化学性交感神经切除对肌筋膜激痛点炎症和肌卫星细胞成肌分化的影响  

Effects of chemical sympathectomy on inflammation of myofascial trigger points and myogenic differentiation of muscle satellite cells

作　　者：袁仕国 颜丽满[3] 武凯 徐明奎 李义凯 邹宇聪 YUAN Shiguo;YAN Liman;WU Kai;XU Mingkui;LI Yikai;ZOU Yucong(Academy of Orthopedics,Guangdong Province,the Third Affiliated Hospital of Southern Medical University,Guangzhou 510630,China;Department of Orthopedics,Hainan Province Hospital of Traditional Chinese Medicine,Haikou 570203,China)

机构地区：[1]南方医科大学第三附属医院,广东省骨科研究院,广州510630 [2]海南省中医院骨伤科,海口570203 [3]广州中医药大学第四临床医学院,广州510006

出　　处：《实用医学杂志》2020年第15期2059-2065,共7页The Journal of Practical Medicine

基　　金：海南省自然科学基金面上项目(编号:817340)。

摘　　要：目的探讨化学性交感神经切除(chemical sympathectomy,CS)对肌筋膜激痛点(myofascial trigger points,MTrPs)局部炎症和肌卫星细胞(muscle satellite cells,MuSC)成肌分化的影响,探索肌筋膜痛的病理机制和治疗新靶点。方法 8周龄雄性SD大鼠18只随机均分为A、B、C组,分别为空白对照、MTrPs造模、MTrPs造模+CS。检测和分析MTrPs局部白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、去甲肾上腺素(NE)、成肌分化抗原(MyoD)、肌细胞生成素(MyoG)、酪氨酸羟化酶(TH)和配对盒转录因子7(Pax7)等的表达,以及病理形态变化。结果 A组肌细胞呈规则多边形或长条形,无炎症细胞浸润;B组形成挛缩结节并萎缩,炎症细胞浸润,间隙增大且不等宽;C组肌细胞再生,呈大小不等的多边形或长条形,少量挛缩结节。IL-6、TNF-α的表达为B> C> A(P <0.05),而NE和TH均为B> A> C(P <0.05),MyoD、MyoG的表达分别以B、C组最高(P <0.05),Pax7为A> C> B(P <0.05)。结论 CS促进MTrPs肌细胞修复,减轻局部炎症,抑制交感神经过度活跃和高支配,可能抑制MuSC的过度激活和使成肌分化较温和进行而保护MuSC。Objective To investigate the effect of chemical sympathectomy(CS) on the local inflammation of myofascial trigger points(MTrPs) and muscle differentiation of muscle satellite cells(MuSC),and to explore the pathological mechanism and new targets for the treatment of myofascial pain syndrome.Methods Eighteen male SD rats of 8-week-old were randomly divided into groups A,B,and C equally,which were blank control,modeled with MTrPs and modeled with MTrPs+CS,respectively.Localized expression of interleukin 6(IL-6),tumor necrosis factor-α(TNF-α),noradrenaline(NE),myogenic differentiation antigen(MyoD),myogenin(MyoG),tyrosine hydroxylase(TH),paired box gene 7(Pax7) and pathological changes were detected and analyzed.Results The muscle cells in Group A were regular polygons or strips without infiltration of inflammatory cells,while in Group B the gaps were enlarged and unequal with contracture knots and atrophy and inflammatory cells infiltrated.Muscle cells in Group C were regenerated,showing different polygonal or long sizes with few contracture knots.The expressions of IL-6 and TNF-α were B> C> A(P <0.05),while NE and TH were B> A> C(P <0.05).The expressions of MyoD and MyoG were highest in Group B and Group C respectively.(P <0.05),Pax7 was A> C> B(P <0.05).Conclusion CS promoted the repairing of MTrPs myocytes,reduced local inflammation,inhibited sympathetic nerve overactivity and hyperinnervation,and protected MuSC by inhibiting MuSC over-activation and softening myoblast differentiation.

关 键 词：肌筋膜疼痛综合征 扳机点 交感神经 炎性因子 肌卫星细胞 

分 类 号：R685.4[医药卫生—骨科学]