| BackgroundAcupuncture has been widely used in China to be one of the valid,major indications in treating disease,in particular pain.Earlier studies have demonstrated that treatment with acupuncture have a good analgesic effect in control of back pain,leg pain,joint pain and other diseases.Despite the efficacy of warm acupuncture,moxibustion,however,does have some disadvantages,such as the presence of smoke,the limited space of local air pollution,and easy to burn skin when ash falls as well as uncontrollable temperature.Heat acupuncture therapy is an alternative treatment giving the corresponding heat stimulation,during which the electrodes inside of the tissue are heated.It has been considered an alternative approach to replace moxibustion with good analgesic effect.Our previous work has shown that "non-painful" heating-needle stimulation(43 ?)can specifically evoke the endogenous descending inhibition alone without activating descending facilitation.In addition,the thalamic ventral(ventromedial,VM)nuclear are documented to be involved in the regulation of descending inhibition.It is well known that,strategy of "Treating Diseases in Upper Part by Managing Lower" is commonly used in clinical medicine treatment principles.Although "Treating Diseases in Upper Part by Managing Lower" has a clear clinical analgesic efficacy,neural mechanisms involved in the regulation of the analgesic is currently still unclear.This topic will build muscle pain model which is induced by intramuscular injection based on complete Freund's adjuvant(complete Freund's adjuvant,CFA),through the lower limbs "Chengshan points(BL57)" and upper limbs "Neiguan(PC6)" were given time courses,temperature and heat stimulation,exploring " Treating Diseases in Upper Part by Managing Lower " treatment efficacy and the difference,as well as exploring further spin cord and more high central: nuclei of the hypothalamus,participating in the above nerve regulation mechanism which may has analgesic effect.Objective Through the selection of upper limb Neiguan point and lower extremity Cheng Shan points in 43 degrees Celsius or 46 degrees Celsius heat in rats with complete Freund's adjuvant muscle pain model,compare therapeutic effect of muscle pain of Neiguan and Chengshan acupuncture point of CFA models,and further to determine the "disease treatment is clinical feasibility.Finally,the related nuclei of thalamus were treated with different receptor antagonists to explore the mechanism of central regulation and controlMethods1.Noxious mechanical and thermal stimuli: mechanical stimulation We used von Frey instrument of pain and hot instrument to measured after rat paw withdrawal reflex threshold a latency.before or after modeling rats.2.CFA modeling: different doses of CFA were injected into the side of hind limb gastrocnemius muscle of rats to elicit muscle pain model.Injection site was in the middle part of the gastrocnemius,the needle depth was about 0.5 cm,and the injection time exceeded over 30 s..meanwhile,the degree of inflammatory swelling of the affected tissues was observed3.Needle heat treatment: under 4% isoflurane inhalation anesthesia,heat needle(concentric stainless steel needle: diameter 1.05 mm,length 30 mm)pierce the lower extremities "Chengshan points" / upper extremity "Neiguan",depth 0.5 cm,adjusting heating temperature to be 43 ? or 46 ?,while giving different time courses muscle stimulation process heat,the temperature does not change more than ± 0.25 ?.4.Microinjection of the brain: in anesthetized with sodium pentobarbital(50 mg / kg,intraperitoneally),use stereotaxic instrument to conduct craniotomy to place cannula(VM nucleus located anterior fontanelle after 2.3-3.3 mm,midline next to the open1.6 mm,under the skull 7-7.4 mm).Rat's wound was cleaned with sterile 0.9%saline,and antibiotics,and closed with dental cement.One week recovery period is arranged,and then microinjection of atipamezole or WAY-100635 into the target thalamic nucleus was performed.After then,the rats' behaviors were observed during the exposure to heating-needle treatment.5.Rat muscle involvement tissue IL-1 and TNF-? measurement: enzyme-linked immunosorbent assay(ELISA)for measuringResults1.Compared with the control group,the inner side of the gastrocnemius100?200?l CFA injection can cause mechanical hyperalgesia in rats with bilateral response(P <0.05).1 day after injection with 50-100?l CFA,rats showed a reduced pain response bilateral thermal phenomenon;and after injection 1h after 200?l CFA injection,rats were induced to reduce the phenomenon of thermal pain response,and maintain seven days(P < 0.05);the inner side of the gastrocnemius muscle injection with100-200?l CFA causes rats side hind limb tissue inflammatory swelling(P <0.05),while the contralateral hindlimb no significant change(P > 0.05).2.15-45 min 43 ? heat intramuscular needle BL57 acupoint stimulation had no significant effect on the CFA-induced inflammation in rats with bilateral mechanical allodynia(P > 0.05);compared with 15 min 43 ? heat needle,30-45 min 43 ?heat stimulation can induce more significant bilateral reduced pain response in rats hot phenomenon(P <0.05);induced inflammatory swelling after 30-45 min 43 ?heat acupuncture on rats was significantly lower(P < 0.05).3.30-45 min 46 ? heat acupuncture needle BL57 within CFA induced muscle stimulation have bilateral mechanical allodynia significantly higher phenomenon(P<0.05)in rats inflammation,and reduce pain response bilateral thermal phenomenon is more obvious(P <0.05);15-45 min 46 ? heat has no significant effect(P >0.05)on induced inflammation in rat hind inflammatory swelling.4.Similar to Ipsilateral hind BL57 acupoint stimulation effect,after giving PC6 acupoint 30 min 43 ? needle after heat treatment on ipsilateral / contralateral upper extremity muscles,none significantly affect(P > 0.05)on bilateral mechanical hyperalgesia,but it can significantly enhance the bilateral level to reduce the thermal pain response(P < 0.05);and significantly reduce inflammatory swelling of the ipsilateral limb(P < 0.05).Having given PC6 acupoint 30 min46 ? needle after heat treatment on Ipsilateral / contralateral upper extremity muscles,bilateral mechanical hyperalgesia was significantly higher(P < 0.05),and decreased heat pain on both sides to reduce the phenomenon of reaction(P <0.05);however,after 30 min 46 ? heat inside the needle ipsilateral / contralateral upper extremity muscles PC6 acupuncture treatment,ipsilateral CFA inflammation inflammatory swelling of hind limbs did not change significantly(P > 0.05).5.Thalamus VM microinjection atipamezole can inhibit significantly heat needle phenomenon caused by reduced(P < 0.05)caused byheat pain reaction 43 ?;while in the VM microinjection atipamezole and WAY-100635 inhibited the phenomenon of pain(P < 0.05)caused by 46 ? heat hot needle.6.43 ? heat needle BL57 and PC6 acupoint stimulation can significantly reduce tissues in IL-1 and TNF-? content(P < 0.05)on muscle pain model in rat CFA affected.Conclusion1.Intramuscular injection in the CFA-induced inflammatory rats has caused muscle pain,resulting in the affected tissue swelling,IL-1 and TNF-? content organization increased,behavioral shows hindfeet mechanical hyperalgesia increased,and heat pain reaction phenomenon reduced.2.43 ? heat pin can individually activates endogenous descending inhibition,significantly reducing paw swelling in rat CFA-induced inflammation,and reduce IL-1 and TNF-? content in the affected tissues.3.46 ? heat needle,can simultaneously activate the descending inhibition of endogenous and descending facilitation,but cannot reduce the CFA paw swelling induced inflammation in rats.4.Using the 43 ? heat acupuncture on Ipsilateral lower extremity BL57 and ipsilateral / contralateral upper extremity PC6,has the same effect on analgesia CFA-induced inflammation rats,indicating that " Treating Diseases in Upper Part by Managing Lower " has the theoretical basis.5.5 Thalamic VM microinjection atipamezole does work significantly on inhibiting43 ? heat loss for hot pain in rats;and atipamezole and WAY-100635 inhibited46 ? heat for hot rat pain diminished role.These results suggest that different mechanisms of hypothalamic nuclear VM pin at different temperatures for heat induced by stimulation of descending inhibitory regulation. |
PDF Full Text Request