Effects Of Tongbi Prescription Hot Compress Combined With Acupuncture On Intervertebral Disc Degeneration In Cervical Spondylosis Rabbits

Objective: Establishment of cervical spondylosis model in rabbits by non-invasive head-down method,intervening with Tongbi prescription hot compress combined with acupuncture therapy,to explore the influence of Tongbi prescription hot compress combined with acupuncture therapy on intervertebral disc degeneration in cervical spondylosis rabbits and its possible mechanism from the perspectives of the imageoloy of cervical vertebra,the histomorphology of intervertebral disc,inflammatory factor and apoptosis.Methods: Six rabbits were randomly selected from thirty New Zealand white rabbits as normal group,the other rabbits were used non-invasive low head method to establish the rabbit model of cervical spondylosis,after modeling,they were randomly divided into model group,acupuncture group,drug group and combination group,Six rabbits in each group.In addition to normal group,the other groups established cervical spondylosis model,after successful modeling,acupuncture treatment for acupuncture group(30 min/time per day),Tongbi Recipe hot compress treatment for drug group(20 min/time per day)and Tongbi Recipe hot compress combined with acupuncture therapy for combination group(50min/time per day).The cervical spine X-ray and pain threshold of rabbits in each group were measured and scored before modeling,the 30 th day of molding and after treatment.The C3-6 intervertebral discs of each group were collected after treatment for 15 times,hematoxylin-eosin staining was used to observe the morphological changes of C3-4 discs and score,the concentration of tumor necrosis factor-alpha(TNF-?)and interleukin-1beta(IL-1?)in the C5-6 intervertebral disc were detected by enzyme-linked immunosorbent assay(ELISA)and real-time quantitative PCR was used to detect the relative expression of Caspase-3 and Bcl-2 m RNA in C4-5intervertebral discs.Results: The pain threshold of rabbits neck: compared with the model group,the pain threshold of acupuncture group,drug group and combination group were significantly increased(P<0.05),But there was no significant difference between the three groups(P<0.05).X-ray results:(1)image: in addition to the normal group,the other rabbits showed different degrees of cervical degeneration after modeling;after treatment,the images of acupuncture group,drug group and combination group shows the degeneration of cervical vertebra in drug group is alleviated.(2)score: compared with the model group,the X-ray scores of acupuncture group,drug group and combination group were all decreased(P<0.05).HE staining results:(1)histomorphology: In the model group,there were more vacuolar chondrocytes in cartilage endplate staining,The cartilage lacuna of the model group was larger than that of the normal group,and Some chondrocytes pyknosis or even dissolution.The annulus fibrosus staining of the model group showed loose and disordered fiber arrangement,more tearing,and cell swelling and degeneration.Cartilage endplate staining in acupuncture group,drug group and combination group showd that most of the chondrocytes were normal structures,cartilage pits existed,and there were few vacuolar degeneration cells;Compared with the model group,the arrangement of fiber rings of the three group were more orderly,the layers were relatively clear,and the cell morphology was slightly better.(2)score: compared with the model group,the scores of acupuncture group,drug group and combination group were all decreased(P<0.05);and the score of the combination group was lower than that of the acupuncture group and the drug group(P<0.05).The concentration of TNF-? and IL-1? in intervertebral disc: The concentrations of TNF-? and IL-1? in the intervertebral discs of acupuncture group,drug group and combination group were lower than those of the model group(P<0.05);and the concentration of IL-1? in the combination group was lower than that in the acupuncture group and drug group(P<0.05).The expression levels of Casepase-3 and Bcl-2 m RNA in intervertebral disc: Compared with model group,the expression of Casepase-3 m RNA decreased and the expression of Bcl-2 m RNA increased in acupuncture group,drug group and combination group(P<0.05);and combination group had lower Casepase-3m RNA expression and higher Bcl-2 m RNA expression than acupuncture group and drug group(P<0.05).Conclusion: Tongbi prescription hot compress combined with acupuncture therapy can improve the neck pain threshold of cervical spondylosis model rabbits and relieve neck pain.Tongbi prescription hot compress combined with acupuncture therapy may reduce the degree of disc degeneration and delay the process of disc degeneration,the mechanism may be related to reducing the secretion of inflammatory factors TNF-? and IL-1?,reducing inflammation and up-regulating the expression of anti-apoptosis factor Bcl-2 m RNA and inhibiting the expression of apoptosis executive factor Caspase-3 m RNA to reduce the apoptosis of intervertebral disc cells.The therapeutic effect of Tongbi prescription hot compress combined with acupuncture on the degeneration of intervertebral disc and the apoptosis of intervertebral disc cells is better than that of simple acupuncture and simple Tongbi Decoction.