椎动脉型颈椎病动物造模的技术方法与结果评价
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摘要
背景:椎动脉型颈椎病动物模型的构建及其评价方法逐渐成为新的研究热点。目的:阐述椎动脉型颈椎病动物模型的国内、外研究进展,并评价各自造模方法的优、缺点。方法:通过下列检索关键词:椎动脉型颈椎病、颈性眩晕、颈源性眩晕、动物、造模、模型,cervical vertigo,basal-vertebral ischemia,cervical spondylosis of vertebral artery type,animal,model,检索1998至2018年中国知网、万方中文数据库、维普中文科技期刊数据库和PubMed数据库、Cochrane图书馆和Embase数据库,依据椎动脉型颈椎病的纳入、排除诊断标准,筛选出椎动脉型颈椎病动物造模的中、英文文献。结果与结论:通过归纳分析得出,造模方式涵盖注射硬化剂法、植骨压迫法、动力失衡法、瘀血阻络法、椎动脉结扎法及混合造模法。其中以注射硬化剂法最为常见;植骨压迫法其与人体的发病机制最为相仿,但缺点在于造模难度大,骨块大小不一,且骨块无法完全固定在相应位置上;力学失衡法通过切除单侧的肌肉、骨质,造成颈椎失衡,其可操作性相对较高,但其造模周期较长;结扎或夹闭单侧椎动脉法虽相对简单、易行,但是椎动脉型颈椎病的发病机制并非简单的椎动脉狭窄,其忽略了体液因子、交感神经及椎神经等对于椎动脉血流速度、管腔大小的影响。各种造模方法皆有利弊,且造模的评判标准、造模时间及造模成功率结果不一。
BACKGROUND: Construction of animal models of vertebral artery type of cervical spondylosis and evaluation have become a new issue of concern.OBJECTIVE: To describe the research progress of animal models of vertebral artery type of cervical spondylosis at home and abroad, and to evaluate the advantages and disadvantages of each method. METHODS: The keywords were "cervical vertigo, basal-vertebral ischemia, cervical spondylosis of vertebral artery type, animal, model" in Chinese and English, respectively. CNKI, WanFang, VIP, PubMed, Cochrane Library, and Embase databases were retrieved for the articles published from 1998 to 2018. Chinese and English articles on animal modeling of vertebral artery type of cervical spondylosis were selected according to the inclusion and exclusion diagnosis criteria of vertebral artery type of cervical spondylosis. RESULTS AND CONCLUSION: Through induction and analysis, modeling methods include hardener injection, bone graft compression, dynamic imbalance, blood stasis blocking collaturation, vertebral artery ligation and mixed modeling method. Of them, hardener injection method is most commonly used. Bone graft compression method is the most similar pathogenesis to the human body. However, the disadvantage is that the modeling is difficult and the size of the bone block is various. So the bone is not in the right position. Dynamic imbalance method can cause cervical spine imbalanced by resecting the unilateral muscle and bone. This method has high operability, but has long modeling period. Although ligating or clipping the unilateral vertebral artery is easy to operate, the pathogenesis of vertebral artery type of cervical spondylosis is not just vertebral artery stenosis, which ignores the influence of humoral factors, sympathetic nerves and vertebral nerves on the blood flow velocity and lumen size of vertebral artery. Each method has advantages and disadvantages. The evaluation criteria, time and success rate are different.
BACKGROUND: Construction of animal models of vertebral artery type of cervical spondylosis and evaluation have become a new issue of concern.OBJECTIVE: To describe the research progress of animal models of vertebral artery type of cervical spondylosis at home and abroad, and to evaluate the advantages and disadvantages of each method. METHODS: The keywords were "cervical vertigo, basal-vertebral ischemia, cervical spondylosis of vertebral artery type, animal, model" in Chinese and English, respectively. CNKI, WanFang, VIP, PubMed, Cochrane Library, and Embase databases were retrieved for the articles published from 1998 to 2018. Chinese and English articles on animal modeling of vertebral artery type of cervical spondylosis were selected according to the inclusion and exclusion diagnosis criteria of vertebral artery type of cervical spondylosis. RESULTS AND CONCLUSION: Through induction and analysis, modeling methods include hardener injection, bone graft compression, dynamic imbalance, blood stasis blocking collaturation, vertebral artery ligation and mixed modeling method. Of them, hardener injection method is most commonly used. Bone graft compression method is the most similar pathogenesis to the human body. However, the disadvantage is that the modeling is difficult and the size of the bone block is various. So the bone is not in the right position. Dynamic imbalance method can cause cervical spine imbalanced by resecting the unilateral muscle and bone. This method has high operability, but has long modeling period. Although ligating or clipping the unilateral vertebral artery is easy to operate, the pathogenesis of vertebral artery type of cervical spondylosis is not just vertebral artery stenosis, which ignores the influence of humoral factors, sympathetic nerves and vertebral nerves on the blood flow velocity and lumen size of vertebral artery. Each method has advantages and disadvantages. The evaluation criteria, time and success rate are different.
引文
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[6]徐凯,高海燕,程慧,等.正清风痛宁穴位注射对颈性眩晕患者体液因子的影响[J].新中医,2013,45(6):51-53.
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[9]Morinaka S.Musculoskeletal diseases as a causal factor of cervical vertigo.Auris Nasus Larynx.2009;36(6):649-654.
[10]朱明双,郑重,黄勇,等.注射硬化剂法制作家兔颈椎病椎动脉型动物模型[C]//第五次全国中西医结合骨伤科学术交流会.2000.
[11]朱明双,郑重,黄勇,等.家兔椎动脉型颈椎病模型制作的实验研究-经颅多谱勒检测[J].海南医学院学报,2000,6(3):134-137.
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[13]宋敏,蒋宜伟,邱桐.活血定眩丸对椎动脉型颈椎病兔血液流变学、ET、NO的影响[J].甘肃中医学院学报,2005,22(6):23-27.
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[15]谷海洋.颈部推拿对椎动脉型颈椎病模型家兔作用的实验研究[D].杭州:浙江中医药大学,2009.
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[17]罗仁浩,陈秀玲.电针对家兔颈性眩晕模型的实验研究[J].新中医,2012(7):150-151.
[18]洪媚,牛森林.百会穴长时间留针法对颈性眩晕家兔椎-基底动脉供血的影响[J].中国中医药科技,2013,20(4):332-333.
[19]胡兆斌,傅强.通络定眩方对椎动脉型颈椎病兔血液流变学、ET、NO的影响[J].实用临床医药杂志,2013,17(15):1.
[20]李敏.针刀疗法对椎动脉型颈椎病兔血清一氧化氮和血浆内皮素的影响[D].南京:南京中医药大学,2015.
[21]吴昊.通督活血汤干预椎动脉型颈椎病模型兔实验研究[D].呼和浩特:内蒙古医科大学,2016.
[22]陆永雷,陈朝晖,程露露,等.三种椎动脉型颈椎病动物模型的比较研究[J].中医药临床杂志,2016(9):1266-1268.
[23]苟慧.椎动脉型颈椎病(CSA)家兔模型的交感神经逆行追踪和荧光组化学研究[D].重庆:重庆医科大学,2017.
[24]潘子毅,李俊华.壮颈康复剂治疗实验性椎动脉受压的研究[J].中国中医骨伤科杂志,2002,10(5):31-33.
[25]李俊华,潘子毅.椎动脉受压动物模型血浆内皮素的变化[J].中国中医骨伤科杂志,2003,11(5):16-18.
[26]皮全民,谢明夫,梁帮领.椎动脉型颈椎病动物模型的建立[J].当代医学,2008,139(7):30-31.
[27]孙定平.活血定眩胶囊对CSA模型大鼠血管功能影响的实验研究[D].兰州:甘肃中医药大学,2016.
[28]李清林.活血定眩胶囊对CSA模型大鼠外周血TNF-α、IL-6、IL-1β及T淋巴细胞亚群CD3~+、CD4~+、CD8~+的影响及机制研究[D].兰州:甘肃中医药大学,2016.
[29]凌泽莎,贾功伟,谭波涛,等.注射复合rhBMP-2骨水泥制作猕猴椎动脉型颈椎病模型[J].中山大学学报(医学科学版),2016,37(5):775-780.
[30]张军,齐越峰,孙树椿.家兔颈椎两侧肌肉平衡失调对椎动脉血流的影响[J].中国骨伤,2002,15(5):280-281.
[31]宋沛松,孔抗美,齐伟力,等.肌力失衡与后柱失稳大鼠颈椎病模型的研究[J].汕头大学医学院学报,2004,17(2):70-71.
[32]郭建阔.椎动脉供血不全动物模型的建立及颈性眩晕发病机制的探讨[D].郑州:河南大学,2010.
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