电痛阈测定法对光敏剂亚甲兰镇痛效果的评定

目的:利用电痛阈测定法精确评定光敏剂亚甲兰的镇痛效应。方法:50只SD大鼠随机分为5组:生理盐水组、0.25%亚甲兰组、0.5%亚甲兰组、0.75%亚甲兰组、1%亚甲兰组。将清醒大鼠的右下肢给予刺激,左肢引导,给予以0.28mA为起始强度、0.02mA为阶梯值的5个串长的连续递增的电刺激,观察给予一定的刺激强度后经过一定的潜伏期后出现第一个复合波形后的相对应的电流值,作为动物给药前之基础痛阈值。选择靠近刺激电极中枢段的右侧坐骨神经为阻断点,神经刺激器定位,注射药物,同样的方法观察记录给药后的1h、2h、3h、4h、6h、8h、12h、24h的痛阈的变化,来确定药物的镇痛效果及药物的起效时间和作用高峰时间。结果:0.25%组亚甲兰无效应,0.5%组在4小时起效,与对照组比较有显著差异,但是很快又恢复至对照水平。0.75%组注射后3小时起效果,与对照组比较有显著差异,且这种效果可以持续12小时:1%组注射后2小时起效果,与对照组比较有显著差异,且这种效果可以持续24小时之久。结论:亚甲兰可以提高大鼠的痛阈值,且有浓度递增效应。0.75%组和1%组阻滞效果显著,2小时至3小时起效,4小时达高峰。

电痛阈测定法与视觉模拟法用于评定硬膜外术后镇痛效果的比较

视觉模拟法(VAS)是目前临床疼痛测量常用的方法之一。电痛阈测定法通过给予一定电刺激引起痛觉,根据痛阈变化间接反映疼痛感觉改变。我们将上述两种方法同时用于硬膜外术后镇痛效果评价,旨在探讨二者的优缺点和相关性。研究方法麻醉方法、硬膜外镇痛方式、监测和病例分组均同前文,疼痛评定:(1)VAS法采用一长度为10cm的无标记线段,左端表示完全无痛,右端表示可想象的最剧烈的疼痛,两者之间为疼痛逐渐加剧,令受试者根据疼痛剧烈程度在线段的相应长度处划标记,以标记到线段左端的距离(cm)值为VAS评分值;(2)

不同镇痛模式治疗慢性非癌性疼痛患者的效果分析

目的:探究不同镇痛模式应用于慢性非癌性疼痛患者的镇痛效果。方法:选择2021年8月—2022年9月于启东市人民医院接受治疗的120例慢性非癌性疼痛患者为研究对象,分为研究组(n=60,接受综合镇痛)与对照组(n=60,单纯接受药物镇痛),比较两组患者的治疗效果。结果:两组患者接受治疗后电痛阈及温度痛阈均较治疗前升高(均P<0.05),研究组患者电痛域及温度痛域均明显高于对照组(7.91±0.41 mA vs 7.21±0.39 mA,48.23±1.65℃vs 47.01±1.55℃,均P<0.05)。两组患者治疗后汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分均较治疗前降低(均P<0.05),研究组HAMA和HAMD均明显低于对照组(7.12±1.56分vs 9.89±2.08分,8.12±2.14分vs 10.23±2.98分,均P<0.05)。两组患者治疗后血清β-内啡肽(β-EP)、促肾上腺皮质激素(ACTH)及皮质醇(COR)水平较治疗前降低,研究组β-EP、ACTH及COR均明显低于对照组(均P<0.05)。研究组不良反应发生率低于对照组(10%vs 25%,P<0.05)。结论:采取综合镇痛措施治疗慢性非癌性疼痛患者,可提高电痛阈和温度痛阈,改善焦虑抑郁等不良情绪,降低炎症因子及不良反应发生率。

Role of transient receptor potential vanilloid subetype 1 in the increase of thermal pain threshold by moxibustion

OBTECTIVE:To explore the role of transient receptor potential vaniiloid subetype 1(TRPV1) in the increase of the thermal pain threshold by moxibustion.METHODS:Forty Kunming mice(20 ± 2) g were randomized into control group,capsaicin group,capsazepine group,moxibustion group and moxibustion + capsazepine(MC) group with 8 mice in each,and 16 C57BL/6 wild-type mice(18 ± 2) g were randomized into wild-type(WT) control group and WT moxibustion group with 8 mice in each,and 14 TRPV1 knockout mice(18 ± 2) g were randomized into knockout(KO) control group and KO moxibustion group with 7 in each.Each mouse in the capsaicin group was subcutaneously injected with the amount of 0.1 mL/10 g into L5 and L6 spinal cords;each mouse in the capsazepine group was intraperitoneally injected with the amount of0.1 mL/10 g.Similarly,each mouse in the moxibustion group was given a suspended moxibustion with specially-made moxa-stick for 20 min on L5 and L6 spinal cords.Each mouse in MC group was intraperitoneally injected with the amount of 0.1 mL/10 g first,then after 15 min was given a suspended moxibustion for 20 min on L5 and L6 spinal cords.Each mouse in WT moxibustion group and KO moxibustion group was given a suspended moxibustion with specially-made moxa-stick for 20 min on L5 and L6 spinal cords.The control group,WT control group and KO control group were of no treatment in any way.After all treatments were completed,the digital-display measurement instrument for thermal pain was used to measure the threshold of thermal pain in each group respectively.RESULTS:Compared with the control group,the thresholds of thermal pain in the moxibustion group and MC group were significantly increased(P <0.01);no significant changes in the thresholds in the capsaicin group and the capsazepine group(P > 0.05);compared with moxibustion group,he threshold of thermal in MC group was obviously decreased(P < 0.01).Compared with WT control group,the threshold of thermal pain in WT moxibustion group was significantly increased(P <0.01);compared with KO control group,no changes in the threshold in KO moxibustion group(P > 0.05).CONCLUSION:TRPV1 participated in the process of increasing the threshold of thermal pain by stimulating L5 and L6 of mice spinal cord with burning mosa-stick.