经皮穴位电刺激对家兔正畸牙痛的防治作用

Preventive and therapeutic effects of TEAS on rabbits with orthodontic toothache

目的:探讨经皮穴位电刺激(transcutaneous acupoint electrical stimulation,TEAS)防治正畸牙痛的作用机制。方法:将24只雄性新西兰兔随机分为空白组、正畸组和TEAS组,每组8只。正畸组和TEAS组采用拉簧和结扎丝制作正畸家兔模型。造模后,TEAS组给予"阿是穴"(双侧上颌第一磨牙体表对应点)及"合谷"疏密波电刺激,20min/次,每日2次,连续治疗2d,共治疗4次;空白组和正畸组常规饲养,同样方法抓取固定。观察记录各组家兔一般行为、总进食量,测定痛阈值,采用酶联免疫吸附法(ELISA)检测各组家兔血清前列腺素E2(PGE2)、粒-巨噬细胞集落刺激因子(GM-CSF)、脑脊液β-内啡肽(β-EP)和八肽胆囊收缩素(CCK-8)含量。结果:与正畸组比较,TEAS组一般行为改善,痛阈提高,进食量增加,差异均有统计学意义(P<0.05,P<0.01);血清PGE2含量明显下降(P<0.05),血清GM-CSF含量呈下降趋势,但差异无统计学意义(P>0.05);脑脊液β-EP含量升高(P<0.05),脑脊液CCK-8含量呈下降趋势,但差异无统计学意义(P>0.05)。结论:TEAS防治正畸家兔牙痛的作用主要是通过在外周选择性抑制并降低血清致痛物质PGE_2含量、在中枢提高脑脊液镇痛物质β-EP含量和保持抗阿片肽痛觉维持物质CCK-8含量稳定实现的,外周和中枢途径均参与了其镇痛作用的发挥。

Objective To explore the action mechanisms of transcutaneous electrical acupoint stimulation （TEAS） on prevention and treatment of orthodontic toothache. Methods Twenty-four male New Zealand rabbits were randomly divided into a blank group, an orthodontic group and a TEAS group, 8 rabbits in each one. The orthodontic model of rabbit was made in orthodontic group and TEAS group by bonding brackets and fixing NI-TI screw with ligature wire. After model establishment, the TEAS group was treated with TEAS at ashi points （skin surface corresponding points to the bilateral upper 1st molars） and ＂Hegu＂ （LI 4） with dilatational wave, 20 min per treatment, twice a day, totally 2-day consecutive treatment （4 treatments） was provided. The rabbit general behavior, total food intake and threshold of pain were observed; the contents of serum prostaglandin E2 （PGE2）, granulocyte macrophage colony stimulating factor （GM-CSF） as well as endorphin （β-EP） fluid and eholecystoki- nin-8 （CCK-8） in cerebrospinal fluid （CSF） were detected. Results Compared with the orthodontic group, the rabbit general behavior, total food intake and threshold of pain in the TEAS group were significantly improved （P〈0.05, P〈0.01）. The serum PGE2 were significantly reduced （P〈0.05）, while GM-CSF presented reducing trend without statistical significance （P〈0.05）. The β-EP in the CSF were increased （P〈0.05）, while CCK-8 in CSF presented reducing trend without statistical significance （P〈0.05）. Conclusion The preventive and therapeutic effects of TEAS on rabbits with orthodontic toothache are achieved by reducing algogenie substance PGE2 in peripheral nervous system selectively, increasing β-EP in CSF in central nervous system and keeping the level of anti-opioid pain maintaining substance CCK-8. Both the central and peripheral nervous systems participate in the analgesic effect of TEAS.