基于PGE2/PKC/TRPV1信号通路研究热敏灸对膝骨性关节炎兔镇痛效应机制  

Analgesic Effect Mechanism of Heat-Sensitive Moxibustion forKnee Osteoarthritis in Rabbits Based on PGE2/PKC/TRPV1 Signaling Pathway

作　　者：付勇[1] 李琳慧 廖璐 喻文 张波[1] 黄仙保 黄辉[1] 罗淑瑜 熊俊[1] 章海凤[1] FU Yong;LI Linhui;LIAO Lu;YU Wen;ZHANG Bo;HUANG Xianbao;HUNG Hui;LUO Shuyu;XIONG Jun;ZHANG Haifeng(The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nangchang 330006,Jiangxi,China;The Graduate School of Jiangxi University of Traditional Chinese Medicine,Nangchang 330004,Jiangxi,China)

机构地区：[1]江西中医药大学附属医院,江西南昌330006 [2]江西中医药大学研究生院,江西南昌330004

出　　处：《辽宁中医杂志》2023年第1期178-182,I0006,共6页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81760889,81960901);江西省自然科学基金重点项目(20192ACBL20024)。

摘　　要：目的观察热敏灸对膝骨性关节炎(KOA)兔血清PGE2、背根神经节PKC、穴区皮肤TRPV1的影响,探讨其治疗KOA的作用机制。方法36只雄性普通级新西兰兔随机分为空白组(6只)、假手术组(6只)、造模组(24只)。采用木瓜蛋白酶溶液注射膝关节腔法造模15d,假手术组关节腔内注射等量的0.9%NaCl溶液。造模成功后,造模组随机分成模型组(6只),艾灸组(18只),艾灸组艾灸“犊鼻”穴,每日1次,每次40 min,共7 d,根据兔艾灸过程中温度变化分为热敏灸组(10只)和非热敏灸组(7只),空白组、假手术组、模型组不予干预措施。干预结束后,肉眼、光镜下观察膝关节滑膜形态学变化;ELISA法检测血清PGE2表达;Real-time PCR法检测各组兔背根神经节PKC mRNA、穴区皮肤TRPV1 mRNA的含量。结果(1)干预后模型组兔膝关节腔内有大量积液,滑膜增生肥厚,伴有血管增生及大量炎症细胞成团聚集;热敏灸及非热敏灸组关节腔内积液减少,滑膜异常增生改善。(2)与空白组比较,模型组血清PGE2含量明显上升(P<0.01);与模型组比较,热敏灸组、非热敏灸组血清PGE2含量下降,差异有统计学意义(均P<0.01);与非热敏灸组比较,热敏灸组血清PGE2含量下降,差异有统计学意义(P<0.05)。(3)与空白组比较,模型组背根神经节PKC mRNA、穴区皮肤TRPV1 mRNA含量升高,差异有统计学意义(均P<0.01);与模型组比较,热敏灸及非热敏灸组PKC、TRPV1 mRNA表达下降,差异有统计学意义(均P<0.01);与非热敏灸组比较,热敏灸组PKC、TRPV1 mRNA表达下降,差异有统计学意义(P<0.05)。结论热敏灸可抑制PGE2、PKC、TRPV1的高表达,从而抑制痛觉过敏,减轻KOA滑膜炎性反应,缓解关节损害,这可能是热敏灸治疗KOA的效应机制之一。Objective To observe the effect of heat-sensitive moxibustion on serum prostaglandin E2(PGE2),dorsal root ganglion protein kinase C(PKC)and transient receptor potential vanilloid(TRPV1)in skin of acupoint area in KOA rabbits,andexplore the mechanism of heat-sensitive moxibustion for KOA.Methods A total of 36 New Zealand male rabbits were randomly divided into a blank group(6 rabbits),a sham operation group(6 rabbits)and a model establishment group(24 rabbits).Papain solution was injected into the joint cavity for 15d,and 0.9%NaCl solution was injected into the joint cavity of the sham operation group.After successful modeling,rabbits in the model establishment group were randomly divided into model group(6rabbits)and moxibustion group(18 rabbits).In the moxibustion group,suspending moxibustion was applied at“Dubi(ST35)”,once a day,40 min for each time,totally for 7 days totally.According to the temperature changes,the rabbits in the moxibustion group were divided into a heat-sensitive moxibustion group(10 rabbits)and a non-heat-sensitive moxibustion group(7 rabbits).No intervention was given in the blank group,sham operation group or model group.After the intervention,the morphological changes of synovial membrane of knee joint were observed by macroscopy and light microscope.Serum nerve growth factor(NGF)was detected by ELISA.Real-time PCR was used to detect the content of PKC in the dorsal root ganglion and TRPV1 in the skin of acupoint area.Results(1)After modeling,in the model group,there was a large amount of effusion in the lumen of the knee joint,synovial hyperplasia and hypertrophy,accompanied by vascular hyperplasia and a large number of inflammatory cells.In heat-sensitive moxibustion and non-heat-sensitive moxibustion group,the effusion in the joint cavity was reduced and the synovial hyperplasia was improved.(2)Compared with that of the blank group,the serum PGE2 content in the model group increased significantly(P<0.01).Compared with that in the model group,the serum PGE2 content in non-heat-sens

关 键 词：热敏灸 膝骨性关节炎 前列腺素E2 蛋白激酶C 瞬时感受器电位香草酸受体1 

分 类 号：R-33[医药卫生]