初探放射式冲击波治疗大鼠神经病理性疼痛模型的效果  

THE EFFECT OF RADIAL SHOCK WAVE THERAPY IN NEUROPATHIC PAIN MODEL: A PILOT STUDY

作　　者：付淼[1] 李多依[1] 于晓彤[2] 罗芳[1] 樊碧发[3] 

机构地区：[1]首都医科大学附属北京天坛医院疼痛中心,北京100050 [2]上海理工大学医疗器械与食品学院,上海200093 [3]中日友好医院疼痛科,北京100029

出　　处：《中国疼痛医学杂志》2015年第7期499-504,共6页Chinese Journal of Pain Medicine

摘　　要：目的:初步探讨不同强度的放射式冲击波疗法(radial shock wave therapy,RSWT)对大鼠坐骨神经慢性压迫(chronic constructive injury,CCI)模型的镇痛效果。方法 :本实验分为两部分,第一部分:单次RSWT。SD大鼠36只,随机等分为6组:假手术组(SHAM组),只暴露坐骨神经而不结扎。其余5组建立CCI模型,其中神经病理性疼痛模型组(NP组)不予治疗,另4个不同强度的RSWT组(1.0 bar、1.5 bar、2.0 bar和2.5 bar RSWT组)结扎坐骨神经后14 d,分别给与1.0 bar、1.5 bar、2.0bar或2.5 bar强度治疗。第二部分:重复RSWT。36只大鼠分组情况同第一部分,4个RSWT组自结扎后14 d分别给予重复的4个不同强度RSWT,1周1次,共4次。测量所有大鼠治疗前后机械缩足反射阈值(MWT)及热缩足反射潜伏期(TWL)变化以评价镇痛效果;测定大鼠坐骨神经功能指数并观察副作用发生情况。结果:单次RSWT后前3 d不同强度RSWT组大鼠的MWT和TWL均迅速提高。在第3 d达到峰值,显著高于NP组(P<0.01),此后逐渐降至基线。重复RSWT组大鼠治疗后MWT和TWL逐渐上升,4次治疗后维持在较高水平至少4 w,与NP组有显著性差异(P<0.01)。各组重复RSWT前后坐骨神经功能指数无显著性改变。结论:单次RSWT用于CCI模型所致神经病理性疼痛起效迅速,但维持时间短暂(5 d)。而重复RSWT对神经病理性疼痛来说是更为有效的治疗方法。Objective： To observe the effects of radial shock wave therapy（RSWT）on neuropathic pain rats with sciatic nerve ligation. Methods： RSWT was administered in a rat model of NP induced by chronic constructive injury（CCI） using single and repeated treatment protocols. In the single RSWT experiment, 4 RSWT groups received different energy densities（1.0, 1.5, 2.0 and 2.5 bar） of RSWT once on day 14 after ligation of the right sciatic nerve, while no treatment was given to the NP-model group（NP group） and shamoperated group（sham group）（n = 6 in each group）. In the repeated treatment protocol, 4 repeated sessions of RSWT（1.0, 1.5, 2.0 and 2.5 bar） were given to 4 RSWT groups at an interval of 1 week from 14 days postCCI; the NP group and sham group received no treatment（n = 6 in each group）. The analgesic effect of RSWT was assessed by measuring changes in the mechanical withdrawal threshold（MWT） and thermal withdrawal latency（TWL）. In addition, the safety of RSWT was assessed through the measurement of the sciatic functional index（SFI） and observation of the complications associated with RSWT. Results： Both the MWT and TWL rapidly increased after a single session of RSWT, and significantly higher than those in the NP group（P〈 0.01）. However, the MWT and TWL gradually decreased and returned to baseline levels by day 10. Following repeated sessions of RSWT, both the MWT and TWL gradually increased, and maintained at high levels for at least 4 weeks after 4 sessions of RSWT. Both thresholds were significantly different from those in the NP group（P 〈0.01）. In addition, no significant changes of SFI were observed in RSWT groups after repeated sessions of RSWT. Our study observed local mild skin ecchymosis in about half of the rats following RSWT, which disappeared within 6 days, and there was no increased pain or other side effects in any animals. Conclusion： A single session of RSWT is rapidly effective, but maintained for a short period of time（5 days）. Ho

关 键 词：放射式冲击波疗法 神经病理性疼痛 CCI模型 机械性缩足反射阈值 热缩足反射潜伏期 

分 类 号：R402[医药卫生—临床医学] R-332