基于啮齿类动物模型的推拿治疗神经病理性疼痛机制研究进展  

Research progress on the mechanism of tui na for neuropathic pain based on rodent model

作　　者：吴丽萍 唐宏亮 梁英业 王开龙 庞军 WU Liping;TANG Hongliang;LIANG Yingye;WANG Kailong;PANG Jun(The First Clinical College of Guangxi University of Traditional Chinese Medicine,Nanning 530200,China)

机构地区：[1]广西中医药大学第一临床医学院,南宁530200 [2]广西中医药大学附属防城港医院

出　　处：《环球中医药》2024年第3期558-564,共7页Global Traditional Chinese Medicine

基　　金：国家自然科学基金(82074574,82205305,82260976,82260961);2022年广西青年岐黄学者培养项目。

摘　　要：神经病理性疼痛(neuropathic pain,NP)的机制被认为是多因素的。近年大量研究发现,啮齿类动物模型是临床前NP较理想的模型,而推拿通过多种分子机制作用于NP的发展。本文基于慢性压迫性损伤和脊神经结扎的两种啮齿类动物模型,从推拿调节星形胶质细胞和M1型小胶质细胞,以减少神经炎症,抑制细胞外信号调节激酶和p38丝裂原活化蛋白激酶的激活,并减少Ca^(2+)离子通道的表达,从而降低损伤敏感神经元的过度兴奋性,以及抑制促炎症因子白细胞介素-1β/18/6和炎症介质囊泡谷氨酸转运蛋白2、NOD样受体蛋白3炎症小体、长链非编码RNA BANCR的分泌,减少伤害感受器三磷酸腺苷受体P2X3和压电型机械敏感离子通道组件2的表达,调节疼痛回路中γ-氨基丁酸能传递方面。笔者总结分析推拿在神经病理性疼痛中缓解神经炎症、抑制神经元凋亡、促进突触重塑的分子机制,以期为进一步临床应用及研究提供理论参考。The mechanism of neuropathic pain is considered to be multifactorial.In recent years,a large number of studies have found that the rodent model are promising models for preclinical neuropathic pain,and massage acts on the development of NP through a variety of molecular mechanism.Based on two rodent models of chronic compressive injury and spinal nerve ligation,this paper regulated astrocytes and M1 microglia from massage to reduce neuroinflammation,inhibit the activation of extracellular signal-regulated kinase and p38 mitogen-activated protein kinase,and reduced the expression of Ca^(2+) ion channels,thereby reducing the hyperexcitability of injury-sensitive neurons and inhibiting the secretion of pro-inflammatory factors interleukin-1β/18/6 and inflammatory mediators vesicle glutamate transporter 2,NOD-like receptor protein 3 inflammasome,long-chain non-coding RNA BANCR.Then,the expression of the nociceptor adenosine triphosphate receptor P2X3 and the piezoelectric mechanically sensitive ion channel component 2 were reduced,and the transmission ofγ-aminobutyric acid in the pain circuit were regulated.This paper summarized the molecular mechanism of tui na in alleviating neuroinflammation,inhibiting neuronal apoptosis and promoting synaptic remodeling in neuropathic pain,in order to provide theoretical references for further clinical application and research.

关 键 词：推拿 啮齿类动物模型 神经病理性疼痛 慢性压迫性损伤 脊神经结扎 痛觉超敏 研究进展 

分 类 号：R244.1[医药卫生—针灸推拿学]