| Sciatica is the most common neuropathic pain in clinic.It refers to the syndrome of pain along the sciatic nerve and its distribution caused by various causes.According to statistics,the prevalence of sciatica is the first in all kinds of neuropathic pain.The global prevalence rate is 1.6-4.5%,and 121.8/100000 in China,of which 6.5%are women and 3.0%are men.In recent years,it has a rising trend,seriously affecting the quality of life of patients.Nearly 90%of the causes of sciatica are caused by lumbar disc herniation,and its treatment mainly refers to the treatment of lumbar disc herniation.Modern medical treatment mainly includes surgical treatment and non-surgical treatment.Surgical treatment is mainly aimed at patients with clear diagnosis,serious condition and no obvious remission after three months of non-surgical treatment.Non-surgical treatment mainly includes bed rest and drug treatment.Drug treatment mainly includes non steroidal analgesics and hormone drugs.At present,there are still some problems in the treatment of sciatica in modern medicine,such as recurrence after operation,side effects caused by drug treatment and so on.Sciatica is a modern medical term,which belongs to the category of "white vein disease of lower limbs" in traditional Mongolian medicine.According to the cold and heat theory of Mongolian medicine,the lower extremity leukaemia is mostly caused by cold external causes,and the treatment is usually based on warm and hot treatment.Mongolian medicine usually uses Mongolian medicine to treat leukaemia and traditional therapy to treat leukaemia of lower limbs,or both.The main drugs used in the treatment were zhacong-13 Weiwan,shijueming-25,Erdun wurile and mercury-18.When the cold was more severe,warm drugs such as Naru-3 Weiwan were used.Traditional Mongolian medicine uses kidney point,hip point,thigh point and other points for cupping,moxibustion,acupuncture and warm acupuncture.Mongolian warm needling therapy is a kind of warm needling therapy in which the silver needle is inserted into the acupoints of the body to introduce acupuncture stimulation and warm stimulation.Mongolian medicine warm acupuncture uses acupuncture stimulation and warm heat stimulation to regulate the body’s signal energy and nerve body fluid immunity to achieve the purpose of treating diseases.Warm needling therapy mainly regulates the balance of internal and external environment of the body to achieve the purpose of disease prevention and treatment.It has been proved by clinical experiments that warm acupuncture has anti-inflammatory and analgesic effects.Because of its complex mechanism,the use of Mongolian warm needle therapy in clinical practice is limited.In this study,Mongolian warm needling therapy was used to treat the chronic compression of sciatic nerve(CCI)model in rats,and the changes of pain behavior,serum inflammatory factors,antioxidant enzymes,NF KB signal pathway and Nrf2 signal pathway related protein expression of sciatic nerve were observed to explain the mechanism of Mongolian warm needling therapy on the anti-inflammatory,anti-oxidation and analgesic effects of sciatica.[Objective]:(1)to observe the changes of pain behavior,serum inflammatory factors and antioxidant enzymes,and to explain the mechanism of Mongolian warm needle therapy on sciatica.(2)to observe the changes of NF KB signal pathway and Nrf2 signal pathway related protein expression in sciatic nerve of CCI model rats,and to reveal the mechanism of Mongolian warm needle therapy on anti-inflammatory and anti-oxidation of sciatica.(3)try to understand and elaborate the concept of cell signal pathway in modern medicine from the balance of internal and external environment,white vein and the operation law of Heyi in the whole theory.[research method]:60 male SD rats of SPF grade were randomly divided into CCI model group,sham operation group,warm needling group,acupuncture group and Western medicine group,with 15 rats in each group.According to Bennett Xie’s method,the CCI model was made,that is,the right sciatic nerve was separated for about 7mm,and the sciatic nerve was ligated with 4-0 surgical suture for 4 segments(each segment was separated by 1mm),with a total length of 4-5mm.After ligation,the model was made by anti-inflammatory suture.The rats in the sham operation group were only sutured after exposure of the sciatic nerve without ligation,and the other groups were made CCI models.After modeling,the rats in each group were observed on 3,7,15,21 and 30 days respectively,and the pain behavior was evaluated by the mechanical stimulation pain threshold(MWT)and the thermal contraction leg latency(TWL).The rats were placed in a plexiglass box for 30 minutes,and the soles of the feet were stimulated with von Frey cilia of different intensities.Starting from 0.2g in ascending sequence,the cilia were slightly bent into S-shape as the standard,and the stimulation lasted for 8 s,10 times in a row,with an interval of at least 10 s each time.Until more than 5 times of leg lifting in every 10 tests,the grams of the lowest vonfrey cilia that can cause 50%of leg lifting are counted as MWT.The rats were placed in the hot plate apparatus in a quiet state,and were given the thermal stimulation(IR=60)at the base of the claw on the modeling side(right side).The time from the beginning of the thermal stimulation to the emergence of foot retraction and escape reflex(s)was recorded,and repeated three times,with an interval of 10 minutes.The average value was taken as the TWL value.After 15 days of making the model,the rats in the warm acupuncture group were treated with kidney point and hip point for 15 minutes/day,ibuprofen suspension(0.3g*kg-1)for 15 days,and the rats in the acupuncture group were treated with kidney point and hip point for 15 days Minutes/day,15 days of treatment.At the end of treatment,10 rats in each group were taken from abdominal aorta for blood sampling.Serum inflammatory factors,i.e.inflammatory factor IL-1β(IL-1β),anti-inflammatory factor IL-4(IL-4),oxidative stress-related enzymes and metabolites,i.e.free radical related enzymes,i.e.superoxide dismutase(SOD),glutathione(GSH),catalase(CAT),were determined by enzyme-linked immunosorbent assay(ELISA),MDA,etc.The expression of IKB,p-ikb,NF KB and Keap1,Nrf2 and HO-1 were measured by Western blot.Immunohistochemistry was used to observe the morphological changes of DRG cells in 5 rats in each group.[results]:(1)pain behavior:MWT and TWL in the warm acupuncture group were significantly higher than those in the CCI model group(P<0.05).Mongolian medicine warm acupuncture can significantly alleviate the pain response caused by mechanical and thermal stimulation in the CCI model rats.(2)serum changes:the serum inflammatory factor IL-1β in warm acupuncture group was significantly lower than that in CCI model group(P<0.05),IL-4 was significantly higher(P<0.05),SOD was significantly higher(P<0.05),MDA was significantly lower(P<0.05),GSH and cat were not significantly different(P>0.05).(3)changes of signal pathway protein:compared with CCI model group,NF KB signal pathway and Nrf2 signal pathway related protein expression were significantly down regulated.(4)sympathetic sprouting changes:compared with CCI model group,the number of cells in DRG sympathetic sprouting basket structure was significantly reduced.[Conclusion]:(1)Mongolian medicine warm treatment can alleviate the abnormal pain caused by mechanical and temperature after ligation of sciatica node.(2)warm acupuncture can inhibit the release of inflammatory factors and increase the release of inflammatory factors in CCI model rats.Mongolian warm needle therapy can increase the content of SOD in serum.(3)warm acupuncture has anti-inflammnatory and anti-oxidation effects on sciatica,and can reduce the expression of NF KB signal pathway and Nrf2 signal pathway related proteins,and inhibit the sprouting of dorsal root ganglion sympathetic nerve,so as to play an analgesic role.(4)Mongolian medicine warm needle therapy has obvious analgesic effect,safety and no side effects,which can be widely used in the clinical treatment of sciatica. |
PDF Full Text Request