电针干预远近端穴位对肌筋膜疼痛综合征模型大鼠致痛物质、巨噬细胞及相关炎症因子的影响  

Effect of Electroacupuncture at Proximal and Distal Acupoints on Pain-inducing Substances,Macrophages and Related Inflammatory Factors in Myofascial Pain Syndrome Model Rats

作　　者：刘阅阅 郑林遥 陈佳彦 黄于婷 方燕平 饶天予 刘科志 童秀冰 阚宇 景向红[2] 廖军[1] LIU Yueyue;ZHENG Linyao;CHEN Jiayan;HUANG Yuting;FANG Yanping;RAO Tianyu;LIU Kezhi;TONG Xiubing;KAN Yu;JING Xianghong;LIAO Jun(Fujian University of Traditional Chinese Medicine,Fujian,350122;Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences)

机构地区：[1]福建中医药大学,福建省福州市350122 [2]中国中医科学院针灸研究所

出　　处：《中医杂志》2023年第17期1799-1806,共8页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82074181,82204908);福建省自然科学基金项目(2022J01874);福建省教育厅中青年教师教育科研项目(JAT190232);福建中医药大学高层次人才项目(X20190010-人才);福建中医药大学针灸学科开放课题(XZJ2022004)。

摘　　要：目的探讨电针干预远近端穴位治疗肌筋膜疼痛综合征(MPS)的外周镇痛机制。方法将24只SD大鼠随机分为空白组、模型组、近端组、远端组,每组6只。除空白组外,其余各组采用“打击结合离心运动”方式制备MPS模型。造模后近端组大鼠在局部激痛点结节即阿是穴处进行电针干预,频率2/100 Hz、电压2~4 V的疏密波,电流强度以大鼠左下肢出现轻微颤动为宜,每日1次,每次15 min,连续14天。远端组大鼠电针阳陵泉穴加阴陵泉穴,余同近端组。空白组和模型组只做抓取和套头,不做其他干预。干预后测定左右足机械缩足反射阈值(PWMT),计算差值;进行左下肢股内侧肌肌骨超声影像学、肌电监测检测;HE染色法观察左下肢股内侧肌肌肉形态学变化;免疫组化法检测肌肉组织中P物质(SP)、降钙素基因相关肽(CGRP)、CD68、CD206的阳性表达;ELISA法检测腹主动脉血清中白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)、白细胞介素8(IL-8)的含量。结果与空白组相比,模型组大鼠左下肢股内侧肌肌纤维断裂、扭曲、纤维粗细不等,肌筋膜断裂,出现纤颤电位,肌细胞增大、核内移,肌间隙增宽,左右足PWMT差值明显增大,股内侧肌SP、CGRP、CD68、CD206水平明显升高(P<0.01),血清IL-8、TNF-α水平明显升高(P<0.05或P<0.01)。与模型组比较,近端组与远端组肌纤维形态完整,排列有序,肌筋膜连续无断裂,肌细胞形态规则,IL-8水平明显降低(P<0.01);近端组自发性放电幅度及频率降低,左右足PWMT差值显著降低,股内侧肌SP、CGRP、CD68水平明显降低,CD206水平明显升高(P<0.05或P<0.01);远端组出现复杂性放电,股内侧肌CD68水平下降,CD206水平升高(P<0.01)。与近端组相比,远端组IL-8水平明显升高(P<0.05)。结论电针近端穴位能显著改善大鼠痛阈和局部肌组织形态,其作用机制可能与降低致痛物质及相�Objective To explore the possible peripheral analgesic mechanism of electroacupuncture(EA)at promimal and distal acupoints in treatment of myofascial pain syndrome(MPS).Methods Twenty-four SD rats were randomly divided into blank group,model group,proximal group,and distal group,with six rats in each group.MPS model was prepared by“strike combined with centrifugal exercise”in all groups except for the blank group.After modeling,the rats in the proximal group received EA at the local myofascial trigger points(MTrPs),namely the Ashi points,with dilatational waves of frequency of 2/100 HZ and voltage of 2-4 V,current intensity depending on a slight trembling of the left lower limbs,once a day,15min each time,for 14 days.The rats in the distal group re⁃ceived EA at“Yanglingquan”(GB 34)and“Yinlingquan”(SP 9),with the same operations as the proximal group.The rats in the blank group and the model group were only grasped and hedged,without other interventions.After in⁃tervention,the paw withdrawl mechanical threshold(PWMT)was measured,and variability between the left and right hind paws was calculated.Musculoskeletal ultrasound imaging and electromyography monitoring were performed on the left lower extremity vastus medialis.The morphological changes of vastus medialis muscle of the left lower ex⁃tremity were observed by HE staining.The positive expression of substance P(SP),calcitonin gene-related peptide(CGRP),CD68 and CD206 in muscle tissue was detected by immunohistochemistry.Abdominal aortic serum inter⁃leukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleukin-10(IL-10),and interleu⁃kin-8(interleukin-8)were detected by ELISA.Results Compared to those in the blank group,the fibers of the vas⁃tus medial muscle of the rats in the model group were broken and distorted with thickness in variation,and the myofas⁃cia was broken,with fibrillation potential,enlarged muscle cells,inward moved nucleus,and widened muscle space;the variability of PWMT between the left and righ

关 键 词：肌筋膜疼痛综合征 激痛点 电针 近端穴位 远端穴位 P物质 降钙素基因相关肽 巨噬细胞 炎症因子 

分 类 号：R245[医药卫生—针灸推拿学]