Study On The Therapeutic Effect And Mechanism Of Repetitive Peripheral Magnetic Stimulation In Complex Regional Pain Syndrome Ⅰ

CRPS Ⅰ often occurs after injury,intractable pain as the main clinical features,may be accompanied by varying degrees of sensory abnormalities,movement disorders,and autonomic dysfunction.The acute phase（warm type）can be marked by inflammation signs such as redness,swelling,heat and pain.In the meantime,local tissues can present vascular dilation,inflammatory media exudation and so on.Some people can heal themselves over a period of time,or they can be cured after a period of treatment.But there are also some illnesses persistent cured,gradually into the chronic phase（cold type）,the period of CRPS Ⅰ inflammation in patients with gradually decreased,present obvious symptoms of unbearable pain and symptoms do not ease,cure rate is low,the serious influence on the quality of peoples’lives,even introduced mental symptoms.At present,the diagnostic criteria of this disease are rarely based on clinical practice,which are mainly based on clinical symptoms without clear support of objective evidence such as laboratory and imaging.Treatments are also limited.So we are looking for a new treatment to relieve the pain of these patients.Objective:1.To investigate whether rPMS with different frequencies（1Hz,10Hz）has therapeutic effect on tibial fracture rats.2.To investigate the changes of IL-6,TNFαand NSE in serum of CRPS Ⅰ rats after treatment of tibia fracture with rPMS of different frequencies（1Hz and 10Hz）.3.To investigate the changes of NGF gene expression and protein quantification in L_4-5DRG of the affected side of the rats after the treatment of tibia fracture with rPMS of different frequencies（1Hz,10Hz）in CRPS Ⅰ rats.Methods:This thesis includes three parts.In the first part,adult male Sprague-Dawley rats（1 month old）were selected and randomly divided into unmodulated group A（blank group）6 rats,modulated group B（model control group）6 rats,C（CRPS Ⅰ+1Hz group）6 rats,and D（CRPS Ⅰ+10Hz group）6 rats with 3 spare rats,with A total of 27 rats.Among them,21 rats of the model groups were established external fixation model of tibial fracture.After successful modeling,rats in the failure model group（dead,damaged limb）were excluded.Rats in the reserve group were randomly divided into group B,C and D,and finally 6 rats in group A,5 rats in group B,6 rats in group C and6 rats in group D.Paw Mechanical Withdrawal Threshold（PMWT）and Paw Thermal Withdrawal Latency（PTWL）were measured before and after modeling to evaluate the success of the external fixation model of tibial fracture in rats and the conditions of thermal pain and mechanical pain after fracture.Results:In the first part,PTWL and PWMT were measured for the affected posterior foot of all modeling rats after treatment,and the statistical results showed that PTWL of the affected posterior foot of rats in group B,C and D increased after treatment compared with before treatment,and the treatment effect of the treated group C and D was better than that of the untreated group B,with statistical significance（P<0.05）.After treatment,the PWMT of rats in group C and D were increased compared with that before treatment（P<0.05）,and the treatment effect of group D was better than that of group B,the difference was statistically significant（P<0.05）.In the second part,IL-6,TNFαand NSE of all rats were measured before and after treatment.Ⅰt was found that IL-6 of rats in group B,C and D decreased after treatment（P<0.05）,and there was a difference between group D and group B after treatment（P<0.05）,but no significant difference was found between group C and D.After treatment,the serum level of TNFαin group C and D decreased compared with that before treatment（P<0.01）,and there was a difference between group C and D and B（P<0.05）,but no significant difference was found between group C and D.After treatment,the NSE levels in group B,C and D were all decreased compared with before treatment（P<0.05）,but there was no significant difference between the three groups after treatment.In the third part,after treatment,DRG of L_4-5of the affected side of rats were taken for the determination of NGF expression.The NGF gene expression and protein quantity in the DRG of rats in group C and D were significantly lower than those in group B（P<0.01）,and there was no significant difference between group C and D.Conclusion:1.Both high-frequency and low-frequency rPMS can improve the heat pain and mechanical pain thresholds of CRPSⅠrats,and relieve the pain symptoms of rats.There is no difference between high-frequency and low-frequency rPMS.2.High-frequency and low-frequency rPMS can reduce IL-6 and TNFαof serum in CRPS Ⅰ rats,and reduce inflammatory response and alleviate allodynia,and there is no difference between high-frequency and low-frequency rPMS.3.High frequency RPMS and low frequency rPMS can reduce NGF expression in DRG of CRPS Ⅰ rats,repair DRG function and relieve allodynia,and there is no difference between high and low frequency rPMS.