenneth W. Lindsay, Ian Bone. 임상신경학. 서울:Epublic. 2006:582-3.
  4. 박종운, 이규창, 임중우, 백광세. 척수손상 고양이에서 Thyrotropin Releasing Hormone이 Somato sensory Evoked Potentials에 미치는 영향에 관한 연구. 대한신경외과학회지. 1987;16(1):255-64.
  5. 전상룡, 김준수, 김정훈, 노성우, 임승철, 정천기, 김현집, 권병덕. 백서의 척수손상 후 저체온 요법에 의한 신경회복 비교. 대한외상학회지. 2001;14(1):39-46.
  6. 이건목, 김경식, 이강창. 附子의 經口投與가 RAT의 脊髓損傷에 미치는 영향 및 비교. 대한침구학회. 대한침구학회지. 1998;15(2):105-16.
  7. 안정조. Effects of oriental medicinal drugs on axonal regeneration in the spinal cord neurons. 대전대학교대학원. 2005.
  8. 박인각. 양혈장근건보탕과 녹용약침이 척수손상 유발 흰쥐의 운동기능 회복 및 신경재생에 미치는 영향. 동신대학교 대학원. 2007.
  9. 이기태. Effects of Samultang and its components on axonal recovery of spinal cord neurons. 대전대학교대학원. 2006.
  10. 이건목, 황우준, 김경식, 천미나, 김종환. 持續的인 鍼刺戟이 RAT의 척수손상에 미치는 영향. 대한침구학회. 대한침구학회지. 1997;14(1):273-86.
  11. WEN. Acute central cervical spinal cord syndrome treated by acupuncture and electrical stimulation(AES). Rec Adv Acup Reser. 6ths international congress of neurological surgery. 1979:559-63.
  12. Yang JW, Jeong SM, Seo KM, Nam TC. Effects of corticosteroid and electroacupuncture on experimental spinal cord injury in dogs. J Vet Sci. 2003;4(1):97-101
  13. Yang C, Li B, Liu TS, Zhao DM, Hu FA. Effect of electroacupuncture on proliferation of astrocytes after spinal cord injury. Zhongguo Zhen Jiu. 2005;25(8):569-72.
  14. Hurlbert RJ, Tator CH. Characterization of longitudinal field gradients from electrical stimulation in the normal and injured rodent spinal cord. Neurosurgery. 1994;34(3):471-83. https://doi.org/10.1227/00006123-199403000-00013
  15. 許浚. 東醫寶鑑. 경남:동의보감출판사. 2005:796.
  16. 전국한의과대학침구과학교실. 침구학(하). 서울:집문당. 1998:1447.
  17. Kim YS, Kim SU Oligodendroglial cell death induced by oxygen radicals and its protection by catalase. J Neuroscience research. 1991;29:100-6. https://doi.org/10.1002/jnr.490290111
  18. Behrmann DL, Bresnahan JC, Beattie MS, Shah BR. Spinal cord injury produced by consistent mechanical displacement of the cord in rats: behavioral and histological analysis. J Neurotrauma. 1992;9(3):197-217. https://doi.org/10.1089/neu.1992.9.197
  19. Basso DM, Beattie MS, Bresnahan JC. A sensitive and reliable locomotor rating scale for open field testing in rats. J Neurotrauma. 1995;12(1):1-21. https://doi.org/10.1089/neu.1995.12.1
  20. Rivlin AS, Tator CH. Objective clinical assessment of motor function after experimental spinal cord injury in the rat. J Neurosurg. 1977;47(4):577-81. https://doi.org/10.3171/jns.1977.47.4.0577
  21. Karim A, Arslan MI. Isolation modifies the behavioral response in rats. Bangladesh Med Res Counc Bull. 2000;26(1):27-32.
  22. Sekhon LH, Fehlings MG. Epidemiology, demographics and pathophysiology of acute spinal cordi njury. Spine. 2001;26(supplement15):2-12. https://doi.org/10.1097/00007632-200112151-00002
  23. Stauffer SE. Neurological recovery following injuries to the cervical spinal cord and nerve roots. Spine. 1984;9:532-4. https://doi.org/10.1097/00007632-198407000-00024
  24. Fowler S, Newton L. Complementary and alternative therapies: the nurse's role. J Neurosci Nurs. 2006;38(4):261-4. https://doi.org/10.1097/01376517-200608000-00009
  25. Cardenas DD, Jensen MP. Treatments for chronic pain in persons with spinal cord injury: A survey study. J Spinal Cord Med. 2006;29(2):109-17. https://doi.org/10.1080/10790268.2006.11753864
  26. Han QM, Xie J, Chai ST, Fang J, Liu Q. Effect of Governer Meridian electro-acupuncture on water channel aquaporin-4 in experimental spinal cord injured rats. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2005;25(7):637-9.
  27. Peng B, Meng XF, Li M, Li LL, Zhang J, Liu XC, Shi J, Chen F. Effects of electroacupuncture on th expression of epidermal growth factor receptor and glial fibrillary acidic protein after spinal cord injury in rats. Zhen Ci Yan Jiu. 2007;32(4):219-23.
  28. Paola FA, Arnold M. Acupuncture and spinal cord medicine. J Spinal Cord Med. 2003;26(1):12-20. https://doi.org/10.1080/10790268.2003.11753654
  29. 이건목, 황우준, 조기용, 김기영. 附子 藥鍼이 RAT의 脊髓損傷에 미치는 영향 및 비교. 대한침구학회. 대한침구학회지. 1999;16(1):283-96.
  30. DeLisa JA. Developing an integrative approach to spinal cord medicine. J Spinal Cord Med. 2003;26(1):27. https://doi.org/10.1080/10790268.2003.11753656
  31. 이재규. 전침치료의 이론과 임상. 서울:서원당. 1993:14-7.
  32. 손성철, 황민섭, 윤종화, 김갑성. 脊髓血管畸形에 의한 脊髓損傷患者 1例에 대한 증례보고. 대한침구학회. 대한침구학회지. 2002;19(5):247-57.
  33. 김정호. 교통사고로 인한 경추부 손상으로 내원한 환자 1례에 대한 증례보고. 대한침구학회. 대한침구학회지. 2003;20(6):201-9.
  34. 설재욱, 신미숙, 최진봉. 전침요법을 병용한 척추손상 환자의 치험 1례. 한방재활의학과학회. 한방재활의학과학회지. 2004;14(4):117-27.
  35. 全國韓醫科大學 本草學敎室. 本草學. 서울:永林社. 2004:161, 165, 223, 334, 469, 575, 581, 605, 620, 632, 657, 662.
  36. 나창수. 경혈학각론. 서울:정문각. 2004:75-9, 295, 300-1,
  37. 전국한의과대학 침구경혈학교실. 침구학(상). 서울:집문당. 1994:382-4, 404-5, 648-9.
  38. 변재영, 손인철, 엄태식. 족삼리혈 및 관원혈의 혈성에 관한 문헌적 고찰. 대한침구학회. 대한침구학회지. 1992;9(1):173-8.
  39. Van de Meent H, Hamers FPT, Lankhorst AJ. New assessment techniques for evaluation of post-traumatic spinal cord function in the rat. J Neurotrauma. 1996;13:741-54. https://doi.org/10.1089/neu.1996.13.741
  40. Podratz JL, Winderbank AJ. NGF rescues DRG neurons in vitro from oxidative damage produced by hemodialyzers. Neurotoxicology. 2005;26(3):343-50. https://doi.org/10.1016/j.neuro.2005.01.003
  41. Wang YK, Huang ZQ. Protective effects of icariin on human umbilical vein endothelial cell injury induced by $H_2O_2$ in vitro. phamacol Res. 2005;52(2):174-82.
  42. Lin HH, Chen CH, Hsieh WK, Chiu TH, Lai CC. Hydrogen peroxide increases the activity of rat sympathetic preganglionic neurons in vivo and in vitro. Neuroscience. 2003;121(3):641-7. https://doi.org/10.1016/S0306-4522(03)00517-7
  43. Wrathall JR, Petergrew RK, Harvey F. Spinal cord contusion in the rat. Exp Neurol. 1988;88:108-22. https://doi.org/10.1016/0014-4886(85)90117-7
  44. Schnell L, Fearn S, Schwab ME, et al. Cytokine-induced acute inflammation in the brain and spinal cord. J Neuropathol Exp Neurol. 1999;58:245-54. https://doi.org/10.1097/00005072-199903000-00004
  45. Klusman I, Schwan ME. Effects of pro-inflammatory cytokines in experimental spinal cord injury. Brain Res. 1997;762:173-84. https://doi.org/10.1016/S0006-8993(97)00381-8
  46. Merrill JE, Benveniste EN. Cytokines in inflammatory brain lesions: helpful and harmful. Trends Neurosci. 1996;19:331-8. https://doi.org/10.1016/0166-2236(96)10047-3
  47. Knoblach SM, Fan L, Faden AI. Early neuronal expression of tumor necrosis factor-alpha after experimental brain injury contributes to neurological impairment. J Neuroimmunol. 1999;95:115-25. https://doi.org/10.1016/S0165-5728(98)00273-2
  48. Yoshida K, Gage FH. Cooperative regulation of nerve growth factor synthesis and secretion in fibroblasts and astrocytes by fibroblast growth factor and other cytokines. Brain Res. 1992;569:14-25. https://doi.org/10.1016/0006-8993(92)90364-F
  49. Aiello I, Rosati G, Serra G et al. The diagnostic value of H-index in S1 root compression. J Neurol Neurosurg psychiat. 1981;44:171-2. https://doi.org/10.1136/jnnp.44.2.171
  50. Burke D, Adams RW, Skuse NF. The effect of voluntary contraction on the H-reflex of human limb muscle. Brain. 1989;112:417-33. https://doi.org/10.1093/brain/112.2.417
  51. Tarkka IM, Larson TA. Change of electrically elicited reflexes in hand and hand forearm muscle in man. Am J Phys Med Rehabil. 1987;66:308-11. https://doi.org/10.1097/00002060-198710000-00010
  52. Thompson FJ, Reier PJ, Lucas CC. Altered patterns of reflex exitability subsequent to contusion injury of the rat spinal cord. Neuro. 1992;68:1473-86.
  53. Stephen MH, Phil MEW. Effect of different anesthetics on the paired-pulse depression of the H reflex in adult rat. Exp. Neuro. 2002;1777:494-502.
  54. 김태전, 김승곤. The Study on the Occurrance Rate of HBs Antigen in Patients with Pulmonary Tuberculosis, and the Comparison of GOT, GPT Levels between HBs Antigen positive and Negative Patients. 서울보건전문대학 논문집. 1981;1(1):33-8.
  55. 대한병리학회. 병리학. 서울:고문사. 1998:71-103, 1093-5, 1165-6, 1994.
  56. Travlos A, Anton HA, Wing PC. Cerebrospinal fluid cell count following spinal cord injury. Arch Phys Med Rehabil. 1994;75:293-6. https://doi.org/10.1016/0003-9993(94)90032-9
  57. Firkins SS, Bates CA, Stelzner DJ. Corticospinal tract plasticity and astroglial reactivity after cervical spinal injury in the postnatal rat. Exp Neurol. 1993;120:1-15. https://doi.org/10.1006/exnr.1993.1036
  58. Cao X, Tang C, Luo Y. Effect of nerve growth factor on neuronal apoptosis after spinal cord injury in rats. Chin J Traumatol. 2002;5(3):131-5.
  59. Marty S, Berzaghi MdaP, Berninger B. Neurotrophins and activity-dependent plasticity of cortical interneurons. Trends Neurosci. 1997;20(5):198-202. https://doi.org/10.1016/S0166-2236(96)01026-0
  60. Zhang L, Schmidt RE, Yan Q, Snider WD. NGF and NT-3 have differing effects on the growth of dorsal root axons in developing mammalian spinal cord. J Neurosci. 1994;14:5187-201. https://doi.org/10.1523/JNEUROSCI.14-09-05187.1994
  61. Michael GJ, Averill S, Nitkunan A, Rattray M, Bennett DL, Yan Q, et al. Nerve growth factor treatment increases brain-derived neurotrophic factor selectively in Trk A-expressing dorsal root ganglion cells and in their central terminations within the spinal cord. J Neurosci. 1997;17:8470-6.
  62. Sendtner M, Dittrich F, Hughes RA, Thoenen H. Actions of CNTF and neurotrophins on degenerating motor neurons: preclinical studies and clinical implications. J Neurol Sci. 1994;124:77-83.
  63. Hicks RR, Numan S, Dhillon HS, Prasad MR, Seroogy KB. Alterations in BDNF and NT-3 mRNAs in rat hippocampus after experimental brain trauma. Mol Brain Res. 1997;48(2):401-6. https://doi.org/10.1016/S0169-328X(97)00158-7
  64. 김창재, 문세호, 이병호, 정미영, 채준석, 이문용, 천명훈. 흰쥐에서 척수손상후 반응성 별아교세포에서의 CNTF 발현증가. 대한통증학회지. 1998;11(2):182-93.
  65. Uchida K, Baba H, Maezawa Y, Furukawa S, Omiya M, Kokubo Y, Kubota C, Nakajima H. Increased expression ofneurotrophins and their receptors in the mechanically compressed spinal cord of the spinal hyperostotic mouse(twy/twy). Acta Neuropathol(Berl). 2003;106(1):29-36.
  66. Crowe MJ, Bresnahan JC, Shuman SL, Masters JN, Beattie MS. Apoptosis and delayed degeneration after spinal cord injury in rats and monkeys. Nature Med. 1997;3:73-6. https://doi.org/10.1038/nm0197-73
  67. Allen AR. Remarks on histological changes in spinal cord due to impact: an experimental study. J Ner Ment Dis. 1914;41:141-7. https://doi.org/10.1097/00005053-191403000-00002
  68. Ducker TB, Kindt GW, Kempe LG. Pathological findings in acute experimental spinal cord trauma. J Neurosurg. 1971;35:700-8. https://doi.org/10.3171/jns.1971.35.6.0700
  69. Nemecek S. Morphological evidence of microcirculatory disturbances in experimental spinal cord trauma. Adv Neurol. 1978;20:395-405.