Two Interventions On The Lumbar Disc Herniation To Observe Clinical Effect And NO Changes In Plasma And Correlative Experimental Research

Objective:Lumbar disc herniation(LDH) is a clinical common disease, it belong to the scope of neuropathic pain in modern medicine. At the present time LDH can be treated with many methods, but lack of effective and specific laboratory indices to diagnose. This study is from both clinical and experimental aspects. Firstly, to observe the clinical effect on LDH with electro-acupuncture combined with acupoint injection and electro-acupuncture and the changes of plasma NO levels before and after intervention. Secondly, to establish spared nerve injury model (SNI) in order to investigate the effect of electro-acupuncture(EA) on hyperalgesia and NOS positive neurons expression in dorsal horns of spinal cord in rats with SNI. Through clinical and experimental research, to discuss electro-acupuncture on neuropathic pain and its' relationship with NOS/NO.Methods:This study contains clinical and experimental aspects. On clinical research,49 patients with lumbar disc herniation were randomly divided into electro-acupuncture combined with acupoint injection group(24 cases) and electro-acupuncture group(25 cases), both were treated a course of treatment. Contrast, analysis the efficacy of two groups before and after treatment according to low back pain score criterion(JOA score), McGill pain score, straight leg raising test changes, clinical efficacy criterion, changes in plasma NO levels. On experimental research, SD rats were randomly divided into sham-operation(SO) group, model(M) group and electro-acupuncture(E) group(both n=8).Spared nerve injury(SNI) model was adopted, in the E group EA(2Hz,onset 1mA,enhance 1mA each 10 minutes) was applied to "Wei zhong"(BL 40) and "Huan tiao"(GB 30) for 30 minutes to observe the mechanical pain threshold and thermal pain threshold in rats. Observe the changes of NOS in spinal cord dorsal horns of rats in each group and quantified its' expression with average optical density by nicotinamide adenine dinucleotide phosphate enzyme (NADPH-d) method.Results:①Two kinds of interventions for lumbar disc herniation both have a good effect. Electro-acupuncture combined with acupoint injection therapy is slightly better than EA in the "low back pain score" (P＜0.05), but has no significant differences in relieving pain and improving straight leg raising test (P>0.05).②Two kinds of interventions can effectively reduce NO levels in plasma (P＜0.01), but have no significant differences between each other (P>0.05).③SNI surgery can significantly reduce the mechanical pain threshold in rats, but no significant changes in thermal pain threshold, while the expression of NOS-positive neurons in spinal cord dorsal horn of rats increased.④EA can significantly improve the mechanical pain threshold in rats(P＜0.01), while reduce the expression of NOS-positive neurons in SNI rats'spinal cord dorsal horns effectively (P<0.05).Conclusion:①Two kinds of interventions can improve clinical symptoms in patients with lumbar disc herniation and lower NO levels in plasma, but take the simplicity of clinical operations and effectiveness into account, using electro-acupuncture may be better.②Combined with experimental research, it can be considered that the electroacupuncture on neuropathic pain may be related to the effective regulation of NOS/NO.