两种脊柱手法治疗模型大鼠急性神经根炎症的镇痛效果观察

Lei HAN; Ping ZHAO; Xue HAN; Jie WEI; Fei WANG; Yi LI; Guang-jin GUO

doi:10.1007/s11655-021-3276-y

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两种脊柱手法治疗模型大鼠急性神经根炎症的镇痛效果观察

Original Article | Updated：2022-06-27

- 两种脊柱手法治疗模型大鼠急性神经根炎症的镇痛效果观察
- Analgesic Effects of Two Types of Spinal Manipulation in Acute Lumbar Radiculopathy Model Rats
- Chinese Journal of Integrative Medicine 2022年28卷第6期页码：518-530
- Affiliations：
  
  1.Spine Center of Manipulative Orthopedics, Air Force Medical Center, Beijing (100142), China
  2.Department of Bone and Joint Imaging Diagnosis, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing (100102), China
- Author bio：
  
  Prof. ZHAO Ping, E-mail: kzzp@sina.com
- Funds：
  
  Youth Project of National Natural Science Foundation of China(81503602)
- DOI：10.1007/s11655-021-3276-y
  中图分类号：
- 纸质出版日期：2022-06-01，
  
  网络出版日期：2021-09-29，
  
  录用日期：2019-08-24
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Lei HAN, Ping ZHAO, Xue HAN, 等. 两种脊柱手法治疗模型大鼠急性神经根炎症的镇痛效果观察[J]. Chinese Journal of Integrative Medicine, 2022,28(6):518-530.

Lei HAN, Ping ZHAO, Xue HAN, et al. Analgesic Effects of Two Types of Spinal Manipulation in Acute Lumbar Radiculopathy Model Rats[J]. Chinese Journal of Integrative Medicine, 2022,28(6):518-530.
Lei HAN, Ping ZHAO, Xue HAN, 等. 两种脊柱手法治疗模型大鼠急性神经根炎症的镇痛效果观察[J]. Chinese Journal of Integrative Medicine, 2022,28(6):518-530. DOI： 10.1007/s11655-021-3276-y.

Lei HAN, Ping ZHAO, Xue HAN, et al. Analgesic Effects of Two Types of Spinal Manipulation in Acute Lumbar Radiculopathy Model Rats[J]. Chinese Journal of Integrative Medicine, 2022,28(6):518-530. DOI： 10.1007/s11655-021-3276-y.

摘要

目的:

观察2种脊柱手法对自体髓核组织诱导的急性神经根炎症模型大鼠根性疼痛的干预效果

探讨其作用机制.

方法:

采用随机数字表法将108只雄性SD大鼠随机分为6组

包括空白组、假手术组、模型组、假手法组、松动手法组及调整手法组

每组18只. 其中空白组为无任何干预的正常对照; 假手术组只在相应椎节(L5-6)左侧做局部软组织切开; 模型组通过手术在特定椎节(L5-6)左侧椎间孔外口神经根处植入自体髓核组织

建立急性L5神经根炎模型; 假手法组对模型大鼠施行匀速旋转运动; 松动手法组对模型大鼠施行低速低幅旋转运动; 调整手法组对模型大鼠施行高速低幅旋转运动. 3种模拟手法分别于造模后1、3、5、8、10、12天进行干预

其余3组无任何特殊干预. 每组各取6只大鼠于术前1天及术后第1—7、10、12、14天进行一般行为学观察

测定50%机械性撤足痛阈值(PWT)和热辐射刺激缩爪反应潜伏期 (PWL). 另各取6只大鼠分别于术后第5和12天检测术侧L5背根神经节中一氧化氮合酶(NOS)的表达.

结果:

3组模拟手法干预后

调整手法组50%PWT和PWL在术后第6、7天时高于假手法组

第10、12、14天时更高(

0.05或

0.01)

而松动手法组在术后1—4天时高于调整手法组(

0.05或

0.01). 调整手法组和松动手法组NOS表达在术后第12天低于假手法组(

0.01).

结论:

在镇痛方面

调整手法、松动手法均能产生比假手法更好的效果

可能通过减少神经炎症发挥作用. 在治疗早期阶段

与调整手法比较

松动手法刺激反应更小. 脊柱手法可能抑制NOS过度表达

从而减轻神经根强烈的炎症刺激反应.

Abstract

Objective:

To compare the analgesic effects of two types of spinal manipulation (SM) in acute lumbar radiculopathy (ALR) model rats induced by self-transplantation of autologous nucleus pulposus (ANP)

and clarify the therapeutic mechanism.

Methods:

Totally 108 male Sprague-Dawley rats were randomly divided into 6 groups by a random number table (18 rats in each group)

including a blank group with no interference

a sham operation group with a surgery by making a local soft tissue incision on the left side of L5–6 vertebral segment

a model group with ALR of L5 extraforaminal nerve by ANP self-transplantation without other interference

a sham manipulation (SMA) group with simulating physical rotation

as well as a mobilization (MOB) group with simulating low-velocity and variable-amplitude rotation and a manipulation (MAN) group with simulating high-velocity and low-amplitude rotation. The interventions in SMA

MOB

and MAN groups started 1 day after modeling followed by another 5 treatments at days 3

10 and 12. Rats in the other 3 groups did not receive any special intervention. Behavioral pain tests of 50% mechanical pain withdrawal threshold (50% PWT) and paw withdrawal latency (PWL) were conducted 1 day before operation followed by another 10 tests on days 1–7

12 and 14. Immunohistochemical expression of nitric oxide synthase (NOS) was investigated on days 5 and 12 after operation.

Results:

After 3 experimental SM interventions

50% PWT and PWL were higher in the MAN group than the SMA group on days 6 and 7

and higher on days 10

12 and 14 postoperatively (

0.05 or

0.01)

while the same indices were significantly higher in the MOB group than MAN group on days 1–4 (

0.05 or

0.01). The expression of NOS was lower in the MAN and MOB groups than SMA group on day 12 postoperatively (

0.01).

Conclusions:

Both manipulation and mobilization produced better results than sham interference in relieving pain by reducing neuroinflammation possibly. At the early period

compared with manipulation

mobilization presented less sensitive response to pain until later visit. SM may inhibit the overexpression of NOS

thereby alleviating severe radiculopathy.

关键词

Keywords

spinal manipulationradiculopathyanti-inflammationanalgesia

references

Feng TY, ed. Clinical study on the treatment of soft tissue injury with integrated Chinese and Western medicine.Beijing: China Science and Technology Press; 2002:33-35.

Zhang MC, Zhan HS, Shi YY, Huang SY, Wang X.Diagnosis and treatment of intervertebral disc disease based on the theory of "Gucuofeng and Jinchucao". Chin J Orthop Trauma (Chin) 2008;21:441-445.

Zhang MC, Zhan HS, Shi YY, Chen YW, Wang X, Huang SY.Systematic research on joint semi-dislocation and sinews off-position. Shanghai J Tradit Chin Med (Chin) 2009;43:59-63.

Zhu QG, Fang M, Pan L, Gu LX, Shen GQ, Chen YW, et al.Effects of tuina manipulation on the three-dimensional space of cervical vertebral segments of cervical spondylosis patients.Chin J Integr Tradit West Med (Chin) 2012;32:922-925.

Leong DJ, Sun HB. Mechanical loading: potential preventive and therapeutic strategy for osteoarthritis. J Am Acad Orthop Surg 2014;22:465-466.

Julita AT, Stephen I, Richard R. Spinal manipulative therapy reduces inflammatory cytokines but not substance P production in normal subjects. J Manipulat Physiol Ther 2006;29:14-21.

Sluka KA, Skyba DA, Radhakrihnan R, Leeper BJ, Wright A.Joint mobilization reduces hyperalgesia associated with chronic muscle and joint inflammation in rats. J Pain 2006;7:602-607.

Song XJ, Gan Q, Cao JL, Wang ZB, Rupert RL. Spinal manipulation reduces pain and hyperalgesia after lumbar intervertebral foramen inflammation in the rat. J Manip Physiol Ther 2006;29:5-13.

Parvaneh M, Antonio G, Chris T, Thomas H. Areas of capsaicin-induced secondary hyperalgesla and allodynia are deduced by a single chiropractic adjustment: a preliminary study. J Manip Physiol Ther 2004;27:381-387.

Onifer SM, Sozio RS, DiCarlo DM, Li Q, Donahue RR, Taylor BK, et al. Spinal manipulative therapy reduces peripheral neuropathic pain in the rat. Neuroreport 2018;29:191-196.

Brisby H. Pathology and possible mechanisms of nervous system response to disc degeneration. J Bone Joint Surg Am 2006;88(Suppl 2):68-71.

Tang JG, Yuan W, Hou SX, Wu WW, Shang WL. Roles of mechanical compression and non-compression in experimental radiculopathy. Chin J Spine Spinal Cord (Chin)2006;16:865-868.

Fayad F, Lefevre-Colau MM, Rannou F, Quintero N, Nys A, Mace Y, et al. Relation of inflammatory modic changes to intradiscal steroid injection outcome in chronic low back pain. Eur Spine J 2007;16:925-931.

Takahashi N, Kikuchi S, Shubayev VI, Campana WM,Myers RR. TNF-alpha and phosphorylation of ERK in DRG and spinal cord: insight into mechanisms of sciatica. Spine 2006;31:523-259.

Zhao P. Recent study on the mechanism of Western spinal manipulation. Chin J Orthop Trauma (Chin) 2011;24:705-709.

Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine J 2004;4:335-356.

Bronfort G, Haas M, Evans R, Kawchuk G, Dagenais S.Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Spine J 2008;8:213-225.

Han L, Zhao P, Guo W, Wei J, Li Y, Min YQ, et al. A rat model of sciatica induced by autologous nucleus pulposus implant at outlet of lumbar intervertebral foramen. Beijing J Tradit Chin Med (Chin) 2015;34:245-248.

Chaplan SR, Bach FW, Pogrel JW, Chung JM, Yaksh TL.Quantitative assessment of tactile allodynia in the rat paw.J Neurosci Methods 1994;53:55-63.

Dixon WJ. Efficient analysis of experimental observations.Annu Rev Pharmacol Toxicol 1980;20:441-462.

Hargreares K, Dubner R, Brown F, Flores C, Joris J. A new and sensitive method for measuring thermal nociception in cutaneous hyperalgesia. Pain 1988;32:77-88.

Vergnolle N, Cenac N, Altier C, Cellars L, Chapman K,Zamponi GW, et al. A role for transient receptor potential vanilloid 4 in tonicity-induced neurogenic inflammation.British J Pharmacol 2010;159:1161-1173.

Kawakami M, Tamaki T, Weinstein JN, Hashizume H, Nishi H, Meller ST. Pathomechanism of pain-related behavior produced by allografts of intervertebral disc in the rat. Spine 1996;21:2101-2107.

Sasaki N, Kikuchi S, Konno S, Sekiguchi M, Watanabe K.Anti-TNF-alpha antibody reduces pain-behavioral changes induced by epidural application of nucleus pulposus in a rat model depending on the timing of administration. Spine 2007;32:413-416.

Tang JG, Yuan W, Wang XW, Hou SX, Shang WL.Establishment of a new animal model of discogenic sciatic nerve pain. J Spin Surg 2008;6:144-147.

Wei M, Zhang JJ, He QL, Wang L, Ren ZH, Liu XG, et al.Establishment of a new model of sciatic neuralgia induced by lumbar intervertebral disc herniation and a method of epidural catheterization. Chin J Pain Med (Chin) 2011;17:744-748.

Brisby H, Byrod G, Olmarker K, Miller VM, Aoki Y, Rydevik B. Nitric oxide as a mediator of nucleus pulposus-induced effects on spinal nerve roots. J Orthop Res 2000;18:815-820.

Borsani E, Giovannozzi S, Cocchi MA, Boninsegna R,Rezzani R, Rodella LF. Endothelial nitric oxide synthase in dorsal root ganglia during chronic inflammatory nociception.Cells Tissue Org 2013;197:159-168.

Kawakami M, Matsumoto T, Hashizume H, Kuribayashi K,Tamaki T. Epidural injection of cyclooxygenase-2 inhibitor attenuates pain-related behavior following application of nucleus pulposus to the nerve root in the rat. Orthop Res 2002;20:376-381.

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