Objective To observe the analgesic effect of heat-reinforcing needling manipulation for acute inflamma! ry arthritis and its underlying mechanism in experimental rheumatoid arthritis rabbits. Methods A total of 60 rabbits were randomized into control (n = 6),model (n = 6), needle-twirling (n = 24) and heat-reinforcing (n = 24) groups, and the later 2 groups were further divided into 0 h, 0. 5 h, 1 h and 2 h subgroups,with 6 cases in each. Rheumatoid arthritis model was established by injecting mixed solution of egg-albumin (4 mg/ml) and equal volume of complete Freund's adjuvant (CFA) into the subcutaneous tissue (6 points around the shoulder,0. 2 ml/point). Fourteen days later,the injection was repeated once again,and another 6 days later,egg-albumin (0. 4 ml, 20 mg/ml) solution was injected into the bilateral knee-joints. "Zusanli" (ST 36) and "Hegu" (LI 4) were punctured and stimulated by needle-twirling or by heat-reinforcing needling technique for 1 min, with the needle retained for 30 min. The pain threshold of the paw was detected with K~+ import stimulation method. β-EP and PGE_2 contents of the joint tissue were assayed with radioimmunoassay. Results Compared with model group, the pain threshold of needle-twirling group and heat-reinforcing group at each time-point increased significantly (P<0. 01, P<0. 05). Compared with needle-twirling group,the pain threshold of heat-reinforcing group at 0. 5 h, 1 h and 2 h subgroups increased significantly (P<0. 05, P<0. 01). Both β-EP and PGE_2 contents of model group were significantly higher than those of control group (P<0. 01, P<0. 05). In comparison with model group, β-EP contents of needle-twirling group and heat-reinforcing group at each time-point increased significantly (P<0. 01, P<0. 05), and PGE_2 contents of needle-twirling group and heat-reinforcing group at each time-point decreased significantly (P<0. 01, P<0. 05). The β-EP content of heat-reinforcing group was significantly higher than that of needle-twirling group at 2 h (P<0. 05), while PGE_2 content of the former group was significantly lower than that of needle-twirling group at 0 h (P<0. 01). Conclusion Both needle-twirling and heat-reinforcing needling can effectively raise the pain threshold in acute arthritis rabbits, which my be closely associated with their effects in upregulating β-EP content and lowering PGE_2 level in the local joint tissue. The analgesic effect of heat-reinforcing needling manipulation is superior to that of needle-twirling.%目的:观察热补针法的镇痛后效应,探讨其镇痛的外周机制.方法:60只青紫蓝兔随机分为正常组、模型组、捻转组和热补组,后2组又随机分为针后即时、针后0.5 h、针后1 h和针后2 h亚组,每组各6只.用卵蛋白诱导造成关节炎疼痛模型.针刺双侧"合谷"和"足三里"1次,留针30 min,捻转组用捻转针法,热补组用热补针法.以K~+导入法引起家兔腿收缩的最小电流强度作为痛阈;取关节局部组织,用放射免疫法测定β-内啡肽(EP)及前列腺素(PG)E_2含量.结果:模型组痛阈显著低于正常组(P＜0.01);与模型组比较,捻转组和热补组针后各时刻痛阈均显著升高(P＜0.01,P＜0.05);热补组即时痛阈与捻转组比较差异无统计学意义(P＞0.05),其余时刻痛阈热补组均高于捻转组(P＜0.05,P＜0.01).模型组关节局部组织中β-EP、PGE_2含量均高于正常组(P＜0.05,P＜0.01);与模型组比较,捻转组和热补组各时刻β-EP含量均显著升高(P＜0.01,P＜0.05),而PGE2含量均显著降低(P＜0.01,P＜0.05);与捻转组相比,热补组针后2 h β-EP含量显著增高(P＜0.05),而热补组针后即时PGE_2含量显著降低(P＜0.01).结论:热补针法镇痛后效应优于捻转针法;关节局部β-EP和PGE_2 含量变化与两种针法镇痛后效应不同无明显相关趋势.
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