“三法三穴”推拿手法干预早期对Minor CCI模型大鼠脊髓背角IL-17A/RA、C/EBPβ信号通路影响的研究  

The effect of‘three methods and three points’massage intervention on IL-17A/RA and C/EBPβsignaling pathways in the spinal dorsal horn of Minor CCI model rats in the early stage

作　　者：陈金平 刘志凤 于天源[1] 王厚融 张英琦 杨震杰 萨出拉 官乾 徐亚静 张润龙 张汉钰 刘家玥 孙佳伟 CHEN Jinping;LIU Zhifeng;YU Tianyuan;WANG Hourong;ZHANG Yingqi;Yang Zhenjie;SA Chula;GUAN Qian;XU Yajing;ZHANG Runlong;ZHANG Hanyu;LIU Jiayue;SUN Jiawei(School of Acupuncture and Tuina,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学针灸推拿学院,100029 [2]北京中医药大学东直门医院推拿疼痛科 [3]北京医院针灸按摩科

出　　处：《环球中医药》2024年第3期401-406,共6页Global Traditional Chinese Medicine

基　　金：国家自然科学基金(82074573,82274675);北京市自然科学基金(7232278)。

摘　　要：目的 通过观察“三法三穴”推拿手法干预早期对轻度坐骨神经慢性压迫性损伤(Minor chronic compression injury of sciatic nerve, Minor CCI)模型大鼠脊髓背角中白介素-17A(interleukin-17A,IL-17A)、白介素-17A受体(interleukin-17A receptor, IL-17RA)、转录因子CCAAT增强子结合蛋白β(transcription factor CCAAT/enhancer binding protein β, C/EBPβ)表达的影响,明确推拿对周围神经病理性疼痛(peripherally neuropathic pain, pNP)的即刻镇痛机制。方法 SD大鼠随机分为假手术组、模型组、推拿组,8只/组,模型组、推拿组复制Minor CCI模型。使用按摩推拿手法模拟仪模拟点法、拨法、揉法,对推拿组大鼠患侧殷门、承山、阳陵泉进行定时、定性、定量干预1次,通过机械缩足反射阈值(paw mechanical withdraw threshold, PMWT)与冷敏阈值(cold sensitivity threshold, CST)评价干预后即刻对大鼠机械痛觉、温度觉敏化情况变化;通过蛋白免疫印迹法(Western Bolt, WB)检测脊髓背角中IL-17A、C/EBPβ表达;通过荧光定量聚合酶链式反应(real time-polymerase chain reaction, RT-PCR)检测脊髓背角中IL-17A、IL-17RA、C/EBPβ表达。结果 与假手术组、模型组相比,推拿干预1次后可提高Minor CCI模型大鼠PMWT与CST(P<0.01);WB结果显示,与模型组相比,推拿可降低IL-17A、C/EBPβ在脊髓背角中蛋白的表达(P<0.05);RT-PCR结果显示,与模型组相比,推拿可降低IL-17A、IL-17RA、C/EBPβ在脊髓背角中mRNA的表达(P<0.05)。结论 推拿干预1次后,可通过抑制脊髓背角中IL-17A、IL-17RA、C/EBPβ信号通路的表达,改善机械痛觉及冷刺激敏化情况,从而实现即刻镇痛的作用。Objective To observe the effect of“three methods and three points”massage on the expression of interleukin-17A(IL-17A),interleukin 17A receptor(IL-17RA)and transcription factor CCAAT/enhancer binding proteinβ(C/EBPβ)in the spinal dorsal horn of Minor chronic compression injury of sciatic nerve,(Minor CCI)model rats in the early stage.To clarify the immediate analgesic mechanism of tuina on peripheral neuropathic pain(pNP).Methods SD rats were randomly divided into sham operation group,model group and tuina group(n=8).Minor CCI model was reproduced in the model group and the tuina group.A massage manipulation simulator was used to simulate the point method,plucking method and rubbing method,and the rats in the tuina group were given regular,qualitative and quantitative intervention at Yinmen,Chengshan and Yanglingquan on the affected side for 1 time.The mechanical paw withdrawal threshold(PMWT)and the number of cold induced foot lifting were used to evaluate the changes in sensitisation of mechanical nociception and temperature perception in rats immediately after intervention.The expression of IL-17A and C/EBPβin the spinal dorsal horn was detected by Western blot(WB).The expression of IL-17A,IL-17RA and C/EBPβin the spinal dorsal horn was detected by real-time polymerase chain reaction(RT-PCR).Results Compared with the sham operation group and the model group,the PMWT and CST of the Minor CCI model rats was increased after one intervention of tuina(P<0.01).The results of WB showed that compared with the model group,tuina had significantly reduced the protein expression of IL-17A and C/EBPβin the spinal dorsal horn(P<0.05).The results of RT-PCR showed that compared with the model group,tuina could reduce the expression of IL-17A,IL-17RA and C/EBPβmRNA in the spinal dorsal horn(P<0.05).Conclusion Tuina can inhibit the expression of IL-17A,IL-17RA and C/EBPβsignaling pathways in the spinal dorsal horn,improve mechanical pain sensation and cold stimulation sensitization,and achieve immediate analgesia.

关 键 词：推拿 周围神经病理性疼痛 脊髓背角 白介素-17A 白介素-17A受体 转录因子CCAAT增强子结合蛋白β 

分 类 号：R285.5[医药卫生—中药学]