骨骼肌细胞损伤致延迟性肌肉酸痛:如何有效提高损伤肌肉恢复的速度和质量

Damage to skeletal muscle cells leads to delayed muscle soreness: how to effectively improve muscle recovery both in recovery speed and quality

背景:目前临床尚缺乏一种简单有效的防治延迟性肌肉酸痛的方法。目的:查阅国内外有关骨骼肌损伤及修复的相关文献,归纳总结延迟性肌肉酸痛的损伤机制和治疗方法。方法:检索1991年1月至2014年1月万方医学网和PubMed数据库的文献。英文检索词包括"molecular mechanisms;delayed onset muscle sorenes;pain;skeletal muscle";中文检索词包括"骨骼肌;损伤;延迟性肌肉酸痛;分子机制"。纳入与骨骼肌形态结构、延迟性肌肉酸痛机制、骨骼肌治疗和修复的相关研究,阅读全文对24篇文献进行归纳分析。结果与结论:研究表明,骨骼肌损伤与钙失调、能量失调及高浓度的活性氧有关。骨骼肌性损伤包括代谢损伤、机械损伤和炎症损伤。胰岛素样生长因子、过氧化物酶体增殖物激活受体γ辅激活子1α及肿瘤坏死因子α在骨骼肌修复过程中均发挥重要作用。动物实验表明依达拉奉通过直接阻止骨骼肌中自由基的快速过氧化损伤,减少二次损伤和炎症的浸润。临床研究表明中药制剂、按摩、针灸可以延缓运动性肌肉损伤和疲劳的发生,有效提高损伤肌肉恢复的速度和质量;将理疗与中药相结合治疗延迟性肌肉酸痛可达到满意效果。

BACKGROUND： There is no simple and effective method to relieve delayed muscle soreness. OBJECTIVE： To conclude the injured mechanism and therapies of delayed muscle soreness by reviewing literature about damage and repair of the skeletal muscle. METHODS： Wanfang and PubMed databases （from January 1991 to January 2014） were retrieved for articles related to morphological structure of the skeletal muscle, mechanism of delayed muscle soreness, and treatment and repair of the skeletal muscle using the keywords of ＂molecular mechanisms; delayed onset muscle soreness; pain; skeletal muscle; injury＂ in Chinese and English, respectively. Finally, 24 articles were included in result analysis. RESULTS AND CONCLUSION： Studies have shown that skeletal muscle injury is related to calcium imbalance,energy imbalance and high concentration of active oxygen. Skeletal muscle injury includes metabolic injury, mechanica injury and inflammatory injury. Insulin-like growth factor, peroxisome proliferator-activated receptor y-coactivator-la promoter and tumor necrosis factor a play important roles in skeletal muscle repair process. Animal experiments have demonstrated that edaravone may reduce secondary damage and inflammatory infiltration by means of directly preventing rapid peroxidation injury of free radicals in the skeletal muscle. Clinical studies have shown that Chinese medicine preparations, massage and acupuncture can delay the occurrence of exercise-induced muscle injury and fatigue, to improve the speed and quality of the recovery of damaged muscles. The treatment of delayed muscle soreness can achieve satisfactory results by combining physiotherapy with traditional Chinese medicine.