| It is a high summary of the clinical experience of ancient acupuncture and moxibustion,that BL40 is one of the key acupoints for back illness.The BL40 has been selected as one of the preferred acupuncture points in the 2016 guideline for management of acute and chronic nonspecific low back pain in China.It is a commonly used acupoint for non-specific low back pain.The multifidus muscle is located in the most medial part of the spine.It is the paraspinal muscle with the largest area of attachment.It consists of multiple bundles,which originate from the lumbar lamina,spinous process,and the dorsal part of the sacrum,which is relatively de-veloped in the waist,and is especially important for maintaining the stability of the lumbar spine.The dysfunction or injury of lumbar skeletal muscle represented by the multi splitting muscle is closely related to nonspecific low back pain.Therefore,promoting the repair and functional reconstruction of the injured multi splitting muscle is very important for the treat-ment of low back pain.Acupuncture has great effect for in the treatment of low back pain,which has been highly recognized by scholars both at home and abroad.This study is also intended to explore the mechanism of the function of the acupoint at the aspect of repair of skeletal muscle injury.Previous studies showed that electroacupuncture at the BL40 point could promote the re-generation and repair of bupivacaine induced lumbar multifidus muscle injury,and at the same time,the high expression of IGF-1 was found in early stage.Therefore,it is considered that acupuncture promotes skeletal muscle regeneration and repair is related to the high expression of IGF-1.IGF-1 needs its receptor IGF-1R to play a role,and IGFBP3 is important protein which can regulate the biological activity of IGF-1.Therefore,this study intends to bupivacaine induced rat lumbar multifidus injury model,histomorphology observation of electro acupunc-ture BL40 on rat model of lumbar multifidus muscle,IGF-1 receptor and its binding protein expression,to further explore the acupuncture and bone muscle injury,IGF-1 the relationship between the three,and to explore the mechanism of promoting bone.Methods:A total of 90 male Sprague Dawley rats were randomly divided into blank group(BG),model group(MG)and BL40 electroacupuncture group(WG),30 rats in each group.Then the rats in MG and WG were injected with 0.5%bupivacaine into both sides of L4-5 multifidus muscle.After model establishment,the rats in WG accepted electro-acupuncture once each day.The changes of IGF-1 R and IGFBP3 in 3 groups’ multifidus muscle were observed and ana-lyzed at 1st,2nd,3rd,7th and 14th day.Results:1.The results of HE staining showed that the interstitial spaces of 1D in model group increased significantly,suggesting interstitial edema.Degeneration of muscle fibers,uneven arrangement,uneven cell size,necrosis of muscle cells,partial rupture or even a large number of inflammatory cell infiltration.The inflammatory infiltration in BL40 electroacupuncture group is less.At 3D,large cell necrosis and a few undamaged myocytes were seen under ’MG.Muscle fiber fragments were seen under high magnification,but new central nuclear fibers were formed.When there were more central nuclear fibers.There was no inflammatory infiltration in WG,and the nuclei of many new muscle fibers had migrated to the edge of cells and restored to size.2.The expression of IGF-1R and IGFBP3:the IGF-1R expression in the 2D,3D,7d,14d model group was higher than that of the blank group(P<0.05),and the IGF-1R in 1D and 2D electroacupuncture group was higher than that of the model group(P<0.05).The expression of IGFBP3 in the model group of 7D and 14d was higher than that in the blank group(P<0.05),and the expression of IGFBP3 in 2D and 14d electroacupuncture group was lower than that of the model group(P<0.05),and the IGFBP3 showed an upward trend with the increase of time.Conclusion:1.local injection of bupivacaine into the musculus fissure muscle can cause local injury of skeletal muscle,and successfully replicate the rat model of lumbar multi bifid muscle injury.Electroacupuncture at BL40 point can promote the morphological recovery of the lumbar par-avertebral muscles in rats.2.the effect of electroacupuncture at BL40 point on promoting skeletal muscle regenera-tion and repair may be related to the expression change of IGF-1R and IGFBP3.At the early stage of skeletal muscle injury,the expression of IGF-1R was increased to adapt to the increase of IGF-1 concentration,to regulate the expression of IGFBP3 and to increase the protein activ-ity of IGF-1,which was beneficial to the combination of IGF-1 and IGF-1R. |
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