钠离子通道阻滞剂预防慢性疼痛症状发生的观察(英文)  

Sodium ion channel blocker in preventing the occurrence ofchronic ache symptoms

作　　者：唐锡萍[1] 谢益宽[1] 井艳玲[1] 

机构地区：[1]广州医学院病理教研室,广东省广州市510182

出　　处：《中国临床康复》2005年第36期190-192,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:慢性痛包括痛觉过敏和痛觉感觉异常,是患者感到难以忍受和临床缺乏治疗手段的一种病理现象。目的:探讨神经损伤即刻给予钠离子通道阻滞剂(布比卡因)对慢性痛症状产生的预防作用。设计:随机对照观察。单位:广州医学院病理教研室。材料:实验于2002-07在协和医学院基础研究所生理实验室完成。选用成年SD大鼠57只。方法:将慢性压迫性神经损伤(坐骨神经轻度结扎)模型大鼠随机分为对照组(14只)和实验组(43只)。实验组在坐骨神经轻度结扎后即刻于神经损伤区周围包埋布比卡因粉剂或胶溶剂,而对照组不给药。观察两组大鼠在行为学、电生理学和组织形态学上的差异。主要观察指标:①两组大鼠行为学实验结果。②两组大鼠电生理结果。③两组大鼠背根神经节荧光染色切片、摄片结果。结果:纳入大鼠57只,所有动物均存活到实验结束,均进入结果分析。①行为学测定:实验组大鼠始终未出现热痛过敏症状,而对照组大鼠出现了持续的热痛过敏症状。②电生理实验:实验组大鼠坐骨神经中枢端的神经纤维自发放电百分数显著低于对照组(6.79%,46.7%)。③背根神经节切片荧光染色结果:实验组6只大鼠损伤侧L4～5的全部背根神经节切片中看不到明显的交感节后神经纤维芽生,没找到篮状细胞,而在对照组2只大鼠损伤侧L4～5的全部背根神经节切片中可看到明显的交感节后神经纤维芽生,共找到篮状细胞41只。结论:神经损伤后即刻在损伤区给予钠离子通道阻滞剂布比卡因可降低损伤神经纤维的异位放电,并抑制损伤侧背根神经节内的交感芽生,通过这两方面的共同作用最终可预防慢性痛症状的发生。BACKGROUND： Chronic pain, including hyperalgesia and algesthesia paresthesia, is pathological phenomenons making the patients felt unendurable and lacking of clinical treatments. OBJECTIVE： To discuss the role of sodium ion channel blocker （bupivacaine） that may be administered instantly after neurotrauma and may have role of preventing the occurrence of chronic pain. DESIGN： Randomized and controlled study. SETTING： Pathological Department of Guangzhou Medical College. MATERIALS： This experiment was carried out at Physiological Laboratory in the Foundation Research Institute of Beijing Union Medical College in July 2002. Totally 57 adult SD rats were selected. METHODS： Chronic oppression neurotraumatic models were made on rat by mild ligation of sciatic nerve and randomly divided into control group （n=14） and experimental group （n=43）. Rats in the experimental group, but not in control group, were given bupivacaine powder or peptizer embedded around neurotraumatic area instantly after mild ligation of sciatic nerves. Differences in behavior, electrophysiological and histomorphological changes were compared between two groups. MAIN OUTCOME MEASURES： ① behavioral experimental results; ② electrophysiological observations; ③ florescence staining and photograph of dorsal root neuroganglion of two groups. RESULTS： Totally 57 rats enrolled in this study, all animals completed the experiment, and entered the result analysis. ① Behavior examination： Hot pain allergic symptom could not be observed on rats in experimental group during the whole experimental process, but continuously appeared in rats of control group. ② Electrophysiological experiment： Spontaneous discharge percentage of nerve fibers at the central end of experimental rat sciatic nerve was remarkably lower than that of the control group （6.79% vs 46.7%）. ③ Fluorescence dyeing of dorsal root ganglia （DRG） slice： Sympathetic postganglion nerve fiber budding was not obvious in the slices of entire L4-5 dors

关 键 词：疼痛 神经系统疾病 过敏症 

分 类 号：R745.1[医药卫生—神经病学与精神病学]