CAJ | 학술논문

目的：观察鞘内注射吗啡、芬太尼复合小剂量纳洛酮对切口痛大鼠痛行为学及血浆胃动素（MTL）的影响。方法取鞘内置管成功的健康雄性SD大鼠72只，随机分为6组（n=12）：生理盐水（NS）组，切口痛（P）组，吗啡（5μg/kg）＋芬太尼（0.25μg/kg）组（MFP组），吗啡＋芬太尼+纳洛酮1（0.2 ng/kg）、2（1 ng/kg）、3（5 ng/kg）组（MFPN1、2、3组）。后5组行足跖肌切口。各组取其中6只于鞘内置管前24 h（T0）、造模前24 h（T1）、术后1 h（T2）、3 h（T3）、6 h（T4）、24 h（T5）、48 h（T6）、72 h（T7）检测机械缩足阈值（PWMT）与热缩足反射潜伏期（PWTL），剩余6只于术后6 h即刻断头处死，取血浆以ELISA法检测MTL浓度。结果 MFPN2组与NS组各时点PWMT差异无统计学意义，而与NS组相比，T2、T5时点PWTL上调（P<0.05），其余各时点差异无统计学意义。P组、MFPN3组与NS组比较， T2、T3、T4时点PWMT、PWTL显著下调（P<0.05）。而MFPN3组与P组比较，T6时点PWMT及T3、T4时点PWTL下调更为显著（P<0.05）。P、MFP、MFPN1、MFPN3组与NS组比较，术后6 h MTL表达下调（P<0.05）。而MFPN2与NS组MTL表达差异无统计学意义。结论鞘内注射1 ng/kg纳洛酮抑制了吗啡＋芬太尼对切口痛大鼠血浆MTL表达的影响，并能上调大鼠热辐射痛阈值，增强了阿片类药物的镇痛效果。
목적：관찰초내주사마배、분태니복합소제량납락동대절구통대서통행위학급혈장위동소（MTL）적영향。방법취초내치관성공적건강웅성SD대서72지，수궤분위6조（n=12）：생리염수（NS）조，절구통（P）조，마배（5μg/kg）＋분태니（0.25μg/kg）조（MFP조），마배＋분태니+납락동1（0.2 ng/kg）、2（1 ng/kg）、3（5 ng/kg）조（MFPN1、2、3조）。후5조행족척기절구。각조취기중6지우초내치관전24 h（T0）、조모전24 h（T1）、술후1 h（T2）、3 h（T3）、6 h（T4）、24 h（T5）、48 h（T6）、72 h（T7）검측궤계축족역치（PWMT）여열축족반사잠복기（PWTL），잉여6지우술후6 h즉각단두처사，취혈장이ELISA법검측MTL농도。결과 MFPN2조여NS조각시점PWMT차이무통계학의의，이여NS조상비，T2、T5시점PWTL상조（P<0.05），기여각시점차이무통계학의의。P조、MFPN3조여NS조비교， T2、T3、T4시점PWMT、PWTL현저하조（P<0.05）。이MFPN3조여P조비교，T6시점PWMT급T3、T4시점PWTL하조경위현저（P<0.05）。P、MFP、MFPN1、MFPN3조여NS조비교，술후6 h MTL표체하조（P<0.05）。이MFPN2여NS조MTL표체차이무통계학의의。결론초내주사1 ng/kg납락동억제료마배＋분태니대절구통대서혈장MTL표체적영향，병능상조대서열복사통역치，증강료아편류약물적진통효과。
Objective To investigate effects of intrathecal injection of morphine and fentanyl combined with low-dose naloxone on the pain behavior and the expression of blood motilin (MTL) in the rat model of incisional pain.Meth?ods A total of 72 healthy male Sprague-Dawley rats (weight 180-220 g), successfully intrathecally catheterized, were ran?domly divided into 6 groups (n=12 ):normal saline group (NS group), incisional pain group (P group), morphine (5μg/kg)+fentanyl (0.25μg/kg) group (MFP group), morphine+fentanyl+naloxone (0.2 ng/kg, 1 ng/kg, 5 ng/kg) group (MFPN1, MF?PN2 and MFPN3 groups). All groups except NS group were made the model of incisional pain on the right plantar surface. At 24-hours before intrathecal cathetherization (T0), 24-hours before modelling (T1), 1-hours (T2), 3-hours (T3) , 6-hours (T4), 24-hours (T5) , 48-hours (T6) and 72-hours (T7) after modelling respectively, paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were detected in right hind paw in 6 rats of each group. The other 6 rats in each group were sacrificed 6-hour after operation. The plasma expression of motilin was detected by ELISA. Re?sults Compared with NS group, the PWMT was not significantly different in all time points in MFPN2 group. The values of PWTL were significantly longer at T2 and T5 in MFPN2 group than those of NS group (P<0.05). The PWMT and the PWTL were significantly decreased at T2, T3 and T4 in P and MFPN3 groups than those of NS group (P<0.05).Compared with P group, the PWMT at T6, and PWTL at T3 and T4 were significantly decreased in MFPN3 group (P<0.05). The MTL at T6 was significantly decreased in P, MFP, MFPN1 and MFPN3 groups compared with that of NS group (P<0.05). There was no significant difference in MTL between MFPN2 group and NS group (P>0.05).Conclusion In the rat model of incision?al pain, intrathecal injection of naloxone at 1 ng/kg can inhibit the down-regulation of blood motillin caused by morphine and fentanyl, and which can up-regulate the PWTL, enhancing the analgesic effects of opioids.