【摘要】 目的探讨电针改善椎动脉型颈椎病(VCS)所致感觉神经性听力损失和慢性内耳缺血的机理。方法60只成年日本大耳兔随机分为对照组、模型第2周组、模型第4周组、模型第8周组和电针组,每组12只。电针组和所有模型组以组织硬化剂-775注射液注射至家兔左侧颈椎横突附近软组织建立VCS慢性椎-基底动脉供血不足(VBI)模型。模型第2周组和模型第4周组分别于注射后第2周和第4周,通过手术以激光多谱勒血流计(LDF)测定内耳血流量(IEBF)。从注射后第6周开始,电针组进行电针治疗2周,其余2组不作任何处理。注射后第8周,其余3组分别测定10Hz低刺激率和50Hz高刺激率90dBnHL短声听性脑干反应(ABR)、低频(1kHz)和高频(6kHz)短纯音耳蜗电图(EcochG)听神经动作电位(AP)阈值及IEBF,将结果进行比较。结果模型第8周组50Hz刺激率ABR的Ⅲ波峰潜伏期(PL)和Ⅰ-Ⅲ波峰间潜伏期(IPL)延长(P<0.05-0.01),电针组与对照组无显著差异(P>0.05)。3组之间10Hz刺激率ABR无显著差异(P>0.05)。模型第8周组和电针组1kHz、6kHz短纯音AP阈值显著高于对照组(P<0.001),模型第8周组6kHzAP阈值显著高于1kHz(P<0.05),电针组AP阈值显著低于模型第8周组(P<0.001)。模型第2周组IEBF与对照组无显著差异(P>0.05),模型第4周组和模型第8周组显著低于对照组(P<0.05-0.001),模型第8周组显著低于模型第2周和第4周组(P<0.001),电针组显著高于模型第8周组(P<0.001),电针组与对照组无显著差异(P>0.05)。结论VBI可影响脑干外周听觉通路传导,慢性内耳缺血可导致听觉障碍,尤其是高频听觉损失。电针可调节VBI内耳微循环,改善脑干神经元突触效能和听觉通路传导,增强耳蜗高、低频感音水平,从而改善听觉功能。更多还原

【Abstract】 Objective: To explore the mechanism of electroacupuncture improving the cervicogenic sensorineural hearing loss and chronic inner ear ischemia induced by vertebroarterial type cervical spondylosis (VCS) . Methods: Sixty adult Japanese big- eared rabbits were divided into the control group,the 2nd week model group(2WM group) , the 4th week model group(4WM group), the 8th week model group(8WM group) and electroacupuncture (EA) group randomly, and 12 animals in each group. Chronic vertebrobasilar insufficiency (VBI) rabbit model of the VCS was established by injecting with sclerosant-775 injection into the solt tissue on the cervical vertebra in EA group and all model groups, and the control group was injected with saline. The inner ear blood flow (IEBF) were respectively measured by laser doppler flowmetry(LDF) with operation in 2 WM and 4WM group on the 2nd and 4th week after injecting . From the 6th week after injected , the EA group was given EA treatment for 2 weeks , and there was no treatment to another remained two groups. From the 8th week ,the auditory brainstem response (ABR) induced by 90 dB nHL click at low (10 Hz) and high (50 Hz) stimulating rate , and the threshold of the cochlear nerve action potential (AP) in electrococheogram (EcochG) induced by low (1 kHz) and high (6 kHz) frequency tone burst and IEBF were measured respectively in remained the three groups. The results were compared. Results: The Ⅲ wave peak latency (PL) and the Ⅰ-Ⅲ wave interpeak latency ( IPL) of ABR at 50 Hz stimulating rate in the 8WM group prolonged longer than those in the control group (P<0.05-0.01) , and there was no remarkable difference between the EA group and the control group (P > 0.05) . There was no significant difference in ABR at 10 Hz stimulating rate among the three groups( P > 0.05) . The thresholds of AP induced by 1 kHz and 6kHz tone burst in the 8WM and the EA group were higher than those in the control group (P < 0.001) , and that at 6 kHz was significandy higher than that at 1k Hz in the 8WM group( P < 0.05) , and those in the EA group were significandy lower than those in the 8WM group( P<0.001) . There was no remarkable difference of IEBF between the 2WM group and the control group (P>0.05),and those in the 4WM group and the 8WM group were remarkably lower than that in the control group (P<0.05-0.001) ,and that in the 8WM group was significant lower than those in the 2WM and 4WM group ( P < 0.001), and that in the EA group was significant higher than that in the 8WM group (P < 0.001) , and with was no remarkable difference between the EA group and the control group( P > 0.05). Conclusion: VBI can affect of the conduction of the peripheral cochlear nerves path of the brainstem. Chronic inner ear ischemia can cause hearing disorders, especially for hearing high frequency sound. EA can ameliorate the function of hearing by adjusting the inner ear microcir culation and improving the neuron synapses efficiency for conduction of cochlear path of the brainstem, and raise the cochlear sensory levels of high and low frequency sound.更多还原