滞动针干预“激痛点”对肌筋膜疼痛综合征模型大鼠中枢镇痛的作用机制  

Mechanism of central analgesia in rats with myofascial pain syndrome by intervention of“trigger points”with stagnant moving needles

作　　者：赵丽萍[1,2] 陈艺箔 王雅倩 李之彤 张琪 苟波 Zhao Liping;Chen Yibo;Wang Yaqian;Li Zhitong;Zhang Qi;Gou Bo(Graduate Department,Xi’an Physical Education University,Xi’an 710068,Shaanxi Province,China;Brain Disease Hospital,Xi’an Hospital of Traditional Chinese Medicine,Xi’an 710068,Shaanxi Province,China;Key Laboratory of Sports Technology Analysis and Skill Assessment of General Administration of Sport,Xi’an Physical Education University,Xi’an 710068,Shaanxi Province,China;School of Sports and Health Sciences,Xi’an Physical Education University,Xi’an 710068,Shaanxi Province,China)

机构地区：[1]西安体育学院研究生部,陕西省西安市710068 [2]西安中医院脑病医院,陕西省西安市710068 [3]西安体育学院国家体育总局运动技术分析与技能评定重点实验室,陕西省西安市710068 [4]西安体育学院运动与健康科学学院,陕西省西安市710068

出　　处：《中国组织工程研究》2025年第17期3614-3623,共10页Chinese Journal of Tissue Engineering Research

基　　金：科技部重点研发项目课题(YFC2006903),项目名称:个人运动数据实时监测与健康评估,项目负责人:苟波。

摘　　要：背景:滞动针治疗肌筋膜疼痛综合征的镇痛效果显著,但镇痛机制尚不明确。目的:探索滞动针干预激痛点缓解肌筋膜疼痛综合征疼痛的作用机制。方法:按照随机数字表法将54只SD大鼠随机分为空白组(n=16)和造模组(n=38),造模组采用“打击结合离心运动”方式制备左侧股内侧肌筋膜疼痛综合征模型,造模12周后随机挑选6只验证造模成功,将剩余32只造模大鼠随机分为模型组(n=16)与滞动针组(n=16),使用滞动针对滞动针组大鼠左侧股内侧肌局部激痛点进行干预治疗,2次/周,治疗4周。造模前后及治疗后进行左足机械缩足阈值测定;治疗后第4周,苏木精-伊红染色观察大鼠左侧股内侧肌肌肉组织形态学变化,ELISA法检测血清和中脑导水管周围灰质中P物质、β-内啡肽水平,免疫组化检测中脑导水管周围灰质中小胶质细胞标志物(Iba-1)和c-fos阳性表达,Western Blot检测中脑导水管周围灰质脑源性神经营养因子蛋白表达。结果与结论:①与空白组比较,造模后模型组、滞动针组大鼠机械缩足阈值降低(P<0.05);治疗4周后,滞动针组大鼠机械缩足阈值高于模型组(P<0.05);②苏木精-伊红染色结果显示,模型组肌纤维排列紊乱、粗细不等,肌细胞增大并出现核内移现象,细胞内出现圆形挛缩结节以及紧张带;滞动针组肌纤维排列整齐,肌细胞多呈角状,细胞内偶见挛缩结节;③与空白组比较,模型组血清中P物质水平升高(P<0.05),血清中β-内啡肽及脑中P物质、β-内啡肽水平均降低(P<0.05);与模型组比较,滞动针组血清中P物质水平降低(P<0.05),血清中β-内啡肽及脑中P物质、β-内啡肽水平均升高(P<0.05);④与空白组比较,模型组c-fos、Iba-1阳性表达及脑源性神经营养因子蛋白均升高(P<0.05);与模型组比较,滞动针组c-fos阳性表达升高(P<0.05),Iba-1阳性表达及脑源性神经营养因子蛋白均降低(P<0.05);(5)结果表明,滞动针可�BACKGROUND:The analgesic effect of stagnant moving needle on myofascial pain syndrome is remarkable,but the analgesic mechanism is still unclear.OBJECTIVE:To investigate the analgesic mechanism of stagnant moving needle acupuncture in the treatment of myofascial pain syndrome.METHODS:Fifty-four SD rats were randomly divided into a blank group(n=16)and a modeling group(n=38).The models of left myofascial pain syndrome in the modeling group were prepared by using the method of“striking combined with centrifugal movement”.Twelve weeks after modeling,six mice were randomly selected to verify the success of the modeling.The rest of the 32 rats were randomly divided into the model group and the stagnant moving needle group,with 16 rats in each group.The stagnant needle moving group was treated by stagnant moving needle into the local excitation point nodule of the left medial vastus muscle fascia in rats,twice a week,for 4 weeks.The mechanical foot contraction reflex threshold of the left foot were measured weekly in the pre/post modeling and post-intervention groups of rats.At 4 weeks after treatment,hematoxylin-eosin staining was used to observe the morphological changes in the muscle tissue of the left medial femoral muscle of rats,ELISA was used to detect the levels of substance P andβ-endorphin in the serum and the gray matter around the midbrain aqueduct.Immunohistochemistry was used to detect positive expression of microglia markers(Iba-1)and c-fos in the gray matter around the midbrain aqueduct.Western blot assay was used to detect the expression level of brain-derived neurotrophic factor protein in the periaqueductal gray.RESULTS AND CONCLUSION:Compared with the blank group,the mechanical pain threshold of the rats in the model group and the stagnant moving needle group decreased after modeling(P<0.05).After 4 weeks of treatment,the mechanical pain threshold of the rats in the stagnant moving needle group was higher than that in the model group(P<0.05).Hematoxylin-eosin staining results showed that in the

关 键 词：肌筋膜疼痛综合征 激痛点 滞动针 中枢镇痛 脑源性神经营养因子 中脑导水管周围灰质 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学] R259