电针联合腹腔注射氯胺酮对神经源性痛大鼠脊髓神经元凋亡的影响  

Effects of electroacfupuncture combined with intraperitoneal ketamine on expression of neuronal apoptosis in spinal cord in rats with chronic neuropathic pain.

作　　者：杨京利[1] 马国平[1] 刘菊英[1] 王燕[1] 周青山[2] 

机构地区：[1]郧阳医学院附属太和医院麻醉科,湖北十堰442000 [2]湖北省人民医院麻醉科,湖北武汉430060

出　　处：《四川医学》2008年第12期1606-1608,共3页Sichuan Medical Journal

摘　　要：目的观察电针联合腹腔注射氯胺酮对神经源性痛大鼠的脊髓神经元凋亡的影响，探讨其镇痛机制。方法成年雄性Wistar大鼠30只，体重230—250g，随机分为5组：A组（n=6，正常组）；B组（n=6，对照组）：结扎左侧坐骨神经中段后腹腔注入等量生理盐水；C组（n=6，电针组）：结扎左侧坐骨神经中段后1、3、5、7d电针阳陵泉和足三里，频率2Hz／100Hz，强度≤2mA，30min／次；D组（n=6，氯胺酮组）：结扎坐骨神经后1、3、5、7d向腹腔注入氯胺酮10mg／kg（1mg／ml）；E组（n=6，针药合用组）：针药使用方法同C、D组。并于术后1、3、5、7d分别进行行为学测定，记录缩爪时间。于结扎后7d取L4-6脊髓，采用TUNEL法观察脊髓神经元凋亡。结果与A组相比，B组脊髓神经细胞凋亡指数升高（P＜0．05）；与B组相比，C、D、E组机械性触诱发痛减轻（P＜0．05）；与C组相比，E组机械性触诱发痛显著减轻（P＜0．05），脊髓神经细胞凋亡指数也显著降低（P＜0．05）。结论结扎坐骨神经可引起脊髓神经元的凋亡，并与神经源性痛的发展相一致。针药合用的镇痛效果强于单独使用电针。其对大鼠脊髓的保护作用可能与抑制脊髓神经元凋亡有关。Objective To investigate the effects of electroacupuncture （EA） combined with intraperitoneal （IP） ketamine on expression of neuronal apoptosis in spinal cord in rats with chronic neuropathic pain（CNP） .Methods Thirty adult male SD rats weighing 230 - 250g were randomly divided into 5 groups（ n = 6 each） ： A control ; B CNP; C EA ＋ CNP; DIP ketamine ＋ CNI6 and E EA ＋ IP ke- tamine＋ CNP. CNP was induced by placing four ligatures around the light sciatic nerve and ling without obstructing the blood supply of the nerve.In group D and E ketamine 10mg/kg（1mg/ml） was injected intrapefitoneally on the 1st,3rd,Sth and 7th day after CNP was induced. In group C and E electrical stimulation of Yanlinquan and Zusanli was performed 30 min/day on the lst,3rd,Sth and 7th day after CNP was induced. The paw mechanical hyperalgesia were measured with Von-Frey filaments. The lumbar segment（ L4-6） of spinal cord .was removed on the 7th day after induction of CNP for determination of the expression of neuronal apoptosis by TUNEL and computer image analysis system. Results The mechanical hyperalgesia and increase in expression of neuronal apoptosis by CNP was significantly attenuated by EA and/or IP ketamine. EA combined with IP ketamine provided best analgesia. Conclusion EA can enhance the analgesic effect of ketanline in rats with chronic neuropathic pain. The cfhanges in neuronal apoptosis in spinal dorsal horn is involved in the mechanism of analgesia produced by EA and ketamine.

关 键 词：电针 神经源性痛 凋亡 氯胺酮 

分 类 号：R245.97[医药卫生—针灸推拿学] R741[医药卫生—中医临床基础]