摘要目的 探讨推拿手法对骨骼肌失神经后肌萎缩及卫星细胞增殖的影响.方法 将90只家兔按随机数字表法分为手法治疗组(42只)、模型对照组(42只)和正常对照组(6只)；手法治疗组和模型对照组按照推拿手法治疗时间或取材检测时间的不同再细分为7个亚组,分别为1周亚组、2周亚组、3周亚组、1月亚组、2月亚组、4月亚组和6月亚组,每组6只家兔.除正常对照组外,其余84只家兔均行右后肢胫神经切断术,建立骨骼肌失神经模型.制模成功率为100％.手法治疗组给予按揉法治疗,模型对照组和正常对照组不做任何干预处理.正常对照组与手法治疗组及模型对照组的1周亚组同时取材检测腓肠肌肌湿重和卫星细胞计数；手法治疗组和模型对照组的2周亚组、3周亚组、1月亚组、2月亚组、4月亚组和6月亚组的家兔分别按治疗时间的不同,在相对应的时间点进行取材及检测.结果 正常对照组家兔的腓肠肌湿重比为(1.013 ±0.102)；手法治疗组和模型对照组的各时间亚组腓肠肌肌湿重比均小于正常对照组；各时间点手法治疗组的肌湿重比均大于同期模型对照组,且手法治疗组在2月亚组、4月亚组和6月亚组的肌湿重比与同期模型对照组比较[(0.578 ±0.163)比(0.470 ±0.062)、(0.575 ±0.110)比(0.453±0.101)和(0.559±0.083)比(0.446 ±0.048)],差异均有统计学意义(P＜0.05).正常对照组的腓肠肌卫星细胞数为(2.33±0.82)个/高倍视野；手法治疗组和模型对照组各时间点肌卫星细胞数量均明显升高,手法治疗组1周亚组和2周亚组的肌卫星细胞数分别为(16.83±5.31)和(51.83±7.94)个/高倍视野,明显高于同期模型对照组的(8.67±2.58)和(32.00±6.93)个/高倍视野,且2组同期比较,差异有统计学意义(P＜0.05)；但从1月以后,手法治疗组的各亚组肌卫星细胞数逐步明显低于同期模型对照组,且手法治疗组在4月亚组和6月亚组的肌卫星细胞数与同期模型对照组比较,组间差异均有统计学意义(P＜0.05)；手法治疗组6月亚组的肌卫星细胞数减少至(2.67±1.63)个/高倍视野,已基本接近正常对照组,但仍高于正常对照组(P＞0.05).结论 推拿手法可以延缓失神经支配后骨骼肌的萎缩,并可促进骨骼肌卫星细胞的增殖转化.

abstractsObjective To observe the effects of tuina on muscle atrophy after denervation and on muscle satellite cell proliferation.Methods Ninety male rabbits with denervated skeletal muscles were randomly divided into a normal group,a control group,and a treatment group.Tuina was applied daily to the right gastrocnemius muscles beginning one day after the modeling.Changes in muscle wet weight ratio and the amount of skeletal muscle satellite cells (SCs) were observed 1,2 and 3 weeks and 1,2,4 and 6 months post-modeling.Results The muscle wet weight ratios of both the treatment group and the control group were lower than those of the normal group.The weight ratio in the treatment group was significantly different from that in the control group after 2 months (0.578 ±0.163 vs 0.470 ±0.062),4 months (0.575 ±0.110 vs 0.453 ±0.101) and 6 months (0.559 ±0.083 vs 0.446 ±0.048).The amount of SCs was also significantly different in the treatment and control groups after 1 week (16.83 ±5.31 vs8.67±2.58),2 weeks (51.83±7.94 vs32.00±6.93) and4 months (11.17±3.49 vs 17.67±4.18).Conclusion Tuina therapy can promote proliferation of satellite cells and delay the atrophy of denervated skeletal muscles.