Effect Of Electroacupuncture At Jiaji Point On Different Pfirrmann Graded LDH And Its Mechanism Of Action

Objective1.Observe the clinical efficacy of electroacupuncture at Jiaji points in treating different Pfirrmann grade lumbar disc herniations.2.To study the mechanism of c AMP-PKA signal pathway involved in effecct of EA on the expression of AQP1?3 in a rabbit of disc degeneration.Methods1.78 patients with single-stage lumbar intervertebral disc herniation grouped according to the Pfirrmann classification method according to the imaging data of the prominent segment of the disc.Visual analogue pain score(VAS),Oswetry dysfunction index(ODI),and improved Macnab efficacy follow-up before and 1 day,1 month,and 3 months after treatment.2.Fifty New Zealand white rabbits were randomly divided into 5groups:normal group(A group),sham operation group(B group),model group(C group),model+EA group(D group),model+EA+blockers group(E group),10 in each group.The disc degeneration model was established by using the external dynamic compression device attached to the rabbit lumbar spine for 28 days,The model group accept production of LIDD model without any treatment.The sham operation group accept the same processing but without Intervertebral pressure,also without any treatment.Model+EA group accept EA treatment since the 1st day after model made.The model+EA+ blockers group accept the same processing as the model+EA group and be injected PKA inhibitors(H-89)at the 1st day.A course for EA treatment lasts for 6 days.The total treatment will have 4 courses.Between each of the courses,1 day will be left.Take MRI test and test dynamic expression of AQP1?3 and c AMP?PKA at the 1st day and 28 th day.Results Clinical research The VAS score and ODI index after treatment in each group were lower than those before treatment,and the difference was statistically significant(P<0.05).Among them,the Pfirrmann II group had the largest decrease,and the Pfirrmann IV group had the smallest.The VAS score and ODI index of the Pfirrmann II and Pfirrmann III groups were lower than those of the first day after treatment(P<0.05),but the 3 months after the treatment and the 1 month after the treatment were compared.No significant further decline.There was no significant difference in VAS score and ODI index between the Pfirrmann IV group and the first day after treatment,and one month and three months after treatment.There was no significant difference(P>0.05).At 3 months after treatment,the excellent and good rate of efficacy evaluation of Pfirrmann II,III,and IV groups was 95.7%,76.4%,41.2%,and the difference between the two groups was statistically significant(P<0.05).Experiment research At the 1st day after the moedl was made,the AQP1?3and c AMP?PKA expression levels of C group,D group and E group were significantly decreased.At the 28 th day after treatment,the AQP1 ? 3and c AMP ? PKA expression levels of D group was higher than C group;the AQP1?3and ?PKA expression levels of E group was lower than D group.Conclusion1.Electroacupuncture at Jiaji points is effective for treatment of lumbar disc herniation,and the clinical efficacy is related to the degree of intervertebral disc degeneration.Pfirrmann grade has guiding significance for electroacupuncture at Jiaji points for indications of degenerative discs.The Pfirrmann II and Pfirrmann III groups are more effective than Pfirrmann IV group.2.c AMP-PKA signal pathway involved in the EA rasised the expression of AQP1 and AQP3 in the degenerated lumbar disc tissue.