电针对断尾大鼠椎管内麻醉下应激反应调控效果的影响  

Effects of electroacupuncture combined with spinal anesthesia on the regulation of stress response in rats

作　　者：刘莉[1] 蒋奕红[2] 熊威威[2] 谭毅[2] 黄志华[2] 李爱国[2] 杨华[3] 

机构地区：[1]广西桂林市桂林医学院研究生院,541001 [2]广西桂林市桂林医学院麻醉科,541001 [3]桂林医学院附属医院中医科,541001

出　　处：《实用医学杂志》2014年第20期3222-3225,共4页The Journal of Practical Medicine

基　　金：2013年广西中医药民族医药继承创新工程(编号:GZZC13-20)

摘　　要：目的:探讨电针不同部位联合鞘内注射芬太尼对大鼠急性应激反应调控作用的影响及与脊髓表达c-fos蛋白相关的机制。方法:将鞘内置管成功的50只雄性SD大鼠随机分为5组(n=10):对照组(Ⅰ组,仅鞘内置管注射生理盐水50μL)、模型组(Ⅱ组,低位尾干切断+鞘内置管注射生理盐水50μL)、鞘内麻醉组(Ⅲ组,模型成功后,鞘内注射芬太尼50μL,2.5μg)、鞘内麻醉+体针组(Ⅳ组,模型成功后,鞘内注射50μL芬太尼,采用电针仪刺激大鼠双侧"足三里"穴,强度<2 m A,频率2/100 Hz,时间30 min)、鞘内麻醉+耳针组(Ⅴ组,模型成功后,鞘内注射芬太尼50μL,取双侧耳尖穴进行穴位电刺激,刺激参数及时间同Ⅳ组),用酶联免疫法(ELISA法)测血清促肾上腺皮质激素(ACTH)和皮质醇激素(CORT)水平,取脊髓L4-6段,采用Western Blot免疫印记法测脊髓c-fos蛋白表达,用IPP6.0凝胶成像系统进行分析。结果:Ⅱ组血清ACTH、CORT水平和脊髓c-fos表达均较Ⅰ组明显升高(P<0.01),与Ⅱ组相比,Ⅲ组、Ⅳ组、Ⅴ组血清ACTH、CORT水平均有不同程度下降,差异有统计学意义(P<0.05),但脊髓c-fos表达在Ⅱ组与Ⅲ组间无差异(P>0.05)。Ⅲ、Ⅳ组间,血清激素水平无差异(P>0.05),Ⅴ组c-fos表达较Ⅳ组低(P<0.01)。结论 :体针和耳针电刺激复合鞘内麻醉均对降低急性疼痛大鼠的应激反应有效;鞘内麻醉下,非神经阻滞区域的耳针作用明显,其机制可能与神经传导诱发脊髓释放c-fos蛋白有关。Objective To investigate the influence of electroacupuncture（EA） in different points combined with spinal anesthesia on acute stress response and mechanisms related with expression of spinal c-fos protein. Methods Fifty adult male Sprague-Dawley rats were randomly divided into 5 groups：groupⅠwere normal rats receiving only 50μL saline intrathecal IT injection;groupⅡwere docked rats receiving IT with 50 μL saline;groupⅢ were docked rats receiving IT injection of 50 μL, 2.5 μg fentanyl; group Ⅳwere docked rats receiving IT injection of fentanyl 50μL and EA at′zu-san-li′;groupⅤwere docked rats receiving EA at′er xue′and IT fentanyl. Serum corticosterone （CORT） and adrenocorticotropic hormone （ACTH） levels were measured by ELISA. Determined the c-fos protein expression levels of L4-6 spinal by western blotting. Result GroupⅡACTH, CORT levels and c-fos expression was significantly higher than those in groupⅠ（P〈0.01）. Compared with groupⅡ, groupⅢ,ⅣandⅤhad higher ACTH and CORT levels （P〈0.05）. However, c-fos expression in the spinal cord between groupⅡandⅢshowed no difference （P〉0.05）. Between groupⅢandⅣ, no differences in serum hormone levels （P 〉 0.05） were detected. In group Ⅴ the c-fos expression was lower than that of the Ⅳ group （P 〈 0.01）. Conclusion Body acupuncture and auricular electrical stimulation combined with intrathecal anesthesia were effective to reduce pain in rats with acute stress reactions. Under intrathecal anesthesia, auricular stimulation played a better role of non-nerve block region, and the mechanism may be due to the release of neurotransmitters induced c-fos protein in spinal cord.

关 键 词：芬太尼 电针 应激反应 脊髓 c—fos 

分 类 号：R614[医药卫生—麻醉学]