慢性膝关节炎疼痛模型的针灸治疗  

Electroacupuncture for chronic pain in a model of knee arthritis

作　　者：徐丽丽 黄娟 胥方元 万永鲜 

机构地区：[1]西南医科大学附属医院康复医学科,四川省泸州市646000 [2]西南医科大学附属医院骨与关节外科,四川省泸州市646000

出　　处：《中国组织工程研究》2017年第24期3864-3869,共6页Chinese Journal of Tissue Engineering Research

基　　金：四川省中医药管理局基金项目(2014-K-125);西南医科大学青年基金项目(2014QN-107);四川省卫计委普及应用项目(17PJ176)~~

摘　　要：背景:已经证实针灸对腰背痛、膝关节痛等急性疼痛等有较好疗效,但是对于慢性疼痛的效果存在争议。目的:建立新西兰兔慢性关节炎疼痛模型,探讨针灸治疗慢性关节炎疼痛机制。方法:(1)32只新西兰兔使用4%木瓜蛋白酶0.3 mL注射双后肢膝关节腔内,制成兔膝骨性关节炎模型。随机分为4组,即生理盐水+电针组,生理盐水+假电针组,k-阿片受体拮抗剂(nor-Binaltorphimine,nor-BNI)+电针组,nor-BNI+假电针组,每组8只。nor-BNI用量1 mg/kg,1次/d,连续3 d;电针干预时间为实验动物给予药物后2 h,1次/d,30 min/次,直至实验动物被处死当天结束;假电针组取穴、针刺方法及时间同电针组,但不通电刺激。使用BBB评分对各组进行下肢行为学评分。给药1,3,5,7日分别处死,分离脊髓组织后多聚甲醛固定,使用免疫荧光法检测脊髓组织白细胞介素17及白细胞介素17受体A、NR1的表达水平;(2)另取24只新西兰兔,12只兔建立膝骨性关节炎模型后随机分为模型+生理盐水组、模型+2μg白细胞介素17抗血清组;剩余12只分为对照+生理盐水组、对照+2μg白细胞介素17抗血清组。以2μg白细胞介素17抗血清溶于10μL生理盐水中进行椎管内给药,1次/d,连续3 d。使用BBB评分对新西兰兔下肢功能进行行为测试,每次行为测试后,Western-blot测定样品中p-NR1,白细胞介素17R的表达水平。结果与结论:(1)nor-BNI+电针组BBB评分明显增高(P<0.05);而脊髓组织白细胞介素17及白细胞介素17受体A、NR1的表达水平明显减低(P<0.05);(2)使用nor-BNI拮抗阿片类受体后,nor-BNI+电针组脊髓组织NR1的表达水平与nor-BNI+假电针组相比无明显差异(P>0.05);(3)使用白细胞介素17抗血清处理后,模型+2μg白细胞介素17抗血清组BBB评分明显增高(P<0.05);而该组脊髓组织白细胞介素17及NR1的表达水平明显减低(P<0.05),但仍高于2个对照组(P<0.05);(4)实验证实,慢性关节炎疼痛原因为白细BACKGROUND： Acupuncture has been found to be effective for alleviating low back pain and acute pain due to knee arthritis, but its effect on chronic pain is under discussion. OBJECTIVE： To investigate the mechanism underlying electroacupuncture （EA） alleviating chronic pain in a New Zealand rabbit model of knee arthritis. METHODS： （1） Thirty-two New Zealand rabbits were selected, and the knee osteoarthritis model was established by injecting 4% papain into the knee articular cavity of rabbit＇s bilateral hind limbs. The model rabbits were randomly divided into four groups （n=8 per group）： normal saline plus EA, normal saline plus sham EA, nor-Binaltorphimine （nor-BNI） plus EA, and nor-BNI plus sham EA groups. The dosage of nor-BNI was 1 mg/kg, once daily, for censecutive 3 days, 30-minute EA was given at 2 hours after administration, once daily, until the day the rabbits were killed. Sham EA indicated no given electric current. The behaviors of the lower limbs were evaluated by Basso, Beattle, Bresnahan scores. The rabbits were respectively killed at 1, 3, 5 and 7 days after administration, the spinal cord was separated, and then fixed with formaldehyde. The expression levels of intedeukin-17, interleukin-17 receptor A and NR1 in the spinal cord tissues were detected by immunofluorescence. （2） The other 24 New Zealand rabbits were randomly divided into model and control groups （n=12 per group）, and the knee osteoarthritis model was established in the former group. Afterwards, the two groups were randomized into two subgroups, followed by given the intrathecal administration of normal saline, or 2 pg interleukin-17 antibody serum dissolved in 10 pL normal saline, once daily, for consecutive 3 days. The behaviors of the lower limbs were evaluated by Basso, Beattie, Bresnahan scores, and the expression levels of p-NR1 and interleukin-17 receptor were detected by western blot assy. RESULTS AND CONCLUSION： The Basso, Beattie, Bresnahan scores in the nor-BNI plus EA group were signifi

关 键 词：电针 慢性关节炎 疼痛 组织工程 组织构建 关节炎 白细胞介素17 阿片受体 

分 类 号：R318[医药卫生—生物医学工程]