CAJ | 학술논문

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及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症痛模型,以足三里为治疗穴位,采用利多卡因预处理(穴位注射2%盐酸利多卡因),将80只大鼠随机分为正常组(Control)、模型组(Model)、利多卡因预处理组(normal+Lido)、电针组(Electroacupuncture,EA)、利多卡因预处理电针组(Lido+EA)、犊鼻穴注射利多卡因足三里电针组(DLido+ZEA)、下巨虚穴注射利多卡因足三里电针组(Xlido+ZEA)、手针组(Manual Acupuncture,MA)、利多卡因预处理手针组(Lido+MA)及犊鼻穴注射利多卡因足三里手针组(Dlido+ZMA),每组8只.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或P<0.01),两组肥大细胞脱颗粒率都明显高于M组(P<0.01).说明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,同样的操作在远心端穴位则无影响,神经阻滞对针刺(电针或手针)引起的穴区肥大细胞脱颗粒无明显影响.结论:在手针情况下,针刺镇痛有效神经传导信号在穴位的启动和针感的产生是在肥大细胞脱颗粒之后,它是产生神经信号的直接原因;而对电针情况,电信号是直接刺激神经感受器产生信号启动,肥大细胞脱颗粒成为伴随或反馈效应.
목적:탐토조체혈위신경후침자대우좌제형관절염(AA)대서진통효응화혈구비대세포탈과립적영향급진일보료해수침화전침진통효응적외주궤제차이.방법:이좌제형관절염대서위염증통모형,이족삼리위치료혈위,채용리다잡인예처리(혈위주사2%염산리다잡인),장80지대서수궤분위정상조(Control)、모형조(Model)、리다잡인예처리조(normal+Lido)、전침조(Electroacupuncture,EA)、리다잡인예처리전침조(Lido+EA)、독비혈주사리다잡인족삼리전침조(DLido+ZEA)、하거허혈주사리다잡인족삼리전침조(Xlido+ZEA)、수침조(Manual Acupuncture,MA)、리다잡인예처리수침조(Lido+MA)급독비혈주사리다잡인족삼리수침조(Dlido+ZMA),매조8지.이대서축조반사잠복기급비대세포탈과립솔위관찰지표.결과:EA급MA조통역도고우M조(P<0.05혹P<0.01),량조비대세포탈과립솔도명현고우M조(P<0.01).설명조체침자혈위혹동신경간근심단혈위신경대침자적진통효응유명현적억제작용,동양적조작재원심단혈위칙무영향,신경조체대침자(전침혹수침)인기적혈구비대세포탈과립무명현영향.결론:재수침정황하,침자진통유효신경전도신호재혈위적계동화침감적산생시재비대세포탈과립지후,타시산생신경신호적직접원인;이대전침정황,전신호시직접자격신경감수기산생신호계동,비대세포탈과립성위반수혹반궤효응.
Objective: To observe the effects of nerve block on MA and EA analgesia and mast cells degranulation in adjuvant arthritis rats in order to analyze the difference between the underlying peripheral mechanism of MA and EA analgesia. Methods: Zusanli (ST 36) was chosen as the acupuncturing point on adjuvant arthritis rats. Eighty SD rats were randomized into 10 groups, including control, model, normal+Lido, EA, Lido+EA, DLido+ZEA, Xlido+ZEA, MA, Lido+MA, Dlido+ZMA groups, with 8 rats in each group. Paw Withdraw Latencies and mast cells degranulation ratios were recorded and computed. Results: Compared with model group, the pain threshold (PT) and mast cells degranulation ratios of EA and MA groups were obviously increased (P<0.05 or P<0.01). The analgesia effects of both MA and EA were obviously attenuated after nerve block by pretreated with Lidocaine hydrochloride at the acupuncturing point or at the acupiont of proximal end in the same neural stem while they were not by the same manipulations at the acupoint of distal end. Degranulation ratios of mast cells caused by MA or EA were not obviously affected by nerve block. Conclusion: The effective signal of nerve conduction of MA analgesia is generated after the degranulation of mast cells in the process of acupoints activation or needle sense and it is the direct cause of generation of nerve signal. In the condition of EA, the acupoints activation is caused by the stimulation of electric signal on nerve receptor while the degranulation of mast cells is concomitant or feedback effect.