模拟腰椎旋转手法抑制瞬时感受器电位离子通道香草素受体4/一氧化氮疼痛转导通路的作用研究  

Experimetal study on inhibiting transient receptor potential vanilloid 4/nitric oxide pain signal pathway by lumbar rotatory manipulation on rats model with lumbar radicular pain

作　　者：韩磊 李艺 郭广进 赵平 HAN Lei;LI Yi;GUO Guangjin;ZHAO Ping(Department of Orthopedic Therapy,Medical Center of Air Force of Chinese People’s Liberation Army,Beijing 100142,China)

机构地区：[1]中国人民解放军空军特色医学中心正骨治疗科,北京100142

出　　处：《安徽医药》2020年第4期677-680,共4页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金青年项目(81503602)。

摘　　要：目的观察模拟腰椎旋转手法对腰神经根疼痛模型大鼠背根神经节(dorsal root ganglion,DRG)内瞬时感受器电位离子通道香草素受体4(transient receptor potential vanilloid 4,TRPV4)表达、一氧化氮(Nitric Oxide,NO)含量变化的影响,探讨手法抑制TRPV4/NO疼痛转导通路的作用。方法2017年3月至2018年10月,将144只雄性SD大鼠随机分为假手术组、模型组、模型+钌红组,每组各48只。其中假手术组只在相应椎节(L5 6)左侧做局部软组织切开,未建模;模型组通过手术在特定椎节(L5 6)左侧建立L5神经根疼痛模型;模型+钌红组在建模后向L5背根节注射TRPV4抑制剂钌红0.1 nmol。所有组别均施行统一量化的模拟腰椎旋转手法,频率1次/隔日,治疗期为3周。每组各取24只大鼠于术后第9、21天时取出手术同侧的L5 DRG,其中18只用于TRPV4通道蛋白表达的检测;6只用于NO代谢产物亚硝酸盐含量的检测。结果经蛋白质印迹法条带比较,发现模型组TRPV4为高表达,模型+钌红组TRPV4表达比模型组减弱,但仍强于假手术组。经腰椎旋转手法干预后,在术后第9、21天时模型组亚硝酸盐含量均值(9.17 nm/mL,5.31 nm/mL)均明显低于模型+钌红组(14.36 nm/mL,9.45 nm/mL),均明显高于假手术组(6.23 nm/mL,3.84 nm/mL)(均P<0.001)。结论TRPV4/NO通路是调控神经根疼痛敏感状态的重要信号转导通路之一。腰椎旋转手法可能是通过调控DRG神经元上的TRPV4/NO通路,来达到迅速缓解DRG神经痛敏的作用。Objective To observe the changes of lumbar rotatory manipulation on the expression of transient receptor potential vanilloid 4(TRPV4)and nitric oxide(NO)content in dorsal root ganglion(DRG)of rats with lumbar radicularpain model,and to explore the effect of manipulation on TRPV4/NO pain signal pathway.Methods One hundred and forty four male Sprague Dawley rats were randomly assigned into three groups:sham surgery group,radicular pain model group,model+ruthenium red(RR)group,with 48 rats in each group.The sham surgery group performed local soft tissue incision on the left side of the corresponding verte bral segment(L5 6)without modeling;the model group established the L5 nerve root pain model on the left side of the specific vertebral segment(L5 6)through surgery;the model+ruthenium red(RR)group with TRPV4 inhibitor0.1 nmol into the L5 dorsal root ganglion after modeling.All groups were subjected to a unified and quantified simulated lumbar rotatory manipulation,with a frequency of 1 time per 2 days,and the treatment period was 3 weeks.The left L5 dorsal root ganglion(DRG)of 24 rats in each group were collected on days 9,21 respectively after surgery for detecting the expression of TRPV4with 18 rats and nitrite content with 6 rats in each group.Results Western blot results showed thatthe TRPV4 expression in the model+RR group was weaker than that in the model group,but it was still stronger than that in the sham operation group.After lumbar rotatory manipulationtreat ing,the nitrite content in the model groupon the 9th and 21st day after operation was 9.17 and 5.31,which was lower than14.36 and 9.45of the model+RR group andwas higher than 6.23 and 3.84 of the sham operation group(all P<0.001).Conclusion The TRPV4/NO pathway is one of the important signal transduction pathways that regulate the sensitive state of nerve root pain.Lumbar rotatory manipulation can rapidly alleviate radicularpain,which may be achieved by regulating the TRPV4/NO pathway on DRG neurons.

关 键 词：推拿 脊柱 神经根病 腰椎旋转手法 香草素受体4 一氧化氮 钌红 大鼠 Sprague Dawley 

分 类 号：R-332[医药卫生] R274