精准针刺激痛点联合拉伸对大鼠前扣带皮层CREB表达及其磷酸化的影响
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摘要
目的:探讨针刺肌筋膜激痛点结合静态拉伸对大鼠前扣带回处CREB和p-CREB表达的变化。方法:将60只6周龄雄性SD大鼠随机平均分为对照组(C)、模型组(M)、激痛点组(D)、非激痛点组(ND)、拉伸组(S)和针刺拉伸结合组(SD),每组各10只。采用腓肠肌定点钝性打击结合离心运动的模式建立慢性肌筋膜疼痛激痛点模型,之后分别进行激痛点处针刺、非激痛点处针刺、静态拉伸及针刺激痛点结合拉伸治疗,每周1次,共4周。采用蛋白免疫印记技术和PCR检测大鼠前扣带回处CREB和p-CREB蛋白和mRNA表达水平。结果:与C组相比,M组、S组和ND组的CREB和p-CREB蛋白及mRNA表达水平明显增高(P <0.01)。与M组相比,D组(P <0.01)、S组(P <0.05)及SD组(P <0.01)的CREB蛋白相对表达量显著降低,仅D组的m RNA表达显著降低。结论:本研究证实精准针刺激痛点联合或不联合拉伸均可抑制前扣带回CREB的蛋白和m RNA水平表达,提示二者水平可能与针刺肌筋膜激痛点的镇痛机制相关。
Objective: This study aims to investigate the effects of dry needling of Myofascial Trigger Points(MTrPs)and static stretching on the expression of CREB and p-CREB in the anterior cingulate cortex in rats. Methods: Sixty male Sprague-Dawley rats were randomly assigned into 6 groups: Control Group(C), Model Group(M), Dry Needling of MTrPs(D), Dry Needling of Non-MTrPs(ND), Stretching Group(S), Dry Needling of MTrPs and Stretching Group(SD). The rat model of chronic MTrPs was established by striking on gastrocnemius muscles and eccentric exercise. The palpable taut band, the local twitch response and spontaneous electrical activity were examined for locating MTrPs. After that, the corresponding treatment was adopted respectively in each group once a week lasted four weeks. The expression of CREB and p-CREB was detected by western blot and real-time PCR. Results:Compared with the group C, CREB and p-CREB protein and mRNA level in the group M, group S and group ND were signi?cantly increased(P < 0.01). Compared with the group M, CREB protein level in group D(P < 0.01),group S(P < 0.05) and group SD(P < 0.01) were signi?cantly decreased, and only the CREB mRNA level in group D was signi?cantly decreased(P < 0.01). Conclusion: This study demonstrates that precise acupuncture at MTr Ps combined with(or without) static stretching could inhibit the expression levels of CREB and p-CREB and could be a potential analgesic mechanism underlying MTrPs pain management.
Objective: This study aims to investigate the effects of dry needling of Myofascial Trigger Points(MTrPs)and static stretching on the expression of CREB and p-CREB in the anterior cingulate cortex in rats. Methods: Sixty male Sprague-Dawley rats were randomly assigned into 6 groups: Control Group(C), Model Group(M), Dry Needling of MTrPs(D), Dry Needling of Non-MTrPs(ND), Stretching Group(S), Dry Needling of MTrPs and Stretching Group(SD). The rat model of chronic MTrPs was established by striking on gastrocnemius muscles and eccentric exercise. The palpable taut band, the local twitch response and spontaneous electrical activity were examined for locating MTrPs. After that, the corresponding treatment was adopted respectively in each group once a week lasted four weeks. The expression of CREB and p-CREB was detected by western blot and real-time PCR. Results:Compared with the group C, CREB and p-CREB protein and mRNA level in the group M, group S and group ND were signi?cantly increased(P < 0.01). Compared with the group M, CREB protein level in group D(P < 0.01),group S(P < 0.05) and group SD(P < 0.01) were signi?cantly decreased, and only the CREB mRNA level in group D was signi?cantly decreased(P < 0.01). Conclusion: This study demonstrates that precise acupuncture at MTr Ps combined with(or without) static stretching could inhibit the expression levels of CREB and p-CREB and could be a potential analgesic mechanism underlying MTrPs pain management.
引文
[1]Shah JP,Thaker N,Heimur J,et al.Myofascial trigger points then and now:a historical and scientific perspective[J].PM R,2015,7:746-761.
[2]Liu L,Huang QM,Liu QG,et al.Evidence for dry needling in the management of myofascial trigger points associated with low back pain:a systematic review and meta-analysis[J].Arch Phys Med Rehabil,2018,99:144-152.
[3]Liu L,Huang QM,Liu QG,et al.Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain:a systematic review and meta-analysis[J].Arch Phys Med Rehabil,2015,96:944-955.
[4]Mason JS,Crowell M,Dolbeer J,et al.The effectiveness of dry needling and stretching vs.stretching alone on hamstring flexibility in patients with knee pain:a randomized controlled trial[J].Int J Sports Phys Ther,2016,11:672-683.
[5]Kalichman L,Ben DC.Effect of self-myofascial release on myofascial pain,muscle flexibility,and strength:A narrative review[J].J Bodyw Mov Ther,2017,21:446-451.
[6]Martin-Pintado ZA,Rodriguez-Fernandez AL,Garcia-Muro F,et al.Effects of spray and stretch on postneedling soreness and sensitivity after dry needling of a latent myofascial trigger point[J].Arch Phys Med Rehabil,2014,95(10):1925-1932.
[7]Simons DG.New views of myofascial trigger points:etiology and diagnosis[J].Arch Phys Med Rehabil,2008,89:157-159.
[8]Gerwin RD,Dommerholt J,Shah JP,et al.An expansion of Simons'integrated hypothesis of trigger point formation[J].Curr Pain Headache Rep,2004,8:468-475.
[9]Segond Von Banchet G,Konig C,Patzer J,et al.Long-lasting activation of the transcription factor CREB in sensory neurons by interleukin-1beta during antigen-induced arthritis in rats:a mechanism of persistent arthritis pain[J].Arthritis Rheumatol,2016,68:532-541.
[10]Kusuda R,Ravanelli MI,Cadetti F,et al.Long-term antidepressant treatment inhibits neuropathic pain-induced CREB and PLCgamma-1 phosphorylation in the mouse spinal cord dorsal horn[J].J Pain,2013,14:1162-1172.
[11]Descalzi G,Fukushima H,Suzuki A,et al.Genetic enhancement of neuropathic and inflammatory pain by forebrain upregulation of CREB-mediated transcription[J].Mol Pain,2012,8:90.
[12]Price TJ,Inyang KE.Commonalities between pain and memory mechanisms and their meaning for understanding chronic pain[J].Prog Mol Biol Transl Sci,2015,131:409-434.
[13]吕娇娇,黄强民,汤莉.大鼠慢性肌筋膜疼痛激痛点的电生理和病理组织学研究[J].中国运动医学杂志,2013,32:621-628.
[14]Liu QG,Liu L,Huang QM,et al.Decreased spontaneous electrical activity and acetylcholine at myofascial trigger spots after dry needling treatment:a pilot study[J].Evid Based Complement Alternat Med,2017,2017:3938191.
[15]Fernandez-Carnero J,Gilarranz-De-Frutos L,Leon-Hernandez JV,et al.Effectiveness of different deep dry needling dosages in the treatment of patients with cervical myofascial pain:a pilot RCT[J].Am J Phys Med Rehabil,2017,96:726-733.
[16]Zhang H,LüJJ,Huang QM,et al.Histopathological nature of myofascial trigger points at different stages of recovery from injury in a rat model[J].Acupunct Med,2017,35:445-451.
[17]Simons DG,Hong CZ,Simons LS.Endplate potentials are common to midfiber myofacial trigger points[J].Am J Phys Med Rehabil,2002,81:212-222.
[18]俞晓杰,陈雪吟,朱中亮,等.激痛点针刺治疗慢性腰肌筋膜疼痛综合征的临床治疗效应研究[J].中国疼痛医学杂志,2017,23(3):194-199.
[19]Hsieh YL,Hong CZ,Liu SY,et al.Acupuncture at distant myofascial trigger spots enhances endogenous opioids in rabbits:a possible mechanism for managing myofascial pain[J].Acupunct Med,2016,34:302-309.
[20]Dall’agnol L,Medeiros LF,Torres IL,et al.Repetitive transcranial magnetic stimulation increases the corticospinal inhibition and the brain-derived neurotrophic factor in chronic myofascial pain syndrome:an explanatory double-blinded,randomized,sham-controlled trial[J].J Pain,2014,15:845-855.
[21]Budini F,Gallasch E,Christova M,et al.One minute static stretch of plantar flexors transiently increases H reflex excitability and exerts no effect on corticospinal pathways[J].Exp Physiol,2017,102:901-910.
[22]Lake AD,Myers H,Aefsky B,et al.Immediate and short term effect of dry needling on triceps surae range of motion and functional movement:a randomized trial[J].Int J Sports Phys Ther,2018,13:185-195.
[23]刘琳,刘庆广,薄成志,等.基于H反射通路探究大鼠慢性肌筋膜疼痛激痛点的发病机制[J].中国疼痛医学杂志,2017,23(11):818-823.
[24]代维,张明洁,邱恩超,等.cAMP反应元件结合蛋白在头痛与抑郁中的研究现状[J].中国疼痛医学杂志,2017,23(12):923-926.
[2]Liu L,Huang QM,Liu QG,et al.Evidence for dry needling in the management of myofascial trigger points associated with low back pain:a systematic review and meta-analysis[J].Arch Phys Med Rehabil,2018,99:144-152.
[3]Liu L,Huang QM,Liu QG,et al.Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain:a systematic review and meta-analysis[J].Arch Phys Med Rehabil,2015,96:944-955.
[4]Mason JS,Crowell M,Dolbeer J,et al.The effectiveness of dry needling and stretching vs.stretching alone on hamstring flexibility in patients with knee pain:a randomized controlled trial[J].Int J Sports Phys Ther,2016,11:672-683.
[5]Kalichman L,Ben DC.Effect of self-myofascial release on myofascial pain,muscle flexibility,and strength:A narrative review[J].J Bodyw Mov Ther,2017,21:446-451.
[6]Martin-Pintado ZA,Rodriguez-Fernandez AL,Garcia-Muro F,et al.Effects of spray and stretch on postneedling soreness and sensitivity after dry needling of a latent myofascial trigger point[J].Arch Phys Med Rehabil,2014,95(10):1925-1932.
[7]Simons DG.New views of myofascial trigger points:etiology and diagnosis[J].Arch Phys Med Rehabil,2008,89:157-159.
[8]Gerwin RD,Dommerholt J,Shah JP,et al.An expansion of Simons'integrated hypothesis of trigger point formation[J].Curr Pain Headache Rep,2004,8:468-475.
[9]Segond Von Banchet G,Konig C,Patzer J,et al.Long-lasting activation of the transcription factor CREB in sensory neurons by interleukin-1beta during antigen-induced arthritis in rats:a mechanism of persistent arthritis pain[J].Arthritis Rheumatol,2016,68:532-541.
[10]Kusuda R,Ravanelli MI,Cadetti F,et al.Long-term antidepressant treatment inhibits neuropathic pain-induced CREB and PLCgamma-1 phosphorylation in the mouse spinal cord dorsal horn[J].J Pain,2013,14:1162-1172.
[11]Descalzi G,Fukushima H,Suzuki A,et al.Genetic enhancement of neuropathic and inflammatory pain by forebrain upregulation of CREB-mediated transcription[J].Mol Pain,2012,8:90.
[12]Price TJ,Inyang KE.Commonalities between pain and memory mechanisms and their meaning for understanding chronic pain[J].Prog Mol Biol Transl Sci,2015,131:409-434.
[13]吕娇娇,黄强民,汤莉.大鼠慢性肌筋膜疼痛激痛点的电生理和病理组织学研究[J].中国运动医学杂志,2013,32:621-628.
[14]Liu QG,Liu L,Huang QM,et al.Decreased spontaneous electrical activity and acetylcholine at myofascial trigger spots after dry needling treatment:a pilot study[J].Evid Based Complement Alternat Med,2017,2017:3938191.
[15]Fernandez-Carnero J,Gilarranz-De-Frutos L,Leon-Hernandez JV,et al.Effectiveness of different deep dry needling dosages in the treatment of patients with cervical myofascial pain:a pilot RCT[J].Am J Phys Med Rehabil,2017,96:726-733.
[16]Zhang H,LüJJ,Huang QM,et al.Histopathological nature of myofascial trigger points at different stages of recovery from injury in a rat model[J].Acupunct Med,2017,35:445-451.
[17]Simons DG,Hong CZ,Simons LS.Endplate potentials are common to midfiber myofacial trigger points[J].Am J Phys Med Rehabil,2002,81:212-222.
[18]俞晓杰,陈雪吟,朱中亮,等.激痛点针刺治疗慢性腰肌筋膜疼痛综合征的临床治疗效应研究[J].中国疼痛医学杂志,2017,23(3):194-199.
[19]Hsieh YL,Hong CZ,Liu SY,et al.Acupuncture at distant myofascial trigger spots enhances endogenous opioids in rabbits:a possible mechanism for managing myofascial pain[J].Acupunct Med,2016,34:302-309.
[20]Dall’agnol L,Medeiros LF,Torres IL,et al.Repetitive transcranial magnetic stimulation increases the corticospinal inhibition and the brain-derived neurotrophic factor in chronic myofascial pain syndrome:an explanatory double-blinded,randomized,sham-controlled trial[J].J Pain,2014,15:845-855.
[21]Budini F,Gallasch E,Christova M,et al.One minute static stretch of plantar flexors transiently increases H reflex excitability and exerts no effect on corticospinal pathways[J].Exp Physiol,2017,102:901-910.
[22]Lake AD,Myers H,Aefsky B,et al.Immediate and short term effect of dry needling on triceps surae range of motion and functional movement:a randomized trial[J].Int J Sports Phys Ther,2018,13:185-195.
[23]刘琳,刘庆广,薄成志,等.基于H反射通路探究大鼠慢性肌筋膜疼痛激痛点的发病机制[J].中国疼痛医学杂志,2017,23(11):818-823.
[24]代维,张明洁,邱恩超,等.cAMP反应元件结合蛋白在头痛与抑郁中的研究现状[J].中国疼痛医学杂志,2017,23(12):923-926.