背景:退变颈椎间盘组织可释放多种细胞因子和炎症介质,它们在颈椎病的发生、发展过程中起重要作用。目的:观察抗细胞因子的中西药(益气化瘀方抗骨增生胶囊和葡糖胺)联合应用、基因治疗对家兔退变颈椎间盘内细胞因子含量的影响。设计:随机对照观察。单位:河北省人民医院骨科,河北省人民医院中心实验室。材料:实验于2003-03/2004-01在河北省人民医院中心实验室完成。选用新西兰兔35只,雌雄不拘,按随机数字表法分为7组,即正常对照组、模型浅层组、模型全层组、药物治疗浅层组、药物治疗全层组、基因治疗浅层组及基因治疗全层组,每组5只。方法:除正常对照组外,其余6组家兔均通过切除颈背部肌肉,建立颈椎动力平衡失调模型,诱导颈椎间盘退变。浅层组切除颈背浅肌群,全层组切除颈背浅肌群和深肌群。术后7个月,①药物治疗组(浅层、全层)家兔给予抗骨增生胶囊(由狗脊、骨碎补、鸡血藤、莱菔子、牛膝、女贞子、肉苁蓉、熟地黄、淫羊藿等成分组成,江苏康缘药业股份有限公司提供)和葡糖胺(山西中远威药业有限公司提供),分别溶于20mL蒸馏水中,调配成糊状后分别按1.1g/kg和0.06g/kg灌胃,2次/d,连用1个月。②基因治疗组(浅层、全层)家兔麻醉后,将带有转化生长因子β1基因的重组质粒DNA注入C2～3,C3～4,C4～5椎间盘中(每个椎间盘用量为20μL)。造模后8个月处死各组动物,切取C3～4,C4～5椎间盘作标本,用双抗夹心ELISA法检测各组动物颈椎间盘中白细胞介素1β、肿瘤坏死因子α含量。主要观察指标:造模后8个月各组家兔颈椎间盘内白细胞介素1β、肿瘤坏死因子α含量。结果:实验过程中35只家兔无脱失,全部进入结果分析。造模后8个月各组家兔颈椎间盘内白细胞介素1β、肿瘤坏死因子α含量比较:模型浅层组和模型全层组家兔显著高于正常对照组(P<0.05～0.01),药物治疗浅层组、基因治疗浅层组显著低于模型浅层组(P<0.05),药物治疗全层组、基因治疗全层组显著低于模型全层组(P<0.05～0.01)。结论:退变颈椎间盘组织释放多种细胞因子和炎症介质,它们可加速颈椎间盘退变。中西药联合应用及基因治疗能对其含量起明显的抑制作用。 BACKGROUND: Degenerative cervical disc tissue can release a variety of cytokines and inflammatory mediators. They play an important role in the occurrence and development of cervical spondylosis. OBJECTIVE: To observe the effect of anti-cytokine Chinese and Western medicines (Yiqi Huayu Fang Fang Gugu hyperplasia capsules and glucosamine) combined application of gene therapy on the cytokine content of degenerative cervical intervertebral discs in rabbits. Design: Randomized controlled observations. Unit: Department of Orthopedics, Hebei Provincial People’s Hospital, Central Laboratory of People’s Hospital of Hebei Province. MATERIALS: The experiment was performed at the Central Laboratory of People’s Hospital of Hebei Province from March 2003 to January 2004. Thirty-five New Zealand rabbits were selected, either male or female, and divided into 7 groups according to the random number table method, namely, normal control group, model shallow group, model full layer group, drug treatment shallow group, drug treatment full layer group, gene therapy shallow layer Group and gene therapy full-thickness groups, 5 in each group. Methods: In addition to the normal control group, the remaining 6 groups of rabbits were treated by resection of cervical dorsal muscles to establish a model of cervical dyskinesia and induce cervical disc degeneration. The shallow group was dissected from the back of the back of the head and the full-thickness group was removed from the back and back shallow and deep muscle groups. At 7 months after surgery, a drug-treated group (shallow, full-thickness) rabbits were given anti-bone hyperplasia capsules (from dog’s ridge, nogwood, Millettia, Laizizi, Achyranthes bidentata, Ligustrum lucidum, Cistanche, Rehmannia Compositions of yellow and epimedium, provided by Jiangsu Kangyuan Pharmaceutical Co., Ltd.) and glucosamine (supplied by Shanxi Zhongyuanwei Pharmaceutical Co., Ltd.), were respectively dissolved in 20 mL of distilled water, and were formulated as pastes and respectively weighed at 1.1 g. /kg and 0.06g/kg gavage, 2 times / d, once a month. 2After anesthetized rabbits in the gene therapy group (shallow, full layer), the recombinant plasmid DNA with the transforming growth factor β1 gene was injected into the C2 ~ 3, C3 ~ 4, C4 ~ 5 discs (each disc volume was 20 μL). . Eight months after model establishment, all animals were sacrificed and C3 ~ 4 and C4 ~ 5 intervertebral discs were taken as specimens. The levels of interleukin-1β and tumor necrosis factor-α in the cervical intervertebral discs of each group were detected by double antibody sandwich ELISA. MAIN OUTCOME MEASURES: The levels of interleukin-1β and tumor necrosis factor-α in cervical intervertebral discs of rabbits in each group at 8 months after model establishment. Results: Thirty-five rabbits did not lose during the experiment, and all of them entered the result analysis. The contents of interleukin-1β and tumor necrosis factor-α in the cervical intervertebral discs of rabbits in each group at 8 months after modeling were significantly higher than those in the normal control group (P<0.05-0.01). The shallow group of drug therapy and the shallow layer of gene therapy were significantly lower than the shallow group (P<0.05). The drug-treated whole layer group and gene therapy group were significantly lower than the model full-thickness group (P<0.05-0.01). Conclusion: Degenerative cervical disc tissues release a variety of cytokines and inflammatory mediators, which can accelerate cervical disc degeneration. The combined use of Chinese and Western medicines and gene therapy can significantly inhibit their content.