经皮穴位电刺激对急性内脏痛大鼠脊髓细胞外信号调节蛋白激酶1/2活化的影响  

Effects of transcutaneous electrical nerve stimulation on the activation of spinal extracellular signal-regulated kinases 1/2 in acute visceral pain rats

作　　者：黄娅琴[1] 雷卫平[2] 肖纯 孙建良[1] 

机构地区：[1]温州医科大学附属第二医院麻醉科,浙江温州325027 [2]杭州市第一人民医院麻醉科 [3]杭州市妇产科医院麻醉科

出　　处：《上海医学》2016年第2期108-111,I0001,共5页Shanghai Medical Journal

基　　金：杭州市科技计划重点项目资助(20140633B06)

摘　　要：目的通过观察经皮穴位电刺激(TENS)对宫颈扩张大鼠脊髓细胞外信号调节蛋白激酶(ERK)1/2磷酸化水平的影响,探讨TENS抑制急性内脏痛的机制。方法将36只Sprague-Dawley(SD)大鼠随机分为单纯刺激组、TENS组和假手术组,每组12只。单纯刺激组大鼠在手术暴露扩张宫颈前于"合谷"和"三阴交"穴位穿刺留针,但不予TENS;TENS组大鼠在手术暴露扩张宫颈前后,于"合谷"和"三阴交"穴位穿刺留针行TENS;假手术组大鼠仅手术暴露宫颈,不行宫颈扩张和穴位穿刺留针。采用免疫组织化学法测定脊髓磷酸化ERK1/2(p-ERK1/2)水平,记录大鼠腹直肌肌电位(EMG)振幅。结果 3组间宫颈扩张前腹直肌EMG振幅的差异均无统计学意义(P值均>0.05),假手术组宫颈扩张前后腹直肌EMG振幅的差异均无统计学意义(P值均>0.05)。单纯刺激组和TENS组宫颈扩张后30、60、120min的腹直肌EMG振幅均显著高于同组宫颈扩张前(P值均<0.05),单纯刺激组宫颈扩张后30、120min的腹直肌EMG振幅均显著低于同组宫颈扩张后60min(P值均<0.05),TENS组宫颈扩张后30、60、120min的腹直肌EMG振幅均显著低于单纯刺激组同时间点(P值均<0.05)。单纯刺激组、TENS组、假手术组的脊髓p-ERK1/2阳性细胞数分别为(33.57±6.79)、(26.86±6.23)、(9.45±1.16)个,单纯刺激组和TENS组均显著多于假手术组(P值均<0.05),单纯刺激组又显著多于TENS组(P<0.05)。结论脊髓ERK1/2信号通路参与宫颈扩张所致的急性内脏痛的信号转导过程,抑制ERK1/2的活化可能是TENS缓解内脏痛的机制之一。Objective To explore the effect of transcutaneous electrical nerve stimulation （TENS） on the activation of spinal extracellular signal-regulated kinases （ERK） 1/2 in rats with acute visceral pain. Methods Thirty-six Sprague-Dawley rats were randomly divided into three groups： uterine cervical distension （UCD） group, TENS group, and sham operation group （n = 12 each）. The abdominal walt was incised in all rats. Then two metal rods were inserted through cervical canals, and acupuncture needles were put into bilateral Hegu and Sanyinjiao in UCD group and TENS group. In addition, the needles in TENS group were connected with Han＇s Acupoint Nerve Stimulator. The expression of phosphorylated ERK 1/2 （p-ERK1/2） in spinal dorsal horn was determined by immunohistochemical analysis. Electric potential of rectus abdominis was recorded by electromyography （EMG）. Results There was no significant difference in electric potential of rectus abdominis before UCD between groups （all P〉0.05）. Electric potential of rectus abdominis did not significantly change after UCD in sham operation group as compared with baseline （all P〉0.05）. Electric potential of rectus abdominis at 30, 60, and 120 min after UCD in UCD group and TENS group were significantly higher than baseline （all P〈0.05）. Electric potential of rectus abdominis at 30 and 120 min after UCD were significantly lower than that at 60 after UCD in UCD group （both P〈0.05）. Electric potential of rectus abdominis in TENS group were significantly lower than those in UOD group at 30, 60, and 120 min after UCD （all P〈0.05）. The number of p-ERK1/2 positive cells in UCD group, TENS group and sham operation group were 33.57 ± 6.79, 26. 86 ±6.23, and 9. 45 ±1. 16, respectively. Compared with sham operation group, the number of p-ERK1/2 positive cells in TENS group and UCD group were significantly increased （both P〈0.05）. And the amount of p-ERK1/2 positive cells in UOD group was significantly more than TENS group （P〈0

关 键 词：穴位电刺激 急性内脏痛 细胞外信号调节蛋白激酶1/2 脊髓 

分 类 号：R245[医药卫生—针灸推拿学]