运动改善动物坐骨神经损伤性疼痛的Meta分析  

Exercise improves pain induced by sciatic nerve injury in animal models:a Meta-analysis

作　　者：孙新政 陈晓可 王成浩 何辉 Sun Xinzheng;Chen Xiaoke;Wang Chenghao;He Hui(College of Human Sport Science,Beijing Sport University,Beijing 100084,China;China Institute of Sports and Health,Beijing Sport University,Beijing 100084,China)

机构地区：[1]北京体育大学运动人体科学学院,北京市100084 [2]北京体育大学中国运动与健康研究院,北京市100084

出　　处：《中国组织工程研究》2022年第2期321-328,共8页Chinese Journal of Tissue Engineering Research

基　　金：中央高校基本科研业务费专项资金资助课题(校2020036),项目负责人:何辉。

摘　　要：目的:药物治疗神经病理性疼痛的效果有限且不良反应多,而运动是治疗疼痛的一种较好的方式。文章系统性评价运动对大鼠、小鼠坐骨神经损伤诱发神经性疼痛的干预效果。方法:检索万方、中国知网、PubMed、Embase和Web of Science数据库,检索时限从各数据库建库起至2020年4月,收集跑台、游泳、转轮等运动对大鼠、小鼠坐骨神经损伤诱发疼痛影响的研究。由2位研究者按照纳入标准独立完成文献筛选、资料提取及SYRCLE动物实验偏倚风险评估工具进行方法学质量评价,运用RevMan 5.3和STATA 12.0分析软件进行统计分析。结果:共纳入12篇对照动物实验文献,运动组133只鼠,对照安静组135只鼠。Meta分析结果显示,运动能够显著提高大鼠、小鼠坐骨神经损伤后的机械痛阈值(SMD=0.84,95%CI:0.28-1.40,P=0.003);热痛阈值(SMD=1.54,95%CI:0.93-2.15,P<0.00001)。对坐骨神经损伤后的运动干预时长进行亚组分析,异质性显著降低,术后运动≤3周能显著提高机械痛阈值(SMD=1.04,95%CI:0.62-1.46,P<0.00001);术后运动≤4周能显著提高热痛阈值(SMD=1.93,95%CI:1.19-2.67,P<0.00001)。结论:运动能有效改善大鼠、小鼠坐骨神经损伤产生的机械痛敏和热痛敏。疼痛模型、运动开始时间、运动方式和种属不是影响运动改善疼痛效果的主要因素,而疼痛模型的痛觉敏化时长对运动镇痛效果有重要影响。OBJECTIVE: Drug therapies have limited effect on neuropathic pain and result in many side effects. Comparatively speaking, exercise is a good way to relieve pain. Here, we systematically evaluate the interventional effect of exercise on neuropathic pain induced by sciatic nerve injury in rats and mice. METHODS: WanFang, CNKI, PubMed, Embase and Web of Science databases were retrieved before April 2020. A series of studies regarding the effect of treadmill, swimming, wheel and other exercises on neuropathic pain induced by sciatic nerve injury in rats and mice were collected. According to the inclusion criteria, two researchers independently completed literature screening, data extraction and conducted methodological quality evaluation using SYRCLE’ s risk of bias tool for animal studies. RevMan 5.3 and STATA 12.0 analysis software were used for statistical analysis.RESULTS: A total of 12 literatures regarding controlled animal studies were included, and there were 133 rodents in the exercise group and 135 rodents in the sedentary group. Meta-analysis showed that exercise could significantly increase paw withdrawal mechanical threshold [standard mean difference(SMD)=0.84, 95% confidence interval(CI): 0.28-1.40, P=0.003] and paw withdrawal thermal latency(SMD=1.54, 95% CI: 0.93-2.15), P < 0.000 01) in rats and mice after sciatic nerve injury. Subgroup analyses were performed for duration of exercise, indicating a significant reduction in heterogeneity. Postoperative exercise duration ≤ 3 weeks could significantly elevate paw withdrawal mechanical threshold(SMD=1.04, 95% CI: 0.62-1.46, P < 0.000 01). Postoperative exercise duration ≤ 4 weeks could significantly improve paw withdrawal thermal latency(SMD=1.93, 95% CI:1.19-2.67, P < 0.000 01).CONCLUSION: Exercise can effectively improve mechanical and thermal hypersensitivity caused by sciatic nerve injury in rats and mice. Pain models, exercise start point, exercise forms, and species are not the main factors of exercise-induced hypoalgesia, while postoperative

关 键 词：疼痛模型 运动 坐骨神经损伤 神经性疼痛 机械痛阈值 热痛阈值 动物 

分 类 号：R559.9[医药卫生—血液循环系统疾病] R363[医药卫生—内科学]