基于MAPK／p38信号通路探讨灵龟八法开穴电针对产妇分娩镇痛效应及其机制研究

Labor pain is one of the important problems faced by the health care system all the world.Acupuncture analgesia has a long history, and the curative effect is obvious.With The rapid development of the biomedicine,the study on Spirit turtle eight method acupuncture analgesia and its potential mechanism becomes a hot spot of current research.In preliminary study, our team applied Spirit turtle eight method electroacupuncture and acupoint massage to puerperae,and found it can effectively ease the pain and reduce maternal amniotic fluid in the role of PG expression；Animal experiments showed the curative childbirth pain threshold of rats can be improved,and the gene and protein expression of spinal cord DYN can also be elevated.The study confirms that p38 lightning for upstream of PGE2 gene and protein expression regulation substances, controls the occurrence and development of the pain.Thus,in this project,we will study Spirit turtle eight labor analgesia effect based on the MAPK/p38 lightning signal pathway,and detect gene and protein expression of the target cells p38 lightning signal molecule-MKP 1, p38 lightning and PLA2 and the effector molecule-PGE2 by Western blot and Real-time PCR,then reveal spirit turtle eight electric method for labor analgesia effect and its mechanism on molecular level,and provides a simple, safe,effective, no wound non-drug analgesia method for the puerperae labor analgesia,and provide scientific and theoretical basis for labor analgesia acupuncture.

分娩疼痛是目前世界各国健康保健系统所面临的重要问题，针刺镇痛历史悠久，疗效明显，随着时间生物医学的迅速发展，对神奇的灵龟八法开穴镇痛及潜在机制探讨成为当前研究的热点。.课题组前期对产妇应用灵龟八法开穴电针及穴位按摩，发现能有效减缓产妇疼痛及降低羊水中PG表达的作用；动物实验显示，电针分娩大鼠三阴交穴可提高痛阈值并使其脊髓DYN基因与蛋白表达升高。而研究证实p38为PGE2基因和蛋白表达的上游调节物质，调控着疼痛的发生、发展。由此，本项目从MAPK／p38信号通路探讨灵龟八法开穴电针对分娩镇痛效应及采用Western blot、Real-time PCR技术检测靶细胞p38信号分子MKP-1、p38、PLA2及效应分子PGE2的基因与蛋白表达，从分子水平揭示灵龟八法电针对分娩镇痛作用及其机制，为产妇分娩提供一种简单易行、安全有效，无创伤非药物的镇痛方法；为针刺分娩镇痛提供科学依据和理论基础。

分娩疼痛是人类健康保健系统所面临的重要问题，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。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，但其镇痛机制有待明确，随着时间生物医学的迅速发展，对神奇的灵龟八法开穴镇痛及潜在机制探讨成为当前研究的热点。MAPK 信号通路广泛存在真核细胞内，在刺激信号下可通过一系列高度保守的激酶、磷酸酯酶两位点磷酸化和去磷酸化级联反应将胞外刺激信号转换至胞核内，产生生物学效应，调控疼痛的发生发展。近年来，做为疼痛靶标的研究而被人关注。.本项目基于MAPK/P38信号通路，通过对320例初产妇临床观察显示灵龟八法开穴电针组对产妇分娩疼痛具有明显的镇痛效果，且镇痛疗效持续时间要优于药物镇痛，这可能与药物半衰期有关；可有效缩短产妇产程时间，减少产后2h内子宫出血量，提高新生儿出生后1分钟、5分钟的Apgar评分及降低产妇胎盘组织P38信号分子P38、P-p38、MKP-1、PLA2、P-pLA2及效应分子EP2磷酸化蛋白与mRNA表达；提高血清DYN浓度的表达，推测，灵龟八法开穴电针对产妇分娩疼痛的镇痛作用机制是与其抑制P38及其下游信号分子的活化，降低EP2的表达作用有关。.本研究从细胞分子生物水平揭示灵龟八法开穴电针对分娩镇痛的作用机制，为产妇分娩疼痛提供一条有效的镇痛途征，也为灵龟八法开穴电针对产妇分娩镇痛提供理论依据。