目的 探讨腰痹通胶囊改善大鼠腰椎间盘突出症以及其自身免疫调节的机制。方法 取大鼠自身尾椎髓核，移植入腰椎神经根部位以建立腰椎间盘突出模型，并随机分为模型组、腰痛宁胶囊（0.16 g/kg）组和腰痹通胶囊低、中、高剂量（0.17、0.34、0.68 g/kg）组以及对照组、假手术组。给药30 d后，检测大鼠左后肢压痛痛阈、血清免疫球蛋白IgG和IgM水平、外周血T淋巴细胞亚群CD4⁺和CD8⁺比例及神经根部位病理变化。结果 与模型组比较，腰痹通胶囊高、中剂量组大鼠痛阈显著升高（P<0.01、0.05），同时腰痹通胶囊高剂量组大鼠痛阈增加值明显降低（P<0.01）；腰痹通胶囊高、中剂量组能显著降低大鼠血清IgG水平（P<0.01），同时腰痹通胶囊高剂量组能显著降低大鼠血清IgM水平（P<0.05）；腰痹通胶囊高、中剂量组能显著降低大鼠CD4⁺含量（P<0.01、0.05），同时腰痹通胶囊高剂量组能显著降低大鼠CD4⁺/CD8⁺值（P<0.05）。组织病理图显示腰痹通胶囊组局部轴索、神经纤维病变均有不同程度的改善，提示腰痹通胶囊能改善大鼠腰椎间盘突出模型神经根病变。结论 腰痹通胶囊可以改善腰椎间盘突出大鼠模型的症状和神经根病变，其机制可能与调节机体自身免疫状态有关。

Objective To study the improvement of Yaobitong Capsules on prolapse of lumbar intervertebral disc in rats and discuss its mechanism about autoimmune regulator. Methods The model of prolapse of lumbar intervertebral disc was established by transplant of autologous nucleus pulposus of rats. All the rats were randomly divided into model group, Yaotongning Capsules (0.16 g/kg) group, low-, mid-, and high-dose of Yaobitong Capsule (0.17, 0.34, and 0.68 g/kg) groups, control group, and Sham group. After the administration for 30 d, the mechanical pain thresholds of left hind limb, IgG, IgM levels in serum, the ratio between T-lymphocyte subsets CD4⁺ and CD8⁺ cells in the peripheral blood, and pathological changes in the nerve root of rats were detected, respectively. Results Compared with the model group, the mechanical pain thresholds of rats in the mid-, and high-dose of Yaobitong Capsule groups were increased significantly (P<0.01, 0.05), and added value of pain threshold of rats in the high-dose of Yaobitong Capsule groups was obviously reduced (P<0.01). The IgG levels in serum of rats in the mid-, and high-dose of Yaobitong Capsule groups were decreased obviously (P<0.01), and the IgM levels in the high-dose of Yaobitong Capsule groups were also decreased significantly (P<0.01). The contents of CD4⁺ in the mid- and high-dose of Yaobitong Capsule groups were obviously reduced (P<0.01, 0.05), and CD4⁺/CD8⁺ value in the high-dose of Yaobitong Capsule groups was also reduced significantly (P<0.05). The pathological changes indicated that local axonal and nerve fibers of rats in Yaobitong Capsule groups were to some extent improved, and obviously improved in the nerve root. Conclusion Yaobitong Capsules can reduce the sensitivity of mechanical pain, improve the symptoms and nerve root lesions of rats in the model of prolapse of lumbar intervertebral disc, which can be related with regulating autoimmune abnormalities caused by herniated disc in the body.

国家重大新药创制项目（2013ZX09402203）