电针联合刮痧对膝骨性关节炎大鼠疼痛及炎症因子表达的影响

Effects of EA Combined with Guasha on Pain Relief and Expressions of Inflammatory Factors in Rats with KOA

目的:观察电针联合刮痧对膝骨性关节炎(KOA)大鼠疼痛及背根神经节(DRG)和软骨组织中核因子κB p65(NF-κB p65)、P物质(SP)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)及五羟色胺(5-HT)表达的影响,探讨针灸治疗KOA慢性疼痛的最佳组合模式,为临床联合应用提供参考依据。方法:将48只8周龄雄性SD大鼠按1:5比例随机分为空白组和造模组,其中造模组包括模型组、电针组、刮痧组和电针+刮痧组。造模组采用谷氨酸钠碘乙酸关节腔注射法进行造模。干预组大鼠需进行2周的电针和刮痧干预。测定行缩爪潜伏期(PWL)和机械性痛阈值(PWT),苏木素-伊红(HE)染色观察大鼠膝关节软骨组织形态学改变,Western blot法检测大鼠DRG中NF-κB p65、SP蛋白表达,ELISA法检测大鼠膝关节软骨中IL-6、TFN-α与5-HT的含量。结果:模型组大鼠比空白组PWL、PWT显著降低(P<0.05或P<0.01),DRG中NF-κB p65、SP相对表达量以及软骨组织中IL-6、TNF-α及5-HT含量显著升高(P<0.01);相比于模型组,电针组与刮痧组大鼠PWL、PWT显著升高(P<0.01),DRG中NF-κB p65、SP与软骨组织中IL-6、TNF-α及5-HT表达均显著降低(P<0.01)。与单一治疗组相比,电针+刮痧组差异有统计学意义(P<0.05)。结论:电针联合刮痧可显著减少KOA大鼠疼痛相关因子SP、NF-κB p65、IL-6、TNF-α与5-HT的表达,降低大鼠脊髓痛觉敏化程度,最终改善KOA引起的疼痛。

Objective:To observe the effect of electro-acupuncture(EA)combined with Guasha on pain relief and expressions of NF-κB p65,SP,IL-6,TNF-αand 5-HT in dorsal root ganglion(DRG)and cartilage tissues of the rats with knee osteoarthritis(KOA),to explore the best combination mode of acupuncture for chronic pain of KOA,thus to provide a reference for its clinical combined application.Methods:48 SD male rats of 8-week-old were randomly divided into the blank group and the modeling group at a ratio of 1∶5.KOA model was established by intra-articular injection of sodium glutamate iodoacetic acid.The successful modeling rats were then randomly divided into the model group,the EA group,the Guasha group and the combination group(EA plus Guasha).The interventions of EA and Guasha were carried out for 2 weeks.Paw withdrawal latency(PWL)and paw withdrawal threshold(PWT)were measured in the groups.HE staining was used to observe the morphological changes of cartilage in rats with KOA.Western blot method was used to detect the protein expressions of NF-κB p65 and SP in DRG.ELISA method was used to detect the contents of IL-6,TNF-αand 5-HT in cartilage tissues.Results:Compared with those in the blank group,PWL and PWT were significantly decreased(P<0.01),the relative expressions of NF-κB p65 and SP in DRG and the contents of IL-6,TNF-αand 5-HT in cartilage tissues were significantly increased in the model group(P<0.01).Compared with those in the model group,PWL and PWT were significantly increased(P<0.01),the relative expressions of NF-κB p65 and SP in DRG and the contents of IL-6,TNF-αand 5-HT in cartilage tissues were significantly decreased in the EA group and the Guasha group(P<0.01).Compared with those of the EA group and the Guasha group,the effects of the combination group were more significant(P<0.05).Conclusion:EA combined with Guasha can significantly reduce the expressions of SP,NF-κB p65,IL-6,TNF-αand 5-HT in KOA rats,reduce the degree of spinal pain sensitization,and finally improve the pain caused by KOA.