| ObjectiveTo study the mechanism of external treatment with medicated mallet full of Feng Shi Gu Tong(traditional Chinese medicine)medicinal liquor for curing discogenic low back pain by animal experiment.Observing the expression of phospholipase A2 and tumor necrosis factor-αin the tissues of intervertebral discs after external treatment.The observation was about pathological morphology of tissues of intervertebral discs.Preliminary expounding the mechanism of external treatment with medicated mallet full of Feng Shi Gu Tong medicinal liquor for discogenic low back pain. Theoretical and experimental basis about this study will be provided for curing the low back pain in clinical.Methods21 clean grade healthy Japanese white rabbits with big ears(2.0-2.5kg)were divided into 3 groups randomly:external treatment group with medicated mallet full of Feng Shi Gu Tong medicinal liquor(group A),drug treatment group (group B)and model group (group C),there were 7 rabbits in each group. Three groups were made under sterile conditions by surgical modeling, Puncturing pathway of percutaneous was used to destroy intervertebral disc as the modeling method. Concrete operating method was that percutaneous puncture of intervertebral discs were performed under x-ray fluoroscopy with a fine Kirschner wire.Degenerative model of intervertebral disc had been achieved after operation.8 weeks later,group A was treated with medicated mallet full of Feng Shi Gu Tong medicinal liquor which the treatment position was the upper and lower vertebrae and median lumbar vertebrae that was adjacent the model vertebrae. We used a medicated mallet to beat these treatment location uniformity and the frequence was 60 times per minute,10 minutes each time,1 times each day for treatment and consecutive 3 weeks. Group B was treated with Non-steroidal anti-inflammatory analgesic drug which was Voltaren(diclofenac sodium),this drug was used for gastric perfusion. The usage that our treatment was lmg per kilogram,1 times each day and continuous taking two weeks.Group C received no treatment after modeling,but drinking and eating liberally.3 weeks later the animals were killed and all rabbits'intervertebral disc which the L4/5 discs were removed. All the samples were divided into two parts.One part was using Real-time quantitative polymerase chain reaction(Real-time PCR) to measure the expression of PLA2mRNA. The other part was made as paraffin section, using HE staining technique in section examination and IHC method to measure the expression of TNF-α. After the experiment had been accomplished, SPSS16.0(a statistical software) was used to deal with the experiment data.Multiple sets of measurement data were compared by analysis of variance.Results1.The expression of PLA2 The expression of PLA2 of mechanism of external treatment with medicated mallet full of Feng Shi Gu Tong medicinal liquor and the drug treatment group were lower than the modeling group. There was no significant difference in drug treatment group and the external treatment group (P>0.05),there was a significant difference in the external treatment and the modeling group(P<0.01),there was difference between drug treatment group and modeling group(P<0.05).2.Observing the tissue of intervertebral disk under light microscope The results of IHC showed that TNF-αwere strongly positive expression in the specimens of modeling group and weakly positive expression in the both of treatment groups.The results of HE staining technique showed that all specimens had been shown some characteristics of the degenerative, which the structure of annular fibrosus were in disorder and distribution of cells become not even. Characteristics of the degenerative of the modeling group were more obvious than both of the treatment groups.ConcluusionThe external treatment with medicated mallet full of Feng Shi Gu Tong medicinal liquor for curing discogenic low back pain which showed a better therapeutic. The external treatment can reduce the content of TNF-αand PLA2 which in the intervertebral disk of degeneration, the inflammatory reactions were reduced. The therapeutic effect of external treatment was closed to the Non-steroidal anti-inflammatory analgesic drugs.Although these drugs, which had effect of inhibiting the inflammatory reaction and reliefing pain, were used for analgesia and eliminating inflammation. They were restricted in clinic because of the damage of the gastrointestinal tract. The external treatment owned positive effect,it had a role in activating blood circulation to remove stasis,eliminating wind and removing dampness and activating collaterals. Not only can the external treatment ameliorate blood circulation, ease muscle convulsion caused by the pain and promote the absorption of inflammation, but it had some benefits,which was simple operation, no side effects and easily accepted by patients.Therefore this treatment was suitable for clinical use.
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