针刺四关穴联合加巴喷丁对NP患者的疗效及NLRP3/Caspase⁃1/IL⁃1β的影响  

Curative effect of acupuncture at Siguan Point combined with gabapentin on cancer neuro⁃pathic pain and its influence on NLRP3/Caspase⁃1/IL⁃1β

作　　者：何慧鑫[1] 刘智[1] 谢文秀 李维娜 周启 HE Huixin;LIU Zhi;XIE Wenxiu;LI Weina;ZHOU Qi(Department of Anesthesia and Surgery,the First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan,China,410007)

机构地区：[1]湖南中医药大学第一附属医院麻醉手术科,湖南长沙410007

出　　处：《分子诊断与治疗杂志》2025年第1期175-178,183,共5页Journal of Molecular Diagnostics and Therapy

基　　金：湖南省自然科学基金科卫联合项目(2023JJ60347);湖南省教育厅优秀青年项目(24B0371);湖南中医药大学校级课题项目(2020XJJJ048)。

摘　　要：目的探究针刺四关穴联合加巴喷丁对癌性神经病理性疼痛(NP)疗效及Nod样受体蛋白3(NLRP3)/半胱氨酸蛋白酶⁃1(Caspase⁃1)/白细胞介素(IL)⁃1β的影响。方法纳入2023年2月至2024年4月湖南中医药大学第一附属医院收治的癌性NP患者137例,依治疗差异分西药组(n=44)、针刺组(n=45)、联合组(n=48)。西药组行加巴喷丁治疗,针刺组行针刺四关穴治疗,联合组行加巴喷丁联合针刺四关穴治疗。比较三组疗效、不良反应,治疗前后疼痛症状、生活质量,血清疼痛介质及NLRP3/Caspase⁃1/IL⁃1β通路表达;比较联合组不同肿瘤类型患者血清NLRP3/Caspase⁃1/IL⁃1β通路表达。结果总有效率比较,联合组>针刺组>对照组(P<0.05);三组治疗后的癌症患者生活质量测定量表(QLQ⁃C30)、数字分级评分法(NRS)评分较治疗前均改善,且联合组改善更优(P<0.05);三组治疗后的前列腺素(PG)E2、内皮素⁃1(ET⁃1)、P物质(SP)较治疗前均降低,且联合组更低(P<0.05);三组治疗后的血清NLRP3 mRNA、Caspase⁃1 mRNA以及IL⁃1β较治疗前均降低,且联合组更低(P<0.05);治疗后,联合组不同肿瘤类型患者之间的血清NLRP3 mRNA、Caspase⁃1 mRNA以及IL⁃1β水平比较(P>0.05);三组不良反应情况比较,差异无统计学意义(P>0.05)。结论针刺四关穴联合加巴喷丁治疗可提升癌性NP疗效,缓解患者疼痛症状,其可能与抑制NLRP3/Caspase⁃1/IL⁃1β通路表达有关。Objective To explore the effect of acupuncture at Siguan Point combined with gabap⁃entin on NP cancer and the effect of NLRP3/Caspase⁃1/IL⁃1β.Methods A total of 137 patients with cancer⁃ous NP were admitted to our hospital from February 2023 to April 2024.They were divided into three groups based on treatment:the western medicine group(n=44),the acupuncture group(n=45)and the combined group(n=48).The western medicine group received with gabapentin,the acupuncture group received acu⁃puncture at the Siguan point,and the combined group received with gabapentin in combination with acupunc⁃ture at the Siguan point.The efficacy,adverse reactions,pain symptoms,quality of life,serum pain media⁃tors,and expression of the NLRP3/Caspase⁃1/IL⁃1βpathway before and after treatment were compared among the three groups.The expression of the NLRP3/Caspase⁃1/IL⁃1βpathway in different patients within the com⁃bined group was also compared.Results The total effective rate of the combined group was higher than that of the acupuncture group and the control group(c2=17.999,P<0.05).The QLQ⁃C30 and NRS scores of all three groups improved after treatment compared to before,with the combined group showing the most significant improvement(P<0.05).After treatment,levels of PGE2,ET⁃1,and SP were lower in all three groups compared to before,with the combined group having the lowest levels(P<0.05).Additionally,levels of NLRP3 mRNA,Caspase⁃1 mRNA,and IL⁃1βwere lower in all three groups after treatment,with the com⁃bined group showing the lowest levels(P<0.05).There were no significant differences in serum NLRP3 mRNA,Caspase⁃1 mRNA,and IL⁃1βlevels among tumor patients in the combined group(P>0.05).Further⁃more,there were no significant differences in adverse reactions(P>0.05).Conclusion Acupuncture at Siguan Point combined with gabapentin can enhance the efficacy of cancerous NP and alleviate symptoms in patients.This may be due to its ability to inhibit the expression of the NLRP3/Caspase⁃1/IL⁃1βp

关 键 词：针刺 加巴喷丁 Nod样受体蛋白3 半胱氨酸蛋白酶⁃1 白细胞介素⁃1β 癌性神经病理性疼痛 

分 类 号：R730.5[医药卫生—肿瘤] R614[医药卫生—临床医学]