刮痧治疗腰椎间盘突出症不同方案疗效差异:基于血清代谢组学的评价  

Differences in outcomes of different scraping therapy schemes for lumbar disc herniation based on metabonomics

作　　者：陈丽虹[1] 岳容兆 张永怡[1] 张沁[1] 王燕君[1] 桂前 杨敏[1] 徐桂华[1] 谢彤 彭琳秀 Chen Li-hong;Yue Rong-zhao;Zhang Yong-yi;Zhang Qin;Wang Yan-jun;Gui Qian;Yang Min;Xu Gui-hua;Xie Tong;Peng Lin-xiu(School of Nursing,Nanjing University of Chinese Medicine,Nanjing 210023,Jiangsu Province,China;Jiangsu Provincial Key Laboratory of Children Respiratory Diseases(Traditional Chinese Medicine),Nanjing University of Chinese Medicine,Nanjing 210023,Jiangsu Province,China)

机构地区：[1]南京中医药大学护理学院,江苏省南京市210023 [2]南京中医药大学,江苏省儿童呼吸疾病(中医药)重点实验室,江苏省南京市210023

出　　处：《中国组织工程研究》2018年第32期5110-5116,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金资助项目(81473791);江苏省研究生科研与实践创新计划项目(SJCX18_0444).

摘　　要：背景:刮痧干预腰椎间盘突出症在临床应用广泛,结合代谢组学等现代分析技术可多环节、多途径、多靶点对其机制效应进行研究。目的:运用气相色谱-质谱联用技术,分析刮痧对腰椎间盘突出症大鼠血清代谢谱的影响及不同方案的疗效差异。探讨刮痧治疗腰椎间盘突出症的作用机制,为临床治疗提供新的思路和依据,推动刮痧疗法的规范化、标准化进程。方法:48只雄性SD大鼠由浙江省实验动物中心提供,随机分为刮痧组(循经出痧组、循经不出痧组、穴位出痧组、穴位不出痧组)、模型组与空白组,每组8只。刮痧组和模型组制备自体髓核移植非压迫性腰椎间盘突出症模型。刮痧各组分别给予不同刮痧方案进行干预,隔日1次,3 d为一个疗程,共3个疗程。借助电子测痛仪,测定刮痧各组和模型组大鼠造模前后的机械阈值;使用气相色谱-质谱联用技术分析6组大鼠血清内源性差异代谢物。结果与结论:(1)刮痧各组和模型组造模后的机械痛阈值均较造模前显著降低(P <0.01);(2)根据代谢组学分析,共筛选出甘氨酸、丙酮酸、鸟氨酸等14种潜在的生物标志物,涉及甘氨酸、丝氨酸和苏氨酸代谢,丙酮酸代谢和柠檬酸循环等7条代谢通路,其中刮痧通过调节尿素含量、甘氨酸、丝氨酸和苏氨酸代谢、丙酮酸代谢通路对腰椎间盘突出症模型大鼠起到抗炎作用,通过调节精氨酸和脯氨酸代谢通路达到镇痛效果;(3)分析刮痧4组甘氨酸、丙酮酸、鸟氨酸和尿素含量,发现循经出痧组的异常代谢物调节效果最好,由此推测其治疗效果也较其他3组更为显著;(4)今后还需大样本的临床试验进行更为深入的研究。BACKGROUND:Scraping therapy has been widely used to treat lumbar disc herniation.The underlying mechanism can be studied through multiple links,pathways and targets using metabonomics.OBJECTIVE:To analyze the serum metabolic profile changes in lumbar disc herniation rats interfered with scraping therapy and differences in efficacy of different regimens by gas chromatography-mass spectrometry(GC-MS),and to explore the underlying mechanism to provide new ideas and basis for clinical treatment,and promote the normalization and standardization of scraping therapy.METHODS:Forty-eight Sprague-Dawley rats from Zhejiang Provincial Animal Center were randomly divided into Scraping therapy groups(corresponding channels with ecchymosis,corresponding channels without ecchymosis,acupoints with ecchymosis,acupoints without ecchymosis),model group,and blank control group(n=8 per group).A rat model of noncompressive lumbar disc herniation induced by autologous nucleus pulposus was established in the model and scraping therapy groups.Different scraping therapy programs were given to scraping therapy groups,once every other day,for 3 courses(3 days a course).The mechanical pain threshold before and after modeling was detected by electronic pain threshold detector.The serum endogenous differential metabolites were analyzed by GC-MS.RESULTS AND CONCLUSION:After modeling,the mechanical pain threshold in each group was significantly lower than before modeling(P<0.01).According to the metabonomics,14 potential biomarkers such as glycine,pyruvate acid and ornithine were screened out,and these potential biomarkers were involved in seven metabolic pathways,including glycine,serine and threonine metabolism,pyruvate metabolism and citric cycle.Scraping therapy played an anti-inflammatory effect on lumbar disc herniation rats by regulating the urea content,glycine,serine and threonine metabolism,pyruvate,and achieved analgesic effect through the adjustment of arginine and proline metabolism pathways.After comparing the contents of glycine,py

关 键 词：血清代谢组学 刮痧 腰椎间盘突出 组织构建 国家自然科学基金 系统生物学 脊柱疾病 腰椎 椎间盘移位 组织工程 

分 类 号：R318[医药卫生—生物医学工程]