摘要
目的:观察颈部切口痛大鼠痛行为反应变化及电针对颈段脊髓代谢型谷氨酸受体5(mGluR 5)、腺苷-3’,5’-环化磷酸(cAMP)、促分裂素原活化蛋白激酶(MAPK)、环腺苷酸应答元件结合蛋白(CREB)基因表达的影响,分析针刺镇痛行甲状腺手术的机制。方法:将Wistar大鼠随机分为正常组、模型组、扶突组、合谷-内关组及足三里-阳陵泉组,每组8只。异氟烷麻醉下,于大鼠颈部做一长约1.5cm纵形切口,复制切口疼痛模型。各治疗组在造模4、24、48h后给予电针上述诸穴区各30min。热辐射法测定动物的痛阈变化。取C1～C4段脊髓背侧部分的组织,用荧光定量RT-PCR法检测mGluR 5、cAMP、MAPK与CREB基因的表达。结果:与正常组比,术后大鼠颈部切口处热痛阈降低(P<0.05);电针扶突、合谷-内关组动物的痛阈明显升高(P<0.05);足三里-阳陵泉组的痛阈与模型组比差异无统计学意义(P>0.05)。与正常组比,模型组mGluR 5mRNA、cAMP mRNA、CREB mRNA表达量均明显升高(P<0.05),MAPK mRNA表达量轻度升高(P>0.05)。与模型组比,电针"扶突"后cAMP mRNA、CREB mRNA表达量显著降低(P<0.05),mGluR 5mRNA、MAPK mRNA表达量轻度降低(P>0.05);电针"合谷"-"内关"穴以及"足三里"-"阳陵泉"穴的效果不明显(P>0.05)。电针"扶突"穴下调mGluR 5、cAMP、CREB基因表达的作用明显优于电针"合谷"-"内关"穴以及"足三里"-"阳陵泉"穴(均P<0.05)。结论:电针"扶突"能明显升高大鼠颈部切口痛术后痛阈,该作用可能与其下调脊髓C1～C4段mGluR 5、cAMP、CREB基因表达水平有关。与"足三里"-"阳陵泉"及"合谷"-"内关"的作用比较,电针"扶突"的作用具有相对特异性。
Objective To observe the effect of electroacupuncture （EA） at ＂Futu＂ （LI 18）,etc. on the pain threshold and expression of metabotropic glutamate receptor subtype 5 （mGluR 5）, cyclic adenosine monophosphate （cAMP）, mitogen-activated protein kinase （MAPK）, cAMP responsive element binding protein （CREB） genes in the cervico-spinal dorsal region in rats with neck incision pain so as to analyze its underlying analgesic mechanism in performing thyroid surgery. Methods Forty male Wistar rats were randomly divided into control, model, Futu （LI 18）, Hegu （LI 4）-Neiguan （PC 6）, Zusanli （ST 36）-Yanglingquan （GB 34） groups, with 8 cases in each group. Neck-incision pain model was established by making a longitudinal incision along the midline of the neck under anesthesia （isoflurane） except rats in the control group. EA（2 Hz/15 Hz, 1 -2 mA） was applied to bilateral LI 18, LI 4-PC 6 and ST 36-GB 34 for 30 min, 4 h, 24 h and 48 h after modeling, respectively. The thermal pain threshold was detected before modeling, and before and after each treatment. After removing the ventral part, the spinal tissue of the cervi- cal 1 -4 segments was collected for detecting the expression of mGluR 5, cAMP, MAPK, CREB genes by using quantitative realtime-POR technique. Results In comparison with the control group, the pain＇ threshold of the model group was decreased obviously （P〈0.05） . Compared with the model group, the pain thresholds of the LI 18 and LI 4-PC 6 groups were upregulated markedly after treatment （P〈0.05）, No significant differences were found between the LI 18 and LI 4-PC 6 groups, and between the model and ST 36-GB 34 groups in pain thresholds （P〈0.05）. Compared with the control group, the expression le-vels of mGluR 5 mRNA, cAMP mRNA and CREB mRNA in the cervico-spinal cord were upregulated significantly in the model group （P〈0.05）. While in comparison with the model group, cervico-spinal cAMP mRNA, and CREB mRNA were down-regulated markedly （P〈0.05） and mGluR 5 mRNA was down-regulated moderately（P〉0.05） in the LI 18 group, rather than in the LI 4- PC 6 and ST 36-GB 34 groups （ P〉0. 05）. Conclusion EA-LI 18 can significantly suppress neck incision pain induced pain reaction, which may be closely associated with its functions in down-regulating expression levels of intracellular cAMP mRNA and CREB mRNA in the cervico-spinal cord.
出处
《针刺研究》
CAS
CSCD
北大核心
2012年第3期191-196,共6页
Acupuncture Research
基金
国家"973"计划中医理论研究专项(No.2007CB 512505)
国家自然科学基金项目(No.30973796
No.30973796)
国家自然科学基金重大项目(No.90709031)
关键词
颈部切口痛
电针镇痛
脊髓mGluR
5
CAMP
CREB
MAPK基因表达信号通路
Cervical incision pain
Acupuncture analgesia
Spinal cord
Gene expression
Metabotropic glutamate receptor subtype 5
cAMP/MAPK/CREB signaling
