不同部位按法对慢性疼痛激痛点大鼠模型的影响
Effects of different site pressing on local myofascial trigger points in chronic pain model rats
- 北京中医药大学学报 2023年46卷第7期 页码：1008-1019
- 作者机构：
1.广西中医药大学针灸推拿学院 南宁 530001
2.湖南中医药大学针灸推拿与康复学院
- 作者简介：
蒋全睿，男，博士
# 李武，男，博士，副教授，硕士生导师，主要研究方向：推拿手法治病机制研究，E-mail: 272434694@qq.com
- 基金信息：国家自然科学基金项目(81973975;82174526;82274676);湖南省科技创新计划项目(2022RC1221)
DOI：10.3969/j.issn.1006-2157.2023.07.020
中图分类号： R244.13纸质出版日期：2023-07-30，
网络出版日期：2023-05-26，
收稿日期：2023-02-02，
- 稿件说明：
移动端阅览
蒋全睿, 刘丹, 潘杰灵, 等. 不同部位按法对慢性疼痛激痛点大鼠模型的影响[J]. 北京中医药大学学报, 2023,46(7):1008-1019.
JIANG Quanrui, LIU Dan, PAN Jieling, et al. Effects of different site pressing on local myofascial trigger points in chronic pain model rats[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(7):1008-1019.
蒋全睿, 刘丹, 潘杰灵, 等. 不同部位按法对慢性疼痛激痛点大鼠模型的影响[J]. 北京中医药大学学报, 2023,46(7):1008-1019. DOI： 10.3969/j.issn.1006-2157.2023.07.020.
JIANG Quanrui, LIU Dan, PAN Jieling, et al. Effects of different site pressing on local myofascial trigger points in chronic pain model rats[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(7):1008-1019. DOI： 10.3969/j.issn.1006-2157.2023.07.020.
摘要
目的
2
观察局部按法、对侧按法和远端按法刺激对慢性疼痛激痛点大鼠模型局部的影响。
方法
2
将SPF级雄性SD大鼠随意分为空白组10只和造模组50只，以钝性击打结合离心运动法在大鼠左侧大腿内侧肌建立激痛点模型，造模成功后，符合评价标准大鼠随机数字表法分为模型组、局部按法组、对侧按法组和远端按法组，每组10只。空白组、模型组不予干预，其余各组分别以自制按法刺激器干预14 d，局部按法组以按法刺激激痛点局部，对侧按法组以按法刺激激痛点对侧肢体，远端按法组以按法刺激激痛点同侧“太溪”区域。以电生理仪器记录激痛点局部肌电图，以软组织张力测定器检测激痛点软组织张力，以压痛测试仪检测激痛点机械痛阈值。干预结束后取左侧大腿内侧肌或激痛点组织，HE染色观察病理形态，免疫组化和酶联免疫吸附测定检测P物质和降钙素基因相关肽(CGRP)含量。
结果
2
与空白组相比较，模型组机械痛阈值降低，软组织张力升高，自发电活动明显，形态学有明显改变，P物质和CGRP含量增加(
P
<
0.05)；与模型组相比较，局部按法组、对侧按法组和远端按法组机械痛阈值提高，软组织张力、自发电位频率和振幅、P物质和CGRP含量降低(
P
<
0.05)，其中，局部按法组变化幅度最大(
P
<
0.05)且对形态学改善作用明显，对侧按法组对肌电图、CGRP和P物质的改善作用优于远端按法组(
P
<
0.05)。
结论
2
局部按法、对侧肢体按法和远端“太溪”按法刺激均可以缓解激痛点疼痛，降低软组织张力和自发电活动，可能与抑制P物质和CGRP的高表达有关；激痛点局部按法的作用最佳，对侧按法次之，最后是远端“太溪”区域按法。
Abstract
Objective
2
We aimed to investigate the differences in the effects of local pressing
contralateral pressing
and distal pressing stimulation on the local myofascial trigger points (MTrPs) in chronic pain model rats.
Methods
2
SPF-grade male Sprague-Dawley rats were randomly divided into the blank group (
n
=10) and the MTrPs group(
n
=50) in which the MTrPs model was established. The MTrPs model was established in the left medial thigh muscle of rats by blunt strikes combined with centrifugal exercise. Rats that met the evaluation criteria after modeling were randomly divided into the model group
the local pressing group
the contralateral pressing group
and the distal pressing group(
n
=10). Rats in the blank group and the model group did not undergo intervention
and the remaining groups were treated with homemade pressing stimulators for 14 days. The rats in the local pressing group
the contralateral pressing group
and the distal pressing group were subjected to pressing stimulation at their respective sites. Specifically
they received pressing stimulation locally on the MTrPs
on the contralateral limb of the MTrPs site
and at the ipsilateral KI3 area of the MTrPs
respectively. The electromyogram (EMG) was recorded and soft tissue tension and the mechanical pain threshold were detected by electrophysiological instruments
a soft tissue tension tester
and a pressure painmeter
respectively. At the end of the intervention
tissues from the left medial thigh muscle or MTrPs were taken to observe the pathological morphology using HE staining. In addition
SP and CGRP contents were measured using immunohistochemistry and ELISA.
Results
2
Compared with the blank group
the model group had a lower mechanical pain threshold
higher soft tissue tension
obvious spontaneous electrical activity
significant pathological changes
and increased SP and CGRP levels (
P
<
0.05). Compared with the model group
the local pressing group
the contralateral pressing group
and the distal pressing group showed an increased mechanical pain threshold and decreased soft tissue tension
a lower spontaneous potential frequency amplitude
and lower SP and CGRP levels (
P
<
0.05)
with the local pressing group showing the greatest improvement (
P
<
0.05) and significant recovery on morphological analysis. The contralateral pressing group showed a better improvement in EMG
CGRP
and SP than the distal pressing group (
P
<
0.05).
Conclusion
2
Local pressing
contralateral limb pressing
and distal pressing at KI3 can relieve the pain of MTrPs
reduce soft tissue tension
and decrease spontaneous electrical activity
possibly by reducing the expression of SP and CGRP. Local pressing on MTrPs showed the best efficacy
followed by contralateral pressing and then distal pressing at KI3.
关键词
激痛点局部按法对侧按法远端按法太溪大鼠
Keywords
myofascial trigger pointslocal pressingcontralateral pressingdistal pressingKI3rats
references
FERNÁNDEZ-DE-LAS-PEÑAS C, DOMMERHOLT J. International Consensus on Diagnostic Criteria and Clinical Considerations of Myofascial Trigger Points: A Delphi Study[J]. Pain Med, 2018，19(1):142-150.
王列，马帅，马铁明，等. 激痛点与阿是穴、压痛点、腧穴、经筋点、结筋病灶点辨析[J]. 中西医结合研究，2021，13(6):415-417.
李武，蒋全睿，危威，等. “按之则热气至”理论的临床应用探析[J]. 辽宁中医杂志，2020，47(2):83-85.
徐安乐，黄强民，嵇丽娟，等. 缺血性按压治疗肌筋膜疼痛综合征的研究现状[J]. 按摩与康复医学，2018，9(16):89-93.
JIANG QR, FENG X, LIU D, et al. Pressing Intervention Promotes the Skeletal Muscle Repair of Traumatic Myofascial Trigger Points in Rats[J]. J Pain Res, 2021，14:3267-3278.
杨望，罗红燕，吴小平，等. 《针灸大成》太溪穴临床应用规律探析[J]. 中国医学创新，2020，17(35):147-151.
ABOODARDA SJ, SPENCE AJ, BUTTON DC. Pain pressure threshold of a muscle tender spot increases following local and non-local rolling massage[J/OL]. BMC Musculoskelet Disord, 2015，16:265[2023-01-08]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4587678/.
KIM SJ, LEE JH. Effects of sternocleidomastoid muscle and suboccipital muscle soft tissue release on muscle hardness and pressure pain of the sternocleidomastoid muscle and upper trapezius muscle in smartphone users with latent trigger points[J/OL]. Medicine (Baltimore), 2018, 97(36):e12133[2023-01-08]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6133398/.
SHAH JP, DANOFF JV, DESAI MJ, et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points[J]. Arch Phys Med Rehabil, 2008，89(1):16-23.
ZHANG Y, DU NY, CHEN C, et al. Acupotomy Alleviates Energy Crisis at Rat Myofascial Trigger Points[J/OL]. Evid Based Complement Alternat Med, 2020，2020:5129562[2023-01-08]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7064863/.
蒋全睿，吴琼，匡小霞，等. 按压对大鼠肌筋膜激痛点软组织张力的影响及其作用机制研究[J]. 中国疼痛医学杂志，2021，27(5):335-341.
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.
吕娇娇，黄强民，汤莉. 大鼠慢性肌筋膜疼痛触发点的电生理和病理组织学研究[J]. 中国运动医学杂志，2013，32(7):621-628.
中国针灸学会. 实验动物常用穴位名称与定位 第2部分：大鼠[J]. 针刺研究，2021，46(4):351-352.
JIANG QR, LI W, LIU XW，et al.Effect of An-pressing manipulation on the serum levels of T-AOC and CK-MM in volunteers with delayed onset muscle orcness in biceps brachii[J].J Acupunct Tuina Sci，2018，16(2):89-95.
JIANG QR, LI JS, CHEN SH, et al. Orthogonal test on local temperature influenced by different parameters and manipulation types of An－pressing Xinshu (BL 15)[J]. J Acupunct Tuina Sci, 2019, 17(3): 147-154.
吴志伟，张帅攀，房敏，等. 论经筋病病因及调摄[J]. 辽宁中医杂志，2022，49(1):53-55.
李武，危威，葛云鹏，等. 颈项疼痛及功能障碍的经筋辨证与推拿治疗探析[J]. 中国中医药信息杂志，2021，28(3):111-113.
刘桂先. 拨按远端经穴结合肌肉能量技术治疗颈型颈椎病的临床观察[D]. 长沙：湖南中医药大学，2020.
高玉洁，乔海法，王强，等. 基于体表－体表相关探讨针刺远道取穴对经筋病的临床意义[J]. 中华中医药杂志，2022，37(10):5730-5734.
危威. 远端拨按手三阳经筋对颈型颈椎病患者颈部功能效应的临床观察[D]. 长沙：湖南中医药大学，2021.
李峥. 张士杰学术思想与临床经验总结及针刺太溪穴、曲泉穴治疗KOA的临床研究[D]. 北京：北京中医药大学，2011.
侯艺，付亚辉，于若愚，等. 基于数据挖掘缪刺法的临床应用研究[J]. 世界科学技术—中医药现代化，2021，23(3):924-930.
GROSMAN-RIMON L, PARKINSON W, UPADHYE S, et al. Circulating biomarkers in acute myofascial pain: A case-control study[J/OL]. Medicine (Baltimore), 2016, 95(37): e4650[2023-01-08]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402557/.
CHOMPUNUD NA AYUDHYA C, ROY S, THAPALIYA M, et al. Roles of a Mast Cell-Specific Receptor MRGPRX2 in Host Defense and Inflammation[J]. J Dent Res, 2020，99(8):882-890.
ALHOTRA R. Understanding migraine: Potential role of neurogenic inflammation[J]. Ann Indian Acad Neurol, 2016，19(2):175-182.
HIRSCH S, CORRADINI L, JUST S, et al. The CGRP receptor antagonist BIBN4096BS peripherally alleviates inflammatory pain in rats[J]. Pain, 2013，154(5):700-707.
DULIN JD, COYNE PJ, BOHM NM, et al. Fosaprepitant for the Management of Refractory Pain in a Patient with Cancer-Related Dermatomyositis[J].J Palliat Med, 2017，20(12):1415-1419.
ROSSI SG, DICKERSON IM, ROTUNDO RL. Localization of the calcitonin gene-related peptide receptor complex at the vertebrate neuromuscular junction and its role in regulating acetylcholinesterase epression[J]. J Biol Chem, 2003，278(27):24994-25000.
NEW HV, MUDGE AW. Calcitonin gene-related peptide regulates muscle acetylcholine receptor synthesis[J]. Nature, 1986，323(6091):809-811.
GAYDUKOV AE, BALEZINA OP. Ryanodine－ and CaMKII-dependent release of endogenous CGRP induces an increase in acetylcholine quantal size in neuromuscular junctions of mice[J/OL]. Brain Behav, 2018，8(8): e01058[2023-01-08]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6085904/.
0
浏览量
33
下载量
0
CSCD
- 网络PDF下载
- BibTeX下载
- Endnote下载
- RefMan 下载
- NoteExpress下载
- NoteFirst下载
关联资源
相关文章
相关作者
相关机构
- 地址：北京市朝阳区北三环东路11号 邮编：100029
- 联系电话：(010)53911857 Email：jbutcm@bucm.edu.cn
- 技术支持由北京北大方正电子有限公司提供 京ICP备09064830号-19
京公网安备11010802024621 - 本系统建议在Chrome、 IE9+ 以上版本浏览器阅读本站内容，360浏览器请切换至极速模式
- Cookies帮助我们提供服务并提供个性化体验。使用本网站，即表示您同意我们使用Cookies