背景：針灸和電針治療有關可幫助後肢受損神經神經再生已經證實，但對於前肢正中神經的影響尚不清楚。
方法：本研究應用矽膠管，來接合每隻大鼠的截斷正中神經。從形態學，電生理和電生理功能的角度，使用針灸及電針來治療截斷的正中神經，並對其對於正中神經再生的影響進行了評估。
結果：形態上，與對照組相比發現接受針灸和電針治療組有較大面積的總神經面積及血管數量。電生理上，接受電針組相對於對照組有顯著較大幅度的面積和誘發的肌肉動作電位。在功能上，針灸和電針治療促進受傷爪子的能力增強，恢復其握力，並造成一個新的雙邊平衡。
結論：我們的研究結果提供了針灸和電針促進正中神經神經再生方面的多項角度的療效評估。事實上，針灸和電針可以對於神經再生過程產生積極的影響。這個平台，有利於進一步研究使用針灸和電針替代療法治療神經損傷，提供患者的臨床應用。

Background: Acupuncture and electroacupuncture treatments of damaged nerve may aid nerve regeneration related to hindlimb function, but the effects on forelimb-related median nerve was not known.
Methods: A gap was made in rat median nerve by suturing the stumpsinto silicone rubber tubes and the influences of acupuncture and electro- acupuncture treatments on nerve regeneration were evaluated from morphological, electrophysiological and functional angles.
Results: Morphologically, the groups receiving acupuncture and electroacupuncture treatments had larger total nerve area and blood vessel number compared with the controls. Electrophysiologically, the group receiving electroacupuncture had significantly larger amplitude and larger area of the evoked muscle action potentials compared with the controls. Functionally, the acupuncture and electroacupuncture treatment enhanced the injured paw to regain the grasping power, and a faster efficiency to a new bilateral balance.
Conclusion: Our findings provided multi-approach evidence of the efficacy for acupuncture and electroacupuncture treatments to the regeneration of median nerve.Indeed, the acupuncture and electroacupuncture appeared to have a detrimental effect on the regeneration processes. The platform is beneficial to further study of the clinical application of acupuncture and electroacupuncture alternative treatments on nerve-injured patients.

目錄
第一章 前言 1
1.1背景資料 1
1.2神經再生的簡介 1
1.3 矽膠管內神經再生之細胞學變化 2
1.4神經再生長度的標準化評估 10
1.5周邊神經損傷修復的運用 12
第二章 文獻探討 14
2.1 神經再生促進的研究方向 14
2.2 相關針灸及電場對於神經再生文獻之回顧 16
2.3 神經系統在傳統醫學中的定位 21
2.4神經損傷的中醫觀點與相關之中醫病證 22
2.5正中神經與針灸穴位應用的探討 25
2.5.1針灸穴位的探討 25
2.6 實驗研究的動機及目的 26
第三章 材料與方法 28
3.1材料 28
3.2 方法 31
3.2.1實驗動物分組 31
3.2.2 手術過程 31
3.2.3電針刺激過程 33
3.2.4動物針灸穴位的選取 33
3.2.5動物飼養環境 34
3.3資料收集及分析方法 34
3.3.1觀察正中神經成功的結果 34
3.3.2觀察實驗大鼠外表之變化 35
3.3.3再生神經組織切片評估 35
3.3.4再生神經組織學定性分析 36
3.3.5再生神經組織學定量分析 36
3.3.6電生理檢測分析 38
3.3.7大鼠正中神經功能評估抓握取觀察實驗 39
第四章 結果 42
4.1 正中神經成功率結果分析 42
4.1.1矽膠管外觀觀察 42
4.1.2各組神經再生成功率 43
4.1.3各組神經再生成功率統計分析 44
4.2外在觀測與評估結果 44
4.2.1大鼠外觀變化基本資料 44
4.2.2存活情況 44
4.2.3行動方面 44
4.2.4毛色方面 44
4.2.5電針刺激 44
4.2.6傷口方面 45
4.3再生神經組織學定性分析結果 45
4.3.1正常大鼠正中神經切面之描述 45
4.3.2矽膠管內白色再生管狀物切面之觀察 46
4.4再生神經組織學定量分析結果 49
4.4.1再生神經的全部面積(Total Area) 51
4.4.2再生神經內膜面積(Endo. Area) 51
4.4.3神經軸突數目(Axon number) 52
4.4.4神經軸突平均面積(Mean axon area) 53
4.4.5神經軸突密度(axon density) 54
4.4.6神經軸突面積百分比 55
4.4.7再生血管之數目(B.V. number) 56
4.4.8再生血管總面積(B.V. area) 57
4.5電生理檢測分析結果 58
4.5.1電生理檢測 58
4.5.2潛伏期Latency 1 (L1) 59
4.5.3潛伏期Latency 2 (L2) 60
4.5.4波期(Duration) 61
4.5.5振幅(Amplit) 62
4.5.6面積(Area) 63
4.5.7神經傳導速度(MCV) 64
4.6 大鼠正中神經握取功能評估觀察實驗結果 65
4.6.1未受傷肢評估 65
4.6.2受傷肢評估 66
第五章 討論 68
5.1 本研究結果之探討 68
5.1.1矽膠管為導管作為神經傳導介質 68
5.1.2正中神經再生成功率的結果討論 68
5.1.3外在觀測與評估結果討論 70
5.1.4再生神經組織學定量分析結果討論 70
5.1.5電生理檢測分析結果結果討論 72
5.1.6大鼠正中神經握取功能評估觀察實驗結果討論 74
5.2未來研發方向 75
第六章 結論 76
文獻 79
謝辭 89

圖目錄
圖1.1 神經導管再生室模型中影響神經再生之正反兩股力量 7
圖1.2 周邊神經再生機轉假說 8
圖1.3 影響神經再生品質導管內的因素 9
圖1.4 神經間隙標準化圖 11
圖1.5 影響神經再生的原因 12
圖1.6 職業傷病上下肢比例圖13
圖2.1 本實驗室之前所做針對神經再生的研究結果14
圖3.1 功能電刺激器 30
圖3.2 氣體麻醉機 30
圖3.3 大鼠正中神經手術定位圖 32
圖3.4 大鼠手術矽膠管接合圖 32
圖3.5 大鼠手術過程圖 32
圖3.6 實驗進行流程圖 33
圖3.7 抓握器 41
圖3.8 抓握分析 41
圖4.1 截斷神經後五週取出矽膠管的外觀圖 43
圖4.2 神經再生成功圖 43
圖4.3 正常大鼠正中神經橫切面 45
圖4.4 各組在40倍下顯微鏡觀察 47
圖4.5 各組在100倍下顯微鏡觀察 48
圖4.6 各組在400倍下顯微鏡觀察 49
圖4.7 各組之神經再生面積比較長條圖 51
圖4.8 各組之神經內膜面積比較長條圖 52
圖4.9 各組之神經軸突數比較長條圖 53
圖4.10 各組之神經軸突平均面積比較長條圖 54
圖4.11 各組之神經軸突密度比較長條圖 55
圖4.12 各組之神經軸突面積百分比比較長條圖 56
圖4.13 各組之再生血管之數目比較長條圖 57
圖4.14 各組之再生血管總面積比較長條圖 58
圖4.15 電生理檢測波形代表意義 58
圖4.16 各組之潛伏期Latency 1比較長條圖 60
圖4.17 各組之潛伏期Latency 2比較長條圖 61
圖4.18 各組之波期比較長條圖 62
圖4.19 各組之振幅比較長條圖 63
圖4.20 各組之面積比較長條圖 64
圖4.21 各組之神經傳導速度比較長條圖 65
圖4.22 各組之大鼠未受傷肢抓握力比較長條圖 66
圖4.23 各組之大鼠未受傷肢抓握力比較長條圖 67

表目錄
表2.1 本實驗室電針及針灸相關研究 19
表3.1 實驗動物分組表 31
表4.1 各組顯微鏡不同倍數下之型態比較 46
表4.2 組織學定量分析結果 50
表4.3 組織學定量分析比較表 50
表4.4 各組與神經再生全部面積之結果與統計 51
表4.5 各組與神經再生神經內膜面積之結果與統計 52
表4.6 各組與神經神經軸突數之結果與統計 52
表4.7 各組與神經軸突平均面積之結果與統計 53
表4.8 各組與神經軸突密度之結果與統計 54
表4.9 各組與神經軸突面積百分比之結果與統計 55
表4.10 各組與再生血管之數目之結果與統計 56
表4.11 各組與再生血管總面積之結果與統計 57
表4.12 各組之電生理檢測分析結果 59
表4.13 各組與潛伏期Latency 1之結果與統計 59
表4.14 各組與潛伏期Latency 2之結果與統計 60
表4.15 各組與波期之結果與統計 61
表4.16 各組與振福之結果與統計 62
表4.17 各組與面積之結果與統計 63
表4.18 各組與神經傳導速度之結果與統計 64
表4.19 正中神經握取功能 65
表4.20 未受傷肢之結果與統計 66
表4.21 受傷肢握力之結果與統計 67

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