The Effect Of Needle Knife Intervention On Muscle ATP, Muscle Glycogen And Lactic Acid Content In Rat Model Of Trigger Point

Objective:Skeletal muscle pain symptoms,most around joints and the spine,is often caused by injuries during daily work,learning or exercise,which leads to the function disability of joint.And these pains are mostly caused by myofascial trigger point pain,referred to myofascial pain syndrome clinically.The performance of the syndrome are local pain,involving pain,autonomic nervous twitch and skeletal muscle dysfunction.Myofascial pain has seriously affected people's lives and work,and become an important reason for the consumption of health resources.In this study,we observe the medial vastus muscular trigger points' energy metabolism(adenosine triphosphate,muscle glycogen,lactic acid)of the trigger points of rats with the myofascial pain syndrome and the changes of acupotomy intervention.To explore the impact of treating the myofascial trigger points' energy metabolism by acupotomy.Methods:36 SD male rats were randomly divided into normal control group,model group,injection group,acupotomy group.Fasting 12 h before modeling,the trigger point of model rats were established by the method of crush plus eccentric exercise,once a week,for 8 weeks.At the end of modeling,each group randomly selected one evaluation model,the other eight were used for the detection of index.Blank group and model group were fed regularly,without intervention;Injection group and acupotomy group started treatment after successful modeling one week later.Injection group:conventional skin preparation,iodine volts local disinfection,in the medial side of the muscle triggering point(femoral medial is muscle in the middle of the proximal side of the induration),with 1ml syringe to the tension band injection the mixture of 2%lidocaine hydrochloride and 0.9%sodium chloride(1:1)0.5ml,for three weeks,once every week.Acupotomy group:conventional skin preparation,iodine volts local disinfection,in the medial side of the muscle triggering point(femoral medial is muscle in the middle of the proximal side of the induration),straight into the tension band and longitudinal incision with the(0.4mm × 40mm HZ)acupotomy,for three weeks,once every week.By detecting model rats trigger point of electromyography phenomenon and taut band to evaluation model;By detecting the hematoxylin-eosin(HE)staining picture to observe rats trigger pathological changes;By detecting high performance liquid chromatography and colorimetry to observe the medial vastus muscular trigger points'energy metabolism(adenosine triphosphate,muscle glycogen,lactic acid)of the trigger points of rats with the myofascial pain syndrome,and then the differences between the groups were analyzed statistically.Results:1.The positive rate of tension test showed that:By touching the muscle,spotted the taut bands and the positive rate of the experimental group was 100%(8/8)before the treatment.Compared with blank group,it was significant(P<0.01).After treatment,because of the model group did not intervene,1 case of belt tension is not obvious,the positive rate was 87.5%(7/8),and it was also significant difference between the blank and the model groups(P<0.01).Compared with the blank group,injection group and acupotomy group were no significant difference in the taut band(P>0.05).2.Electrophysiological test results showed that:Rat was randomly selected from 4 groups,the electrode needle from the blank group of rat inserted into the medial muscle,spotted a spontaneous electromyography occasionally,for 0.5s?1s and then keep the EMG resting state.The electrode needle was inserted from the possible triggering point of the medial muscle of the experimental group,leading to local twitch responses while the potential was longer than 30s and less than 10min.Randomly extracted experimental group of rats medial femoral muscle are swelling and induration,and where there is no stimulation of the EMG test,can lead to convulsions at the same time the potential is more than 30s and less than 10min,the results accord with the model standard.3.HE staining showed that:After modeling,the blank group cross section:the shape of the muscle cells were polygonal,the size was uniform and the arrangement was close,and no rounded,enlarged and deeply stained muscle cells were found.The longitudinal section:muscle fibers arranged closely and regularly.The experimental group cross section:Enlarged,rounded deep of the contractures were found,and the emergence of inflammatory cell infiltration and nuclear migration phenomenon.The longitudinal section:muscle fibers arranged loose,there are narrowed at both ends of the central expansion or thickness of the spindle muscle fibers ranging from the thickness.After treatment,the blank group cross-section shows:muscle fibers arranged in a regular order,was more dense polygonal structure,uniform size,neat arrangement,muscle gap rules.Longitudinal section shows:muscle fibers arranged closely,the shape of the rules,the thickness of uniform.Model group cross-section display:the emergence of increased,round deep-shaped contracture nodules.Longitudinal section shows:muscle fibers thickness are different,the middle of the expansion,both ends of the thinner,the diameter of the blank group than the increase in visible muscle fibers arranged disorder.Injection group cross-section display:muscle fibers were irregular shape,fiber edema to reduce,no contracture nodules.The longitudinal section showed the muscle fibers were still arranged in a spindle shape,but the diameter of the muscle fibers tends to be blank and the infiltration of inflammatory cells gradually decreased.The arrangement of the fibers were more neat and regular than the model group.No contracture nodules.Longitudinal section shows:part of the spindle muscle fiber thickness of the uniform and closely arranged,regular,muscle gap decreased.4.High performance liquid chromatography and colorimetry showed that:the content of adenosine triphosphate and myosin decreased and the content of lactic acid increased significantly(P<0.05)in the model group compared with the blank group at 8 weeks after modeling.Local muscle tissue adenosine triphosphate,muscle glycogen consumption increased,metabolic slow,metabolites lactate accumulation.Compared with the model group,the levels of adenosine triphosphate and myosin were increased and the content of lactic acid was decreased in the injection group and the needle group(P<0.05).The injection and needle group could affect the adenylate(P.>0.05),but there was no significant difference between the two groups(P>0.05).The above studies have shown that adenosine triphosphate,muscle glycogen and lactic acid are closely related,is the interaction,mutual influence.Conclusion:Acupotomy by intervening in the trigger points of muscle tissue,can reduce the pressure of local muscle tissue,is beneficial to recover the fiber morphology,arrangement and the oedema of the muscle.Acupotomy also can promote the release of local adenosine triphosphate and muscle glycogen,accelerate the metabolism of lactic acid.Thus mediate muscle energy metabolism,improve the continued contracting condition of muscles,alleviate the symptom of muscle pain.