浏览全部资源
扫码关注微信
1.中国中医科学院 中药研究所,北京 100700
2.江西中医药大学,南昌 330004
Published:20 December 2023,
Published Online:04 September 2023,
Received:17 May 2023,
扫 描 看 全 文
王潇潇,李群,胡智星等.恒古骨伤愈合剂对肌筋膜疼痛综合征大鼠的干预作用[J].中国实验方剂学杂志,2023,29(24):19-29.
WANG Xiaoxiao,LI Qun,HU Zhixing,et al.Intervention of Osteoking in Rats with Myofascial Pain Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(24):19-29.
王潇潇,李群,胡智星等.恒古骨伤愈合剂对肌筋膜疼痛综合征大鼠的干预作用[J].中国实验方剂学杂志,2023,29(24):19-29. DOI: 10.13422/j.cnki.syfjx.20231144.
WANG Xiaoxiao,LI Qun,HU Zhixing,et al.Intervention of Osteoking in Rats with Myofascial Pain Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(24):19-29. DOI: 10.13422/j.cnki.syfjx.20231144.
目的
2
明确恒古骨伤愈合剂对肌筋膜疼痛综合征(MPS)模型大鼠的干预作用,并从抗炎角度初步探索其缓解慢性疼痛的药理机制。
方法
2
60只SD大鼠设立分组,分别为正常组、模型组、恒古骨伤愈合剂低、中、高剂量组(0.66、1.31、2.63 mL·kg
-1
),塞来昔布组(21 mg·kg
-1
),通过打击结合离心运动法建立MPS大鼠模型,造模同时灌胃给予恒古骨伤愈合剂和塞来昔布,SMALGO爪压力测痛仪检测大鼠激痛点压痛阈值,Von-Frey针和丙酮刺激法分别检测足底机械痛敏阈值和冷痛敏刺激反应;模型8周和10周,肌电图仪测定激痛点自发放电状态及抽搐反应;CatWalk步态分析仪检测大鼠步态变化;酶联免疫吸附测定法检测血清及激痛点中P物质(SP)、缓激肽(BK)、白细胞介素-1
β
(IL-1
β
)、肿瘤坏死因子-
α
(TNF-
α
)的表达水平;蛋白免疫印迹法(Western blot)检测MPS大鼠激痛点中核转录因子-
κ
B(NF-
κ
B)抑制蛋白
α
(I
κ
B
α
)、磷酸化(p)-I
κ
B
α
、NF-
κ
B p65、p-NF-
κ
B p65的蛋白表达水平;免疫荧光法检测激痛点中p-NF-
κ
B p65的阳性表达情况。
结果
2
与正常组比较,模型组大鼠在8周和10周激痛点肌电信号和局部抽搐反应检测阳性率均为100%,激痛点压痛阈值、机械痛敏阈值明显降低,冷痛超敏反应评分明显升高,步态异常,血清和激动点IL-1
β
、TNF-
α
、SP、BK、p-I
κ
B
α
、p-NF-
κ
B p65蛋白表达水平和p-NF-
κ
B p65入核阳性表达强度均显著升高(
P
<
0.01);与模型组比较,恒古骨伤愈合剂中、高剂量组肌电信号检测和局部抽搐反应阳性率明显降低(
P
<
0.05),恒古骨伤愈合剂中、高剂量组压痛阈值、机械痛敏阈值明显升高,恒古骨伤愈合剂高剂量组冷痛超敏反应评分显著降低(
P
<
0.01),恒古骨伤愈合剂高剂量组站立时间、摇摆时间和步行周期明显升高,摇摆速度、最大接触面积、最大接触强度明显降低(
P
<
0.05),且恒古骨伤愈合剂中、高剂量组p-I
κ
B
α
/I
κ
B
α
、p-NF-
κ
B p65/NF-
κ
B p65蛋白表达水平均明显降低(
P
<
0.05,
P
<
0.01),恒古骨伤愈合剂高剂量组p-NF-
κ
B p65入核阳性表达强度显著降低(
P
<
0.01)。
结论
2
恒古骨伤愈合剂能有效缓解MPS的激痛点疼痛,改善步态,其机制与下调NF-
κ
B p65炎症信号通路降低血液和激痛点组织中炎症因子和疼痛介质的表达有关。
Objective
2
To clarify the intervention effect of Osteoking (OK) in rats with myofascial pain syndrome (MPS) and preliminarily explore the pharmacological mechanism of OK in relieving chronic pain from the perspective of anti-inflammatory disease.
Method
2
The 60 SD rats were divided into normal group, model group, low, medium, and high dose OK groups (0.66, 1.31, 2.63 mL·kg
-1
), and positive celecoxib group (21 mg·kg
-1
). The MPS rat model was established by beating combined with the centrifugal exercise method, and the OK and celecoxib were given at the same time. SMALGO paw pressure pain manometer detected the shock pain point tenderness threshold of rats, and the Von-Frey needle and acetone stimulation method detected the mechanical hyperalgesia threshold and cold hyperalgesia stimulation response respectively. Eight weeks and 10 weeks after modeling, the spontaneous discharge state and convulsion response of MPS rats were determined by electromyograph (EMG) instrument. The gait changes of MPS rats were detected using a CatWalk gait analyzer. The expression levels of interleukin-1
β
(IL-1
β
), tumor necrosis factor-
α
(TNF-
α
), substance P (SP), and bradykinin (BK) were measured by enzyme-linked immunosorbent assay (ELISA). The protein expression levels of nuclear transcription factor-
κ
B (NF-
κ
B) inhibiting protein
α
(I
κ
B
α
), phosphorylates (p)- I
κ
B
α
, NF-
κ
B p65, and p-NF-
κ
B p65 were detected in MPS rats by Western blot. The positive expression of p-NF-
κ
B p65 was detected by immunofluorescence.
Result
2
Compared with the normal group, the model group shows 100% positive rates for EMG signal and local convulsions response at both the 8th and 10th weeks. The tenderness threshold and mechanical hyperalgesia threshold are significantly reduced. Cold hyperalgesia score is significantly increased, and gait is abnormal. The expression levels of serum and trigger points IL-1
β
, TNF-
α
, SP, BK, p-I
κ
B
α
, and p-NF-
κ
B p65, as well as the positive expression intensity of p-NF-
κ
B p65 are significantly increased (
P
<
0.01). Compared with the model group, the positive rate of EMG detection and local convulsion response is significantly reduced in the medium and high dose OK groups (
P
<
0.05). The tenderness threshold and mechanical hyperalgesia threshold increase significantly in the medium and high dose OK groups, and the cold hyperalgesia score is significantly reduced in the high dose OK group (
P
<
0.01). The standing time, swing time, and walking period are significantly increased. The swing speed, maximum contact area, and maximum contact intensity are significantly decreased in the high dose OK group (
P
<
0.05). Moreover, the protein expression levels of p-I
κ
B
α
/I
κ
B
α
and p-NF-
κ
B p65/NF-
κ
B p65 are significantly reduced in the medium and high dose OK groups (
P
<
0.05,
P
<
0.01). The positive expression intensity of p-NF-
κ
B p65 is significantly decreased in the high dose OK group (
P
<
0.01).
Conclusion
2
The mechanism of OK in relieving the pain in trigger points of MPS and improving gait abnormalities is related to the downregulation of the NF-
κ
B p65 inflammatory signaling pathway to reduce the expression of inflammatory factors and pain mediators in blood and trigger point tissue.
肌筋膜疼痛综合征恒古骨伤愈合剂激痛点核转录因子-κB(NF-κB) p65
myofascial pain syndromeOsteokingtrigger pointnuclear transcription factor-κB (NF-κB) p65
沃春新,徐正涛,秦乐,等.体外冲击波治疗大鼠肌筋膜疼痛及其机制初探[J].中国疼痛医学杂志,2018,24(8):586-592.
JAFRI M S.Mechanisms of myofascial pain[J].Int Sch Res Notices,2014,doi:10.1155/2014/523924http://dx.doi.org/10.1155/2014/523924.
邹文静,程凌,徐杰,等.针刺触发点治疗肌筋膜疼痛综合征的临床研究进展[J].按摩与康复医学,2023,14(5):41-45.
葛开发,姚小强,郑先丽,等.肌筋膜激痛点注射疗法的研究进展[J].按摩与康复医学,2022,13(3):51-54.
苏晗,崔俊武,王晶晶,等.肌筋膜疼痛综合征的治疗研究进展[J].广西医学,2021,43(5):621-624.
袁鑫,武羽洁,角建林,等.彝药恒古骨伤愈合剂的药理作用和临床应用[J].中国现代应用药学,2019,36(3):372-376.
黄振星,杨少锋,郭彦涛,等.恒古骨伤愈合剂治疗瘀血阻络型腰椎间盘突出症的临床疗效[J].中国中医骨伤科杂志,2022,30(3):35-38.
中国老年保健协会.肌肉骨骼慢性疼痛诊治专家共识[J].骨科,2021,12(5):389-395.
朱华亮,周宗波,武旭刚,等.身痛逐瘀汤加减治疗瘀血阻滞型腰背肌筋膜疼痛综合征的临床观察[J].中国实验方剂学杂志,2019,25(9):49-54.
黄强民,敖丽娟,刘燕.肌筋膜触发点疼痛特征的要点分析[J].中国临床康复,2004,8(23):4822-4824.
吕娇娇.慢性肌筋膜触发点大鼠模型的电生理和病理组织学研究[D].上海:上海体育学院,2011.
庞博.肌筋膜触发点与肌质网钙离子稳态的关系探究[D].上海:上海体育学院,2020.
陈晨.针刀干预对股内侧肌触发点模型大鼠肌组织内SP、BK、CGRP表达的影响[D].北京:北京中医药大学,2018.
YALCIN I, BOHREN Y, WALTISPERJER E, et al. A time-dependent history of mood disorders in a murine model of neuropathic pain[J]. Biol Psychiatry, 2011,70(10):946-953.
BIBER K,TSUDA M,TOZAKI-SAITOH H,et al.Neuronal CCL21 up-regulates microglia P2X4 expression and initiates neuropathic pain development[J].EMBO J,2011,30(9):1864-1873.
LI D,LEE J H,CHOI C W,et al.The analgesic effect of venlafaxine and its mechanism on oxaliplatin-induced neuropathic pain in mice[J].Int J Mol Sci,2019,20(7):1652.
FLATTERS S J,BENNETT G J.Ethosuximide reverses paclitaxel- and vincristine-induced painful peripheral neuropathy[J].Pain,2004,109(1/2):150-161.
秦丽, 陈乐春, 林志刚, 等.CatWalk步态分析系统用于神经病理性疼痛模型大鼠的评估[J].世界最新医学信息文摘, 2019, 19(37): 217.
王鑫蕊,杨丽,徐榕雪.Catwalk步态分析法检测氧化苦参碱对神经病理性疼痛小鼠步态行为改善[J].辽宁中医药大学学报,2018,20(1):36-39.
HERNÁNDEZ-ORTÍZ A R,PONCE-LUCEÑO R,SÁEZ-SÁNCHEZ C,et al.Changes in muscle tone, function, and pain in the chronic hemiparetic shoulder after dry needling within or outside trigger points in stroke patients:A crossover randomized clinical trial[J].Pain Med,2020,21(11):2939-2947.
HONG C Z,SIMONS D G.Pathophysiologic and electrophysiologic mechanisms of myofascial trigger points[J].Arch Phys Med Rehabil,1998,79(7):863-872.
HUBBARD D R,BERKOFF G M.Myofascial trigger points show spontaneous needle EMG activity[J].Spine (Phila Pa 1976),1993,18(13):1803-1807.
SIMONS D G,HONG C Z,SIMONS L S.Endplate potentials are common to midfiber myofacial trigger points[J].Am J Phys Med Rehabil,2002,81(3):212-222.
陈祢,李超,王宝兰.肌筋膜疼痛综合征电诊断学研究进展[J].新疆医学,2016,46(10):1252-1255.
刘琳,黄强民,汤莉.肌筋膜疼痛触发点[J].中国组织工程研究,2014,18(46):7520-7527.
吕恒勇,李真,王月香,等.慢性肌筋膜激痛点大鼠模型的剪切波弹性模量研究[J].中国临床解剖学杂志,2017,35(1):57-61.
姚明华,黄强民.肌筋膜触发点疼痛的实验动物模型研究[J].中国运动医学杂志,2009,28(4):415-418.
韩蓓,黄强民,谭树生,等.大鼠肌筋膜疼痛触发点自发肌电现象和病理组织学研究[J].中国运动医学杂志,2011,30(6):532-535,531.
SAXENA A,CHANSORIA M,TOMAR G,et al.Myofascial pain syndrome:An overview[J].J Pain Palliat Care Pharmacother,2015,29(1):16-21.
唐荣军,张诗尧,全建林,等.基于病例浅析肌筋膜炎与肌筋膜疼痛综合征的异同[J].中国民间疗法,2019,27(18):2-4,16.
黎霞,李多多,程潞瑶,等.中西医治疗慢性腰痛临床研究的有效率定义及其判定标准存在差异:一项概况性评价[J].中国全科医学,2022,25(20):2534-2540.
CLARK S,HORTON R.Low back pain:A major global challenge[J].Lancet,2018,391(10137):2302.
周兆文,普有登,袁晓峰,等.恒古骨伤愈合剂治疗急性腰扭伤的疗效观察[J].云南医药,2012,33(5):435-436.
THEOHARIDES T C,SPANOS C,PANG X,et al.Stress-induced intracranial mast cell degranulation: A corticotropin-releasing hormone-mediated effect[J].Endocrinology,1995,136(12):5745-5750.
THEOHARIDES T C,TSILIONI I,BAWAZEER M.Mast cells, neuroinflammation and pain in fibromyalgia syndrome[J].Front Cell Neurosci,2019,13:353.
黎志伟,赖有平,邢首平,等.不同剂量右美托咪定复合罗哌卡因对胸科手术患者的镇痛作用及对其P物质和IL-6水平的影响[J].实用医药杂志,2017,34(5):411-413,416.
杨志军,黄佳洋,熊浪,等.氢吗啡酮联合地佐辛麻醉对胸膜炎患者术后镇痛效果及对炎症因子水平的影响[J].空军医学杂志,2019,35(3):246-249.
张义,张莉,郭长青,等.针刀干预对大鼠触发点肌组织P物质和缓激肽的影响[J].中华中医药杂志,2020,35(1):97-100.
TSILIONI I, RUSSELL I J,STEWART J M, et al.Neuropeptides CRH, SP, HK-1, and inflammatory cytokines IL-6 and TNF are increased in serum of patients with fibromyalgia syndrome, implicating mast cells[J].J Pharmacol Exp Ther,2016,356(3):664-672.
薛惠天,王兰兰,孙梦龙,等.云南白药气雾剂与推拿㨰法对兔骨骼肌损伤急性期核因子-κB信号通路及炎症因子变化的影响[J].上海中医药杂志,2023,57(3):80-86.
PABLOS A,CECA D,JORDA A,et al.Protective effects of foam rolling against inflammation and notexin induced muscle damage in rats[J].Int J Med Sci,2020,17(1):71-81.
覃清霞,何莲花,魏梅,等.蔓性千斤拔素D通过TLR2/MyD88/NF-κB信号通路调控CIA大鼠炎症反应的相关机制[J].中国实验方剂学杂志,2023,29(17):134-141.
刘毓东,马兆臣,李聪翀,等.昆仙胶囊通过矫正“免疫-炎症”失衡网络有效干预糖尿病肾病的潜能及其分子机制研究[J].药学学报,2022,57(2):375-384.
KONDYLIS V,KUMARI S,VLANTIS K,et al.The interplay of IKK, NF-κB and RIPK1 signaling in the regulation of cell death, tissue homeostasis and inflammation[J].Immunol Rev,2017,277(1):113-127.
0
Views
29
下载量
1
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution