穴位神经阻滞对肥大细胞功能和手针及电针镇痛的不同影响与机制研究

目的:探讨阻滞穴位神经后针刺对于佐剂型关节炎(AA)大鼠镇痛效应和穴区肥大细胞脱颗粒的影响,并进一步了解手针和电针镇痛效应的外周机制差异。方法:以佐剂型关节炎大鼠为炎性反应痛模型,以"足三里"为治疗穴位,采用利多卡因穴位注射预处理。将80只大鼠随机分为正常组(C)、模型组(M)、利多卡因预处理组(NL)、电针组(EA)、利多卡因预处理电针组(L+EA)、犊鼻穴注射利多卡因足三里电针组(DL+ZEA)、下巨虚穴注射利多卡因足三里电针组(XL+ZEA)、手针组(MA)、利多卡因预处理手针组(L+MA)及犊鼻穴注射利多卡因足三里手针组(DL+ZMA)。以大鼠缩爪反射潜伏期及肥大细胞脱颗粒率为观察指标。结果:EA及MA组痛阈都高于M组(P<0.05,P<0.01),两组肥大细胞脱颗粒率都明显高于M组(P<0.01);NL组痛阈和肥大细胞脱颗粒率与M组比较差异均无统计学意义(P>0.05);L+EA组和DL+ZEA组的痛阈明显低于C组及EA组(P<0.01),而与M组及NL组的差异都无统计学意义(P>0.05);XL+ZEA组痛阈明显高于M组和NL组(P<0.01),而与EA组的差异无统计学意义(P>0.05);手针情况类似。L+EA、D/XL+ZEA组与EA组的肥大细胞脱颗粒率差异无统计学意义(P>0.05),手针情况类似。结论:阻滞针刺穴位或同神经干近心端穴位神经对针刺的镇痛效应有明显的抑制作用,神经阻滞对针刺引起的穴区肥大细胞脱颗粒无明显影响。

Effects of Acupoint-nerve Block on Mast Cell Activity, Manual Acupuncture-and Electroacupuncture-induced Analgesia in Adjuvant Arthritis Rats

Objective To observe the effects of acupoint-nerve block on manual-acupuncture (MA) and electroacupunc-ture (EA) analgesia and mast cells degranulation in adjuvant arthritis (AA) rats in order to analyze the underlying peripheral mechanism of MA and EA analgesia. Methods A total of 80 SD rats were randomized into control, AA model (M) , normal + lido-caine (NL), EA, EA-ST36 +Lidoc (L+EA), Dubi (ST 35)+ Lidoc+EA-ST36 (DL + ZEA), Xiajuxu (ST 39)+ Lidoc+ EA-ST36 (XL + ZEA), MA, Lidoc+MA-ST36 (L+MA), and ST35 +Lidoc + MA-ST36 (DL + ZMA) groups, with 8 cases in each. AA model was established by injection of complete Freund's adjuvant (0. 05 ml) in the rat's right hind-paw under anesthesia. Lidoc hydrochloride (2% , 0. 05 ml) was injected into ST36 or ST35 separately for blocking the local nerve. Paw withdrawal latency (pain threshold, PT) and mast cell degranulation ratios (DGR) were detected. EA (2/100 Hz, 0. 5 mA, 1 mA, 1. 5 mA) or MA was applied to ST36. Results Compared with model group, PT values of EA and MA groups increased significantly (P<0. 05, P<0. 01) and mast cell DGR of EA and MA groups were significantly higher (P<0. 01). Both PT and DGR of NL group were basically not affected by ST36-Lidoc-injection in comparison with model group (P>0. 05). PT values of L+EA and DL + ZEA groups were significantly lower than those of control and EA groups ( P < 0. 01), and comparable to those of model and NL groups (P>0. 05). PT of XL+ZEA group was significantly higher than those of model and NL groups (P<0. 01), and comparable to that of EA group (P>0. 05). Similar situations were found in MA-related groups. Mast cell DGR of ST36 area in L+EA, DL + ZEA and XL + ZEA groups were comparable to that of EA group (P>0.05), and such was the case in MA-related groups. Conclusion After nerve block of the local and proximal acupoints rather than the distal acupoint innervated by the same nerve, the analgesic effect of both MA and EA of ST36 is obviously attenuated; but no marked influences on MA- and EA-induced mast cell de-granulation are found.