| Objective1.The JOA score and VAS score of patients with lumbar disc degeneration were compared between acupuncture clip ridge and electroacupuncture clip ridge,as well as the effects of IL-6、TNF-α、IL-10 and TGF-β1 in serum,so as to analyze the clinical efficacy and optimize the treatment plan for lumbar degenerative disc degeneration.2.To study the effect of jiaji electrolysis on apoptosis of rabbit degenerative intervertebral disc cells.Method1.Clinical trialsPatients with low back pain or lower limb pain as the chief complaint from June 2020.to December 2020.After diagnosis,inclusion and exclusion criteria and routine lumbar magnetic resonance examination,62 cases were selected and randomly divided into two groups,namely treatment group（electroacupuncture group）and control group（acupuncture group）,with 31 cases in each group.The treatment group was given acupuncture at waist Jiaji point,after qi was obtained,electric acupuncture therapy instrument was connected and treated for 30 minutes,while the control group was only given acupuncture at waist Jiaji point,after qi was obtained,the needle was left for 30 minutes,and electric acupuncture was not allowed.Results JOA score and VAS score were used to evaluate the clinical symptom function before and after treatment.The changes of serum levels of inflammatory factors IL-6、TNF-α 、 IL-10 and TGF-β1 were detected by enzyme-linked immunosorbent assay（ELISA）before and after treatment to evaluate the clinical efficacy.2.Animal experimentsTwenty male New Zealand white rabbits with body weight over2.5kg were randomly divided into 4 groups,including normal group,model group,sham model group and electroacupuncture group,with 5rabbits in each group.The normal group was fed normally without any intervention.In the sham model group,two parallel Kirschner wires were inserted between L4 and L5 vertebrae of experimental rabbits without compression device and without intervention.In the model group,after placing kirschner wire between L4 and L5 vertebral bodies of experimental rabbits,corresponding compression instruments were connected to compress the intervertebral bodies for 28 days,and the lumbar disc degeneration model of experimental rabbits was established.The electroacupuncture group was treated as the model group and continued with electroacupuncture for 28 days after vertebral body compression.After 28 days of vertebral compression,the compression device was removed and MRI was used to scan the lumbar intervertebral discs of experimental rabbits in each group.The intervertebral discs of experimental rabbits in each group were observed and evaluated by Pfrirmann grading system.Then,MRI grading of intervertebral discs in each group was compared.After the experiment,all rabbits were sacrificed and the intervertebral disc tissues were taken out.The expression of Bax and Bcl-2 proteins in the intervertebral disc tissues of experimental rabbits was observed by confocal laser microscope.TUNEL staining was used to observe cell apoptosis.Result1.Clinical trial results（1）After treatment,the JOA score of 2 groups increased compared with that before treatment（P<0.05）,and there was no statistical significance in the comparison of JOA score between 2 groups before and after treatment（P>0.05）.（2）After treatment,VAS scores of 2 groups were lower than those before treatment（P<0.05）,and there was no statistical significance in VAS scores of 2 groups before and after treatment（P>0.05）.（3）After 2 courses of treatment,the total effective rate of control group was 90.32%;The total effective rate of the treatment group was93.55%,and the total effective rate of the treatment group was higher than that of the control group,and the difference between the two groups was statistically significant（P<0.05）.（4）ELISA showed that there was no significant difference in serum TNF-α and IL-6 concentrations between the control group and the treatment group before treatment（P>0.05）.After treatment,the serum concentrations of TNF-α and IL-6 in 2 groups were decreased compared with those before treatment（P<0.05）,and the levels in treatment group were lower than those in control group（P<0.05）.（5）ELISA showed that there were no significant differences in serum il-10 and TGF-β1 concentrations between the control group and the treatment group before treatment（P>0.05）.After treatment,the serum concentrations of IL-10 and TGF-β1 in 2 groups were increased compared with those before treatment（P<0.05）,and those in treatment group were higher than those in control group（P<0.05）.（6）Safety evaluation: There were no adverse conditions such as needlesickness,allergy,subcutaneous hematoma in the two groups during the treatment;There are no abnormalities in vital signs.2.Animal Experiment Results（1）After the experiment,lumbar MRI was performed on each group.It was found that l4-L5 intervertebral discs in the normal group and the sham model group had high signal intensity,while the signal intensity of their adjacent intervertebral discs did not change significantly.The l4-L5 intervertebral discs in the model group and the electroacupuncture group showed low signal,even black,and the signal intensity decreased significantly with the adjacent intervertebral discs,indicating that the modeling was successful.The signal intensity of electroacupuncture group was slightly higher than that of model group.Pfirrmann grading results showed that there was no significant change in Pfirrmann grading of lumbar intervertebral disc between the normal group and the sham model group,and there was no statistical significance between the two groups（P>0.05）.Compared with the normal group and the sham model group,the Pfirrmann grading of lumbar intervertebral disc of experimental rabbits in the model group was higher,and the difference was statistically significant（P<0.05）.Compared with the model group,the Pfirrmann grading of lumbar intervertebral disc of experimental rabbits in electroacupuncture group decreased,with statistical significance（P<0.05）.（2）By confocal laser microscopy,the positive expression of Bax protein was labeled with CY3 fluorescein as red light,the positive expression of Bcl-2 protein was labeled with FITC fluorescein as green light,and the nuclei were blue by DAPI staining.Microscopically,there was a small amount of Bax protein expression and a large amount of Bcl-2 protein expression in both the normal group and the sham model group.Compared with the sham model group,the Bax protein expression in the model group was higher,while the Bcl-2 protein expression was lower.Compared with model group,the expression of Bax protein in electroacupuncture group was lower,while the expression of Bcl-2protein was higher.The IOD values of Bax and Bcl-2 proteins in normal group and sham model group were similar,but there was no significant difference（P>0.05）.Compared with sham model group,the IOD value of Bax protein in model group was significantly increased,and the IOD value of Bcl-2 was significantly decreased（P<0.05）.Compared with model group,the IOD value of Bax protein was decreased and the IOD value of Bcl-2 protein was increased in electroacupuncture group,and the difference between the two groups was statistically significant（P<0.05）.（3）After TUNEL staining,apoptotic cells showed brown particles under light microscope,and a small number of apoptotic cells were observed in both normal group and sham model group.Compared with sham model group,apoptotic cells increased significantly in model group.Compared with model group,apoptosis cells in electroacupuncture group were slightly reduced.The results of apoptotic cell count showed that there was no significant difference in the positive number of apoptotic cells between the normal group and the sham model group（P>0.05）.Compared with sham model group,the positive number of apoptotic cells in model group was significantly increased,and the difference was statistically significant（P<0.05）.Compared with the model group,the number of apoptotic cells in electroacupuncture group was decreased,and the difference was statistically significant（P<0.05）.Conclusion1.Clinical research（1）Acupuncture and electroacupuncture at Jiaji point can increase the JOA score of patients with lumbar disc herniation,reduce the VAS score,improve the clinical signs and symptoms of patients,significantly reduce the pain of patients,clinical safety can be.（2）Acupuncture and electroacupuncture at Jiaji point can regulate the inflammatory response of patients with lumbar intervertebral disc herniation,by inhibiting the expression of TNF-α and IL-6,enhancing the expression of IL-10 and TGF-β1,treating lumbar intervertebral disc herniation and delaying the degeneration of lumbar intervertebral disc;Compared with acupuncture jiaji point,electric acupuncture Jiaji point has better effect on regulating the inflammatory response of patients with lumbar disc herniation.2.Animal studiesElectroacupuncture clipping point can reduce Pfirrmann grading index,promote the expression of Bcl-2,inhibit the expression of Bax,and inhibit the apoptosis of intervertebral disc degeneration cells in experimental rabbits. |
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