摘要
目的研究经皮穴位电刺激对类风湿关节炎大鼠外周阿片系统的抗炎镇痛调节机制。方法将60只雄性Wistar大鼠随机分为3组,使用弗氏完全佐剂建立大鼠类风湿关节炎模型,经皮穴位电刺激选用患侧足三里和昆仑穴。检测大鼠热痛阈、关节炎症指数和足跖肿胀度;采用酶联免疫吸附法测定白介素1β(IL-1β)、IL-6、肿瘤坏死因子α(TNF-α)和前列腺素E2(PGE2)表达水平;采用高效液相色谱法测定β内啡肽(β-EP)、甲硫氨酸脑啡肽(met-ENK)和强啡肽A(DYN-A)含量;采用荧光定量PCR法检测阿黑皮素原(POMC)、前脑啡肽原(PENK)和前强啡肽原(PDYN)mRNA表达水平。结果经皮穴位电刺激治疗能够显著提高大鼠热痛阈(P<0.01),降低足跖肿胀度(P<0.01),降低关节炎症指数(P<0.05),能够降低炎症组织中IL-6(P<0.05)和TNF-α(P<0.05)表达水平;对炎症组织中的阿片肽前体mRNA的调节具有选择性,可以上调足跖炎症组织中β-EP前体POMC基因表达水平,但对met-ENK前体PENK无显著影响,差异均无统计学意义(P>0.05)。结论经皮穴位电刺激可能通过激活外周阿片系统,提高炎症局部组织β-EP表达水平参与镇痛调节作用,对类风湿关节炎有良好的抗炎镇痛疗效。
Objective To study the anti-inflammatory and analgesic mechanism of transcutaneous electrical acupoint stimulation(TEAS)targeting the regulation of peripheral opioid system in rats with rheumatoid arthritis(RA).Method Sixty male Wistar rats were randomized into three groups.The RA rat model was established using complete Freund’s adjuvant.Zusanli(ST36)and Kunlun(BL60)points on the affected side were selected for TEAS.Thermal pain threshold,arthritis index and plantar swelling degree were measured in the rats;enzyme-linked immunosorbant assay(ELISA)was used to detect the expressions of interleukin(IL)-1β,IL-6,tumor necrosis factor(TNF)-αand prostaglandin E2(PGE2);high performance liquid chromatography(HPLC)was adopted to determine the contents ofβ-endorphin(β-EP),methionine enkephalin(met-ENK)and dynorphin A(DYN-A);the expressions of proopiomelanocortin(POMC),proenkephalin(PENK)and prodynorphin(PDYN)mRNAs were detected using fluorescence quantitative PCR.Result TEAS significantly reduced the thermal pain threshold(P<0.01),plantar swelling degree(P<0.01),arthritis index(P<0.05),and the expressions of IL-6(P<0.05)and TNF-α(P<0.05)in inflammatory tissue in the rats,all presenting statistical significance;TEAS selectively regulated the opioid precursors mRNAs,up-regulating the precursor ofβ-EP POMC mRNA while producing insignificant effect on the precursor of met-ENK PENK mRNA in plantar inflammatory tissue,yet neither showing statistical significance(P>0.05).Conclusion TEAS may be involved in analgesic regulation through activating the peripheral opioid system,increasing the expression ofβ-EP in topical inflammatory tissue and producing satisfactory anti-inflammatory and analgesic efficacy for RA.
作者
刘天红
宋召军
裘晟晨
LIU Tian-hong;SONG Zhao-jun;QIU Sheng-chen(The Fourth Affiliated Hospital,Zhejiang University School of Medicine,Yiwu 322000,China)
出处
《上海针灸杂志》
2021年第6期769-776,共8页
Shanghai Journal of Acupuncture and Moxibustion
基金
国家自然科学基金项目(81804181)
浙江省自然科学基金项目(LQ17H270003)
义乌市科研计划项目(18-3-105)。
关键词
穴位疗法
电刺激疗法
关节炎
类风湿
外周阿片肽
炎性因子
大鼠
Acupoint therapy
Electrical stimulation therapy
Arthritis,Rheumatoid
Peripheral opioids
Inflammatory factors
Rats
