四种针法对佐剂型关节炎大鼠镇痛后效应及下丘脑作用机制研究

【作者】 李学智；

【导师】 梁繁荣；

【作者基本信息】 成都中医药大学 ， 针灸学， 2003， 硕士

【摘要】 目的：对电针、手针、刺血、穴位注射四种针刺方法的镇痛后效应及其下丘脑机制进行比较研究。 方法：以佐剂性关节炎(AA)大鼠为炎症痛模型，以“昆仑”穴为治疗穴位，采用电针、手针、刺血、穴位注射四种针法，采用放免、原位杂交等检测方法，观察了痛阈、下丘脑β-内啡肽(β-EP)、促肾上腺皮质激素(ACTH)含量及下丘脑原阿黑皮素(POMC)mRNA表达等指标在针刺后即时、24小时、48小时、72小时、120小时5个时间点的变化趋势及相互联系。 结果：四种针法均可使痛阈提高，其即时效应依次为电针、手针、刺血、穴位注射，且有不同程度的后效应。电针的镇痛效应在治疗后即时达到峰值，24小时消失，48小时、72小时又出现镇痛效应；其下丘脑β-EP含量升高、ACTH含量下降及POMCmRNA表达升高并与痛阈的变化有相关性；手针与电针有相同的变化趋势，其β-EP、ACTH含量变化不如电针显著；穴位注射的镇痛效应持续到治疗后72小时，且在48小时达峰，下丘脑的ACTH含量与之有相同的变化趋势；刺血的镇痛效应在治疗后24小时消失，但从48小时又出现镇痛效应并持续到120小时，且在72小时镇痛效应较好，下丘脑β-EP、ACTH、POMCmRNA表达等指标与模型组相比无统计学意义。 结论：四种针法对AA大鼠均有镇痛的即时效应及后效应。电针、手针的镇痛效应及后效应可能通过使下丘脑β-EP升高、ACTH下降、POMCmRNA表达增强而实现；穴位注射可能通过降低下丘脑ACTH含量达到镇痛效应；刺血疗法可能通过下丘脑β-EP、ACTH、POMCmRNA表达以外的途径起到镇痛作用及其后效应。更多还原

【Abstract】 Objective: The study is designed to investigate comparatively on the analgesia after-effects of electro-acpuncture,filiform acupuncture,blood-pricking therapy,medicine injection therapy and their analgesia mechanism in hypothalami.Methods:Useing adjuvant arthritic(AA) rat as the model of inflammatory pain,selecting KUNLUN as the acupoint, adopting electro-acpuncture,filiform acupuncture,blood-pricking therapy,medicine injection therapy, using methods of radioimmunoassay,in situ-hybridization histochemistry,the study observed targets of the changing tendency of pain threshold, content of β - endorphin( β -EP) , adrenocorticotrophin(ACTH) and genie expression of pro-opiomelanocortin(POMCmRNA) in hypothalamus at the point of Oh,24h,48h,72h,120h after above-mentioned therapy have been finished.Results: All the used therapy have various degree of immediate and after-time analgesia effects.Electro-acupuncture’s analgesia effect reached the peak immediately.which faded away 24 hours later and presented again at 48,72hour-points. meanwhile, β -EP raising,ACTH descenting and genie expression of POMCmRNA raising in hypothalamus.Same tendency occurred to filiform acupuncture with a comparatively moderate raised β -EP.The analgesia effect of medicine injection therapy lasted for 72 hours and arrived at its peak at 48 hour-point,the content of ACTH in hypothalamus descented correspondingly.The analgesia of the blood-pricking therapy disappeared 24 hours later then occurred again and lasted during the days afterwards.There’re no evidence to prove that the realization of the analgesia effect of the pricking therapy was relative to the change of the β -EP, ACTH and genie expression of POMCmRNA in hypothalamus.Conclusion: Both the effect of immediate analgesia and that of after-time on inflammatory-pain have been observed in all four methords.In hypothalamus level,eletro-acupunture and miliform acupuncture maybe realized the effect of analgesia by raising the content of β -EP,reducing the content of ACTH,raising the genie expression of POMCmRNA .Medicine puncture therapy maybe have the effect of analgesia by reducing the content of ACTH. The change of the content of the above-mentioned substances were not observed after blood-pricking method was used,therefore there may be any other pathways to explain its mechanism .更多还原