新斯的明经穴位注射对大鼠关节疼痛的镇痛作用及机制研究
Analgesic Efficacy and Mechanism of Acupoint Injection of Neostigmine in a Rat Model of Joint Pain

作者: 张 淼 , 张旭然 :阜新市中心医院骨三科,辽宁 阜新 ;

关键词: 新斯的明穴位注射关节疼痛镇痛Neostigmine Acupoint Injection Joint Pain Analgesia

摘要:
目的:新斯的明可经关节腔注射发挥外周镇痛作用,但关节注射存在技术难度和并发症风险。本研究目的为制备大鼠关节疼痛动物模型,经穴位注射新斯的明,分析镇痛效果及作用机制,为新斯的明外周注射治疗关节疼痛的临床应用提供临床前研究依据。方法:采用雄性Wistar大鼠经踝关节注射单碘醋酸钠生理盐水溶液制备关节疼痛模型,经行为学观察及痛阈测量确认模型制备成功。实验组经后三里穴位注射新斯的明,对照组注射等体积生理盐水。注射后测量两组实验动物舔足次数和热辐射痛阈,取血清样本测量前炎症因子白介素1-1β (IL-1β)和肿瘤坏死因子-α (TNF-α)水平。结果:与对照组相比,实验组动物经穴位新斯的明注射后的舔足次数减少,热辐射痛阈提高,血清IL-1β和TNF-α水平降低,两组间上述指标结果差异具有统计学意义(p < 0.01)。结论:研究表明经穴位于关节周围注射新斯的明,可提高关节疼痛实验动物热辐射痛阈,降低体内前炎症因子表达水平,产生镇痛作用。

Abstract: Objective: Neostigmine could provide peripheral analgesic effects via intra-articular injection, but with obvious technical difficulty and potential complications. The purpose of this study is to inves-tigate the analgesic effect and mechanism of acupoint injection of neostigmine in a rat model of joint pain. Methods: Animal models of ankle joint pain were prepared via intra-articular injection of monosodium iodoacetate in male Wistar rats. The experimental group received acupoint injection of neostigmine while the control group received acupoint injection of normal saline. The numbers of hind paw licking and radiation pain threshold were recorded, and serum IL-1β and TNF-α were measured using ELISA. Results: Compared with the control group, the animals in the experimental group presented less hind paw licking, higher radiation threshold and lower levels of serum IL-1β and TNF-α (p < 0.01). Conclusion: Acupoint injection of neostigmine elevated the radiation pain threshold and lowered the level of proinflammatory pain mediators, providing effective analgesia in the rat model of joint pain.

文章引用: 张 淼 , 张旭然 (2016) 新斯的明经穴位注射对大鼠关节疼痛的镇痛作用及机制研究。 中医学, 5, 12-18. doi: 10.12677/TCM.2016.51003

参考文献

[1] Maheshwari, A.V., Blum, Y.C., Shekhar, L., et al. (2009) Multimodal Pain Management after Total Hip and Knee Arthroplasty at the Ranawat Orthopaedic Center. Clinical Orthopaedics and Related Research, 467, 1418-1423.
http://dx.doi.org/10.1007/s11999-009-0728-7

[2] Zhang, M., Zhang, X.R. and Sun, Y. (2015) Articular Injection of Opioids for Postoperative Pain Management of Knee Arthroplasty: Current Status and Progress. Chinese Journal of Tissue Engineering Research, 19, 6037-6041.

[3] Richmond, C.E., Bromley, L.M. and Woolf, C.J. (1993) Preopera-tive Morphine Pre-Empts Postoperative Pain. Lancet, 342, 73-75.
http://dx.doi.org/10.1016/0140-6736(93)91284-S

[4] Naguib, M. and Yaksh, T.L. (1997) Characterization of Muscarinic Receptor Subtypes That Mediate Antinociception in the Rat Spinal Cord. Anesthesia and Analgesia, 85, 847-853.

[5] Lauretti, G.R., Reis, M.P., Prado, W.A. and Klamt, J.G. (1996) Dose-Response Study of Intrathecal Morphine versus Intrathecal Neostigmine, Their Combination, or Placebo for Postoperative Analgesia in Patients Un-dergoing Anterior and Posterior Vaginoplasty. Anesthesia and Analgesia, 82, 1182-1187.

[6] Yang, L.C., Chen, L.M., Wang, C.J. and Buerkle, H. (1998) Postoperative Analgesia by Intra-Articular Neostigmine in Patients Undergoing Knee Arthroscopy. Anesthesiology, 88, 334-339.
http://dx.doi.org/10.1097/00000542-199802000-00010

[7] 张立贤, 樊碧发, 张亚军. 关节镜术后关节腔和硬膜外隙注射新斯的明镇痛的临床研究[J]. 中国疼痛医学杂志, 2004, 10(2): 123-124.

[8] Lo, I.K., Sciore, P., Chung, M., et al. (2009) Local Anesthetics Induce Chondrocyte Death in Bovine Articular Cartilage Disks in A Dose- and Duration-Dependent Manner. Arthroscopy, 25, 707-715.
http://dx.doi.org/10.1097/00000542-199802000-00010

[9] Gungor, I., Yilmaz, A., Ozturk, A.M., et al. (2014) Bupivacaine and Levobupivacaine Induce Apoptosis in Rat Chondrocyte Cell Cultures at Ultra-Low Doses. European Journal of Orthopaedic Surgery & Traumatology, 24, 291-295.
http://dx.doi.org/10.1007/s00590-013-1202-5

[10] 李辉, 李晓泓, 张露芬. 电针“大椎” “命门”对佐剂性关节炎大鼠抗炎及免疫调节反应的影响[J]. 针刺研究, 2009, 34(4): 225-229.

[11] 黄猛, 谢英元, 丁光宏. 穴位注射组胺在急性佐剂性关节炎大鼠上引起的镇痛效应[J]. 针刺研究, 2010(35): 99-103.

[12] 包飞, 孙华, 吴志宏, 等. 针刺对膝骨关节炎大鼠软骨基质金属蛋白酶及其抑制剂表达的影响[J]. 中国针灸, 2011, 31(3): 241-246.

[13] 侯景栋, 张宝娟, 段世明. 新斯的明用于术后镇痛[J]. 国外医学(麻醉学与复苏分册), 2001, 22(2): 119-122.

[14] Kim, J.K., Kim, T.H., Park, S.W., et al. (2010) Protective Effects of Human Placenta Extract on Cartilage Degradation in Experimental Osteoarthritis. Biological and Pharmaceutical Bulletin, 33, 1004-1010.
http://dx.doi.org/10.1248/bpb.33.1004

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