基于“调神”腧穴配伍的电针通过激活奖赏改善慢性疼痛的机制研究  

Mechanism of Tiaoshen Electroacupuncture Promoting the Relief of Chronic Pain via Activating Reward

作　　者：魏夏利 舒晴 田峻[3] 杨亚南 Wei Xiali;Shu Qing;Tian Jun(Department of Critical Care Medicine,Henan Provincial People's Hospital,Zhengzhou 450003,China;College of Sports Medicine,Wuhan Sports University,Wuhan 430079,China;Department of Rehabilitation Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]河南省人民医院重症医学科,郑州450003 [2]武汉体育学院运动医学院,武汉430079 [3]武汉大学中南医院康复医学科,武汉430071 [4]武汉科技大学附属华润武钢总医院中医科,武汉430080

出　　处：《华中科技大学学报(医学版)》2024年第6期765-772,共8页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：湖北省自然科学基金面上项目(No.2022CFB192);武汉市中医药科研项目(No.WZ22Q05)。

摘　　要：目的对比观察在常规取穴的基础上联用具有“调神”效应的腧穴对慢性疼痛大鼠痛阈值的改善效应及奖赏行为的影响。方法将雄性Wistar大鼠随机分为正常组(n=6)、急性疼痛组(n=6)、慢性疼痛组(n=6)、常规电针组(n=6)、调神电针组(n=6)。应用完全弗氏佐剂(CFA)建立急性疼痛及慢性疼痛模型。常规电针组大鼠取穴“足三里”和“昆仑”,调神电针组大鼠在常规电针取穴基础上联用“百会”和“印堂”。观察各组大鼠的焦虑、抑郁及奖赏行为学表现,取材后对各组大鼠中脑腹侧被盖区(VTA)多巴胺(DA)神经元标志物酪氨酸羟化酶(TH)进行检测分析。结果CFA造模后大鼠痛阈值显著降低(P<0.05)。慢性疼痛组大鼠出现焦虑、抑郁样行为表现(均P<0.05)。急性疼痛组大鼠在疼痛缓解时伴随着奖赏激活,而慢性疼痛组大鼠则表现出奖赏抑制,其VTA区域的TH表达低于急性疼痛组(均P<0.05)。常规电针可上调慢性疼痛大鼠痛阈值、缓解负性情绪及奖赏抑制状态并上调TH的表达;相比于常规电针,调神电针对痛阈值、负性情绪、奖赏及TH具有更明显的调控作用(均P<0.05)。结论调神电针可促进常规电针对慢性疼痛的缓解效应,这一机制可能与激活奖赏有关。Objective To analyze the improvement of pain threshold and reward behavior of chronic pain rats by adding acupoints with Tiaoshen effect to conventional electroacupuncture.Methods Male Wistar rats were randomly divided into normal,acute pain,chronic pain,conventional electroacupuncture,and Tiaoshen electroacupuncture groups.Complete Freund's adjuvant(CFA)was used to establish the acute and chronic pain models.Acupoints of Zusanli and Kunlun were applied to the conventional electroacupuncture group rats.The acupoints of Baihui and Yintang were included in the Tiaoshen electroacupuncture group,in addition to the previously mentioned acupoints.The reward behavior of rats was observed in all groups except the normal group.Tyrosine hydroxylase(TH),a dopamine(DA)neuron marker in the ventral tegmental area(VTA)region of rats in each group,was detected and analyzed.Results The pain threshold was significantly reduced after CFA injection(P<0.05).The chronic pain group rats showed anxiety and depression-like behavior(all P<0.05).Pain relief was accompanied with reward activation in rats of acute pain group.In contrast,reward inhibition was accompanied in rats of chronic pain group,and the TH expression in the VTA region was lower than that in the acute pain group(all P<0.05).After conducting conventional electroacupuncture,the pain threshold was upregulated,the reward inhibition was relieved,and the expression of TH was upregulated in chronic pain rats.After conducting Tiaoshen electroacupuncture,the regulatory effects on pain threshold,negative emotions,reward,and TH expression were promoted when compared to conventional electroacupuncture(all P<0.05).Conclusion Tiaoshen electroacupuncture can promote the relieving effect of conventional electroacupuncture on chronic pain,the mechanism of which may be related to reward activation.

关 键 词：慢性疼痛 负性情绪 奖赏 电针 调神 

分 类 号：R245[医药卫生—针灸推拿学]