【摘要】 目的探讨电针腧穴对肾绞痛大鼠的镇痛作用,并分析其镇痛机制。方法 2015-03-31至2015-04-28选取SPF级雄性SD大鼠26只,依据随机数字表法将所有大鼠分为正常组8只、模型组8只、电针组10只,适应性喂养7 d后,第8天起造模,正常组大鼠自由饮用蒸馏水,模型组及电针组大鼠自由饮用诱石剂水(1%乙二醇溶液+1%氯化铵水溶液),连续10 d,建立草酸钙结石致大鼠肾绞痛模型。造模成功后模型组及电针组均死亡1只。电针组大鼠选穴肾俞、三焦俞、三阴交和水泉进行电针治疗,共治疗3 d。治疗结束后第2天处死3组大鼠取材。比较造模后治疗前(后统称治疗前)及治疗第1、2、3天3组大鼠痛阈、模型组及电针组自发性疼痛评分,采用酶联免疫吸附试验(ELISA)法检测3组大鼠肾组织中血栓素A2(TXA2)、前列环素(PGI2)、5-羟色胺(5-HT)表达水平,观察取材后各组大鼠左肾组织病理学改变情况。结果治疗方法与时间在大鼠痛阈上存在交互作用(P<0.05);治疗方法和时间在大鼠痛阈上主效应显著(P<0.05);治疗前及治疗第1、2天模型组、电针组大鼠和治疗第3天模型组大鼠痛阈均短于正常组(P<0.05);治疗第1、2、3天电针组大鼠痛阈均长于模型组(P<0.05)。治疗方法与时间在大鼠自发性疼痛评分上存在交互作用(P<0.05);治疗方法和时间在大鼠自发性疼痛评分上主效应显著(P<0.05);治疗第1、2、3天电针组大鼠自发性疼痛评分均低于模型组(P<0.05)。模型组大鼠肾组织TXA2、PGI2、5-HT表达水平及电针组大鼠肾组织PGI2表达水平均高于正常组(P<0.05);电针组大鼠肾组织TXA2、PGI2、5-HT表达水平均低于模型组(P<0.05)。正常组大鼠肾脏内未见草酸钙结晶沉积,肾小球形态规则,周围组织无充血、无炎性细胞浸润,肾小管无扩张,细胞排列整齐,结构清晰。模型组大鼠肾小球形态规则,周围组织充血水肿且炎性细胞浸润,肾小管扩张明显且见草酸钙结晶,细胞排列紊乱,上皮细胞脱落坏死。电针组大鼠肾小球形态规则,周围组织少许充血且炎性细胞浸润,肾小管扩张但未见明显草酸钙结晶,细胞排列整齐,结构清晰,未见上皮细胞脱落坏死。结论电针腧穴对肾绞痛大鼠具有镇痛作用,且机制可能与下调炎性递质PGI2、TXA2及神经递质5-HT表达水平有关。更多还原

【Abstract】 Objective To study the analgesic effect and mechanism of electroacupuncture( EA) acupoints in renal colic rats. Methods From March 31,2015 to April 28,2015,26 male SD rats in a SPF grade were selected and divided into normal group( n = 8), model group( n = 8) and EA group( n = 10) by random number table method. The rats were fed adaptively for 7 days. From the 8th day,the rats in normal group were free to drink water,the rats of another groups were free to drink stone inducing agent( 1% ethylene glycol solution and 1% ammonium chloride aqueous solution) for 10 days to establish renal colic models induced by calcium oxalate stone. There were two deaths including one in model group and one in EA group after models were established successfully. The electroacupuncture was applied to " Shenshu "( BL23), " Sanjiaoshu "( BL22), " Sanyinjiao"( SP6) and " Shuiquan"( KI5) in the rats in EA group for 3 days. Rats were executed on the next day after treatment ended. Before treatment and on day 1,2,3 of treatment,pain threshold value was compared among the three groups,spontaneous pain score was compared between model group and EA group,the TXA2,PGI2 and 5- HT expressions among the three groups were detected by ELISA method,the pathological changes of the left kidney tissue of each group were observed after biopsies. Results There was interaction effect between treatment measure and time in pain threshold value( P <0. 05); the main effect between treatment measure and time was significant in pain threshold value( P < 0. 05); Rats in model group and EA group had lower pain threshold than normal group before treatment,and on the first and second day of treatment( P< 0. 05); the rats in model group had lower pain threshold than normal group on the third day of treatment( P < 0. 05); the rats in EA group had higher pain threshold than model group on day 1,2,3 of treatment( P < 0. 05). There was interaction effect between treatment measure and time in the score of spontaneous pain( P < 0. 05); the main effect between treatment measure and time was significant in the score of spontaneous pain( P < 0. 05); the rats in EA group had lower score of spontaneous pain than model group on day 1,2,3 of treatment( P < 0. 05). The rats of model group were higher than normal group in the expressions of TXA2,PGI2 and 5-HT in renal tissue,and EA group was higher than normal group in the expression of PGI2 in renal tissue( P < 0. 05); the rats of EA group were lower than model group in the expressions of TXA2,PGI2 and 5-HT in renal tissue( P < 0. 05). For normal group,no calcium oxalate crystal deposit was observed in kidney; glomerular morphology was regular; no congestion in surrounding tissue, no infiltration of inflammatory cells, and no expansion of kidney tubules were found; the cells were in alignment and clear structure. For model group, glomerular morphology was regular; congestion and edema in surrounding tissue,infiltration of inflammatory cells,obvious expansion of kidney tubules,and calcium oxalate crystal deposit were noted; the cells were in disorder, and epithelial cells fell off and were necrotic. For EA group, glomerular morphology was regular; slight congestion and infiltration of inflammatory cells in surrounding tissue,and expansion of kidney tubules were noted, but no calcium oxalate crystal deposit was observed; the cells were in disorder and clear structure; no epithelial cells fell off and were necrotic. Conclusion The EA acupoints treatment has analgesic effect on renal colic rats. The therapeutic mechanism is possibly achieved by inhibiting the expressions of inflammatory mediators TXA2, PGI2 and neurotransmitter 5-HT.更多还原