不同穴位电针对分娩疼痛相关神经递质mRNA及蛋白表达影响的研究

Labor pain is one of a variety of pains which possess the highest pain threshold. So far, there is no satisfactory antalgic method for the treatment of labor pain. And the current study focuses on non-pharmacological and noninvasive analgesia..Modern medicine holds that the neurotransmitters have two-way regulating action in inducing algogenia and performing analgesia, and it is believed that the pain results from Qi and blood running barriers according to traditional Chinese medicine, known as "obstruction causes pain, malnutrition causes pain". As is well known, acupuncture mediates meridians and regulates Qi and blood, thus easing off pain based on the theory of "no obstruction, no pain". Although acupuncture has been used to treat pain for a great many of years, and achieved beneficial therapeutic outcomes, the potential mechanisms remain uncertain..Based on prophase researches, the present study aims to further explore the antalgic effect of electro-acupuncture at different acupoints, and to observe changes in mRNA levels and the protein expression of DA, 5-HT, NE, PDY, and their receptors in labor rats' brain, spinal cord tissues by Real-time PCR, Western blot, and other molecular biological technology, which will reveal the molecular mechanisms of electro-acupuncture alleviating labor pain. The findings will implicate a safe, effective, and simple treatment for labor pain, and provide scientific evidence and theoretical basis for further studying acupuncture analgesia in labor pain.

分娩疼痛是世界上疼痛阈值最高的疼痛种类之一，对于分娩疼痛，迄今为止，尚无令人满意的镇痛方法，非药物、无创伤镇痛已成为现代研究的热点。.现代医学认为神经递质对痛觉信息有致痛和镇痛双向调节的作用。中医学认为疼痛在于气、血运行障碍，"不通则痛、不荣亦痛"。针刺有"通其经脉，调其血气"来达到"通则不痛"的镇痛作用。针刺镇痛历史悠久，疗效明显，但其潜在机制尚未清楚。.本课题是在前期课题的基础上，进一步探讨不同穴位电针对分娩大鼠的镇痛效应，并应用Real-time PCR、Western blot等现代分子生物学技术检测不同穴位电针对分娩大鼠大脑、脊髓组织中DA、5-HT、NE 、PDY及其受体的mRNA和蛋白表达水平，揭示不同穴位电针对分娩镇痛的分子生物学机制，为分娩疼痛提供一种安全有效、操作简单的治疗方法，亦为电针对分娩镇痛的进一步研究提供科学依据和理论基础。

分娩疼痛是世界上疼痛阈值最高的疼痛种类之一，针灸镇痛具有历史悠久、效果明显，无创伤，对母婴安全无副作用的优势所在，但针灸镇痛机制有待明确，由于目前临床常用的分娩镇痛药物如，杜冷丁注射，镇痛效果明显，但其有可能通过胎盘进入胎儿体内对新生儿产生一过性的不良影响，因此，本研究探讨电针不同穴位对大鼠分娩镇痛效应及其神经递质作用机制，为分娩镇痛提供一种有效、操作简单、对母婴安全、无损伤的治疗方法，为电针分娩镇痛的进一步研究提供科学依据和理论基础。方法：120例模型孕鼠随机分为A空白组、B电针三阴交穴组、C电针合谷穴组、D电针合谷加三阴交组、F电针血海穴组、E药物组，热水甩尾测痛法观察大鼠痛阈值；Real-Time PCR及Western blot检测大鼠中枢神经递质及其受体mRNA与蛋白表达。结果：大鼠痛阈值比较, 干预前,差别无统计学意义（P>0.05）。干预后,有统计学意义（P<0.01）与空白组相比，电针各穴位组及药物组痛阈明显升高；中枢神经递质mRNA与蛋白表达水平，大脑灰质5-HT 、2A受体及NET、α2-AR，与空白组相比，电针各穴位组、药物组表达均明显升高； DA、Drd2 均明显降低；Pdyn、Oprk1组间差异不明显。而脊髓5-HT 、2A受体及Pdyn、Oprk1明显升高； NET、α2-AR明显降低；DA、Drd2组间差异不明显。结论：不同穴位产生不同针效作用，以三阴交组较好，血海相对较差。对于穴位间出现的这种差异性，推测可能与穴位所在的经络腧穴功效及其所处的神经解剖学位置有关；神经递质及其受体相互作用下参与电针穴位镇痛，神经递质镇痛靶点：5-HT 、2A受体在大脑、脊髓；NET、α2-AR在大脑；Pdyn、Oprk1在脊髓；DA、Drd2在大脑。