曲马多联合电针对神经病理性疼痛大鼠行为学及脊髓相关细胞因子的影响

目的：研究曲马多联合电针对神经病理性疼痛大鼠模型的治疗效果及其作用机制。方法：将SPF级wiStar大鼠60只，随机分为空白对照组、电针组、曲马多组（腹腔）、曲马多组（鞘内）和针药联合组，采用坐骨神经分支选择性损伤（SNI）的方法建立神经病理性疼痛模型，造模后第4天开始，连续7天给予曲马多电针和针药联合治疗，观察治疗后大鼠冷诱发持续性疼痛和机械性痛阈的变化。在开始治疗后的第0、1、3、7天处死动物，取整段脊髓组织，测定TNU-α、IL-1β、PGE：及IL-10水平的变化。结果：给予电针、曲马多及针药联合治疗后，手术组动物的冷板抬足次数均有明显下降，50％缩足阈值有明显升高（P〈0．05），治疗7天后，针药联合组冷板抬足次数明显低于其他手术组（P〈0．05），50％缩足阈值明显高于其他手术组（P〈0．05）；治疗3天后，曲马多组（腹腔）、曲马多组（鞘内）和针药联合组TNF-α、IL-1β、PGE2水平均降低（P〈0．05），针药联合组TNF-α、IL-1β城PGE2水平明显降低（P〈0．05）。电针组、曲马多组（腹腔）、曲马多组（鞘内）和针药联合组在治疗第3天和第7天IL-10的水平均升高（P〈0．05），而针药联合组IL-10水平明显升高（P〈0．05）。结论：曲马多联合电针对神经病理性疼痛具有更好的治疗作用。其机制可能是通过调节脊髓中促／抗炎细胞因子的含量，发挥镇痛效应。

Effects of Tramadol and Electronic Acupuncture on Behavioral Science and Spinal Cord Related Cytokines of Rats with Neuropathic Pain

Objective： To study curative effects of tramadol combined with electronic acupuncture in treating rat model with neuropathic pain and its mechanism. Method： Altogether 60 rats were randomly allocated into blank control group, electronic acupuncture group, tramadol group （abdominal cavity）, tramadol group（intrathecal） and the group of acupuncture and drugs, the rat model was established through sciatic nerve injury （SNI） and began to take tramadol at the 4th day after establishing the models, the models were administered with tramadol, electronic acupuncture, dual combination for seven days, the changes of continuous pain caused by the cold and mechanical pain threshold were observed after treating. The changes of TNF-α、IL-1β, PGE2 and 1L-10 were detected by taking the whole tissue of spinal cord at the zero, first, third and seventh day after treating. Result： The number of foot lifting on the cold plate of operation group was decreased significantly, 50% of paw withdrawal mechanical threshold were raised obviously after treating with electronic acupuncture, tramadol and dual combination （P〈0.05）, the number of foot lifting on the cold plate of dual combination group was significantly lower than that of other surgery groups after treating for seven days （P〈0.05）, 50% of paw withdrawal mechanical threshold were notably higher than other surgery groups （P〈0.05）; after treating for three days, the levels of TNF-α、IL-1β and PGE2 in tramadol group （abdominal cavity）, tramadol group （intrathecal） and the group of acupuncture and drugs were decreased（P〈0.05）, the levels ofTNF-α、IL-1β and PGE2 in the group of acupuncture and drugs were lower obviously （P 〈0.05）. The level of IL-10 in Electronic acupuncture group, tramadol group （abdominal cavity）, tramadol group （intrathecal） and the group of acupuncture and drugs were improved at the third and seventh day after treating, while IL-10 level was raised significantly in the group of dual combination （P〈0.05）. Conclusion： Tramadol combined with electronic acupuncture are effective for neuropathic pain, it could relieve pain by regulating the contents ofcytokines.