腰椎关节手法对背根神经节伤害性疼痛大鼠疼痛行为学及一氧化氮含量的影响
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摘要
目的观察腰椎关节手法对背根神经节(DRG)损伤大鼠根性疼痛的影响,探讨脊柱手法的抗炎效果及生物学机制。方法 90只雄性SD大鼠随机分为空白组、假手术组、致炎+致压(复合模型)组、L_(5-6)关节手法组、Etoricoxib组5组,各18只。各组取6只大鼠于术前1天及术后第3、5、9、15、21天行一般行为学观察和热辐射刺激缩爪反应潜伏期(PWL)的测定;另6只大鼠分别于术后第9、21天检测术侧L_5 DRG中一氧化氮代谢产物亚硝酸盐含量。结果所有大鼠均未出现运动功能明显障碍。在PWL测试上,L_(5-6)关节手法组与Etoricoxib组均比模型组明显增长(P<0.05),两组组间比较无明显差异(P>0.05)。在L_5 DRG亚硝酸盐含量上,L_(5-6)关节手法组与Etoricoxib组均比模型组明显降低(P<0.01),2组组间比较无明显差异(P>0.05)。结论模拟腰椎关节手法可以明显减轻炎性反应与机械痛敏,表现出较强的抗炎作用,其效果与口服Etoricoxib无明显区别,其镇痛效应机制可能是通过降低炎性组织中NO含量,促进炎性因子的吸收有关。
Objective To observe radicular pain changes of rat model with acute nerve root irritation after spinal manipulative therapy and discuss the anti-inflammatory and biological mechanism of the manipulation.Methods 90 male SD rats were randomly divided into six groups with 18 rats in each group, including a blank group with no interference, a sham group with a sham surgery, a model group with an acute nerve root irritation set up by surgery but no other interference, a mobilization group with a simulating mobilization treatment on the L_(5-6), an etoricoxib group with etoricoxib lavaged.Common behaviors were observed and paw withdraw latency(PWL) induced by heat irritation was measured 1 day before surgery and on day 3,5,9,15,21 after surgery in 6 rats of each group.The L_5 dorsal root ganglion(DRG) at the operative side were collected on day 9, 21 respectively after surgery for detecting the nitrite content in another 6 rats of each group.Results No obvious motor dysfunction was seen in all rats.The PWL in mobilization and etoricoxib group were significantly higher than that of the model group respectively(P<0.05); but no significant difference was found in PWL between these two groups(P>0.05).There was no significant difference in nitrite content of L_5 DRG between mobilization and etoricoxib group(P>0.05), but there were significantly decreasing when compared with that of model group respectively(P<0.01).Conclusion Spinal mobilization can obviously alleviate inflammation irritation and pain sensitization with a similar effect caused by etoricoxib lavage.The therapeutic mechanism of spinal mobilization might be related with a reduction of nitrite content in acute nerve root irritation of rat model and improvement of absorption of inflammatory factors.
Objective To observe radicular pain changes of rat model with acute nerve root irritation after spinal manipulative therapy and discuss the anti-inflammatory and biological mechanism of the manipulation.Methods 90 male SD rats were randomly divided into six groups with 18 rats in each group, including a blank group with no interference, a sham group with a sham surgery, a model group with an acute nerve root irritation set up by surgery but no other interference, a mobilization group with a simulating mobilization treatment on the L_(5-6), an etoricoxib group with etoricoxib lavaged.Common behaviors were observed and paw withdraw latency(PWL) induced by heat irritation was measured 1 day before surgery and on day 3,5,9,15,21 after surgery in 6 rats of each group.The L_5 dorsal root ganglion(DRG) at the operative side were collected on day 9, 21 respectively after surgery for detecting the nitrite content in another 6 rats of each group.Results No obvious motor dysfunction was seen in all rats.The PWL in mobilization and etoricoxib group were significantly higher than that of the model group respectively(P<0.05); but no significant difference was found in PWL between these two groups(P>0.05).There was no significant difference in nitrite content of L_5 DRG between mobilization and etoricoxib group(P>0.05), but there were significantly decreasing when compared with that of model group respectively(P<0.01).Conclusion Spinal mobilization can obviously alleviate inflammation irritation and pain sensitization with a similar effect caused by etoricoxib lavage.The therapeutic mechanism of spinal mobilization might be related with a reduction of nitrite content in acute nerve root irritation of rat model and improvement of absorption of inflammatory factors.
引文
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[2] 韩磊,赵平,郭伟,等.腰椎间孔外口植入髓核致坐骨神经痛大鼠模型的建立[J].北京中医药,2015,34(3):245-248.
[3] 王百忍,赵经纬.一氧化氮与痛[J].神经解剖学杂志,1995,11(1):69-74.
[4] Hargreares K,Dubner R,Brown F,et al.A new and sensitive method for measuring thermal nociception in cutaneous hyperalgesia[J].Pain,1988,32(1):77-88.
[5] 詹红生,石印玉,张明才,等.基于“骨错缝、筋出槽”病机认识的椎间盘病症诊治新观点[J].上海中医药杂志,2007,41(9):4-6.
[6] 房敏,朱清广,洪水棕.推拿手法调整脊柱骨错缝的杠杆原理分析[J].中国骨伤,2010,23(10):780-783.
[7] Scott K,Steven W,John E,et al.Diagnosis and treatment of lumbar disc herniation with radiculopathy[M].NASS Evidence-Based Clinical Guidelines Committee,2012:26-57.
[8] 牛晓方.依托考昔研究进展[J].医药导报,2010,29(2):221.
[9] 孙喆,李洁,苗军.依托考昔片联合甲钴胺注射液治疗腰椎间盘突出症的疗效观察[J].天津药学,2012,24(4):40-42.
[10] Kawakami M,Tamaki T,Weinstein JN,et al.Pathomechanism of pain-related behavior produced by allografts of intervertebral disc in the rat[J].Spine,1996,21(18):2101-2107.
[11] Hu W,Zhou PH,Rao T,etal.Adrenomedullin attenuates interleukin-1 beta-induced inflammation and apoptosis in rat Leydig cells viainhibition of NF-kappaB signaling pathway[J].Exp Cell Res,2015,339(2):220-230.