合谷穴位埋线对大鼠分娩的镇痛作用及机制研究  

Analgesic effects and mechanisms of Hegu acupoint catgut embedding in a rat model of labor

作　　者：张子敬 黄敏丽 代鸿飞 李嘉欣 林祖恩 孙凤 庞瑞萍 吴玲玲[1] ZHANG Zijing;HUANG Minli;DAI Hongfei;LI Jiaxin;LIN Zuen;SUN Feng;PANG Ruiping;WU Lingling(Obstetrics Department of the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Pain Re-search Center and Department of Physiology,Zhongshan School of Medicine,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第三医院产科,广东广州510630 [2]中山大学中山医学院生理学教研室,中山大学疼痛研究中心,广东广州510080

出　　处：《中国病理生理杂志》2024年第10期1943-1949,共7页Chinese Journal of Pathophysiology

基　　金：广州市科技计划市校(院)联合资助项目(No.SL2022A03J00387)。

摘　　要：目的:观察合谷穴位埋线在大鼠分娩模型中的镇痛效果,并探究其对合谷穴局部降钙素基因相关肽信号(calcitonin gene-related peptide,CGRP)等生物标志物的影响。方法:将36只孕鼠随机分为对照组、合谷针刺组和合谷埋线组。在引产前、分娩启动前、分娩启动时及半产程时,采用热水甩尾法和热刺激缩足反应潜伏期测定法评估痛阈变化。半产程时采集合谷穴局部组织,通过免疫荧光技术检测CGRP、P物质(substance P,SP)和肥大细胞的表达情况,采用ELISA方法测定ATP和腺苷的浓度。结果:引产前,三组的热水甩尾时间、热刺激缩足反应潜伏期差异无统计学意义(P>0.05);分娩启动前,针刺组和埋线组的热水甩尾时间、热刺激缩足反应潜伏期均明显高于对照组(P<0.05);分娩启动时和半产程时,埋线组的热水甩尾时间、热刺激缩足反应潜伏期均明显高于对照组和针刺组(P<0.05)。半产程时CGRP、SP、肥大细胞表达、ATP和腺苷浓度显著高于对照组和针刺组(P<0.05),并且CGRP、SP与肥大细胞呈共表达现象。结论:合谷穴位埋线可有效缓解分娩疼痛。其机制可能与局部CGRP和SP的表达增加,促进肥大细胞脱颗粒,释放ATP并转化为腺苷有关。AIM:This study aimed to observe the analgesic effects of Hegu acupoint catgut embedding in a rat model of labor and investigate its influence on biomarkers such as calcitonin gene-related peptide(CGRP)signals at the Hegu acupoint.METHODS:Thirty-six pregnant rats were randomly divided into three groups:control group,Hegu acupuncture group,and Hegu catgut embedding group.Pain threshold changes were assessed using the tail immersion test and paw withdrawal thermal latency at four time points:pre-induction,before the onset of labor,at the onset of labor,and at the mid-stage of labor.Tissue samples from the Hegu acupoint were collected at the mid-stage of labor to detect the expression of CGRP,substance P(SP),and mast cells using immunofluorescence.The concentrations of ATP and adenosine were measured using ELISA.RESULTS:Before labor induction,there was no significant difference in tail immersion test and paw withdrawal thermal latency among the three groups(P>0.05).Before the onset of labor,both the acupuncture and catgut embedding groups exhibited significantly higher tail-flick times and paw withdrawal latencies compared to the control group(P<0.05).At labor initiation and mid-labor,the catgut embedding group had significantly higher tail-flick times and paw withdrawal latencies compared to both the control and acupuncture groups(P<0.05).During mid-labor,the expression of CGRP,SP,mast cells,ATP,and adenosine concentrations in the catgut embedding group was significantly higher than that in the control and acupuncture groups(P<0.05),with co-expression of CGRP,SP,and mast cells observed.CONCLUSION:Hegu acupoint catgut embedding effectively alleviates labor pain,and its mechanism may involve increased local expression of CGRP and SP,promoting mast cell degranulation,and increasing ATP release and its conversion to adenosine.

关 键 词：合谷 穴位埋线 分娩镇痛 降钙素基因相关肽 P物质 肥大细胞脱颗粒 

分 类 号：R714.3[医药卫生—妇产科学] R441.1[医药卫生—临床医学] R245.9