摘要：
Objective To observe the effects of silver needle diathermy on myofascial pain syndrome (MPS) and the expression of substance P,nerve growth factor,interleukin-1 beta,tumor necrosis factor-alpha in rats.Methods Twenty-four Sprague-Dawley rats were randomly divided into three groups:control,MPS model and treatment groups.The rats in the model and treatment groups were copied the MPS model by traumas on right femoral muscle combined with eccentric exercise,and the treatment group were received thermal acupuncture with silver needle.The change of gait,electro-myography,thermal hyperalgesia,concentration of SP,NGF,IL-1 β,TNF-α in local muscle and serum,and local muscle tissue biopsy were observed and compared between the three groups in all rats.Results (1) Gait:No limp occurred in right hindlimb in the control group at the time of MPS model completed (T1),but the incidence of limp was 100％ in the model and treatment groups.The incidence of limp was 100％ (8/8 rats)in the model group and 12.5％ (1/8 rats)in the treatment group at the 3rd week after the silver needle diathermy (T2).(2)EMG:No spontaneous electrical activity (SEA)occurred in right femoral muscle at T1 in the control group,but appeared in the model and treatment groups.The frequency of SEA was significantly lower in the treatment group than that in the model group at T2 (P＜ 0.01).(3)Thermal hyperalgesia:The thermal withdrawal latency (TWL)was reduced in the model and treatment groups as compared with the control group at T1 (P＜ 0.01).The TWL was longer in the treatment group as compared with model group at T2 (P ＜ 0.01).(4)The expression of SP,N GF,IL-1 β and TNF-α in local muscle tissue was significantly higher in the model group as compared with the control group at T2 (P＜ 0.01),and decreased in the treatment group as compared with the model group (P＜ 0.01).(5)The expression of SP,NGF,IL-1β and TNF-α in serum was significantly higher in the model group as compared with the control group at T2 (P＜ 0.01),and decreased in the treatment group as compared with the model group (P＜ 0.01).(6) Muscle biopsy by HE stained at T2:The control group showed normal configuration,while obviously disorder nodules and muscle fiber structure,thickened sarcolemma in the model group,and new capillaries appeared in the treatment group.Conclusion Silver needle diathermy is an effective method in the treatment of rats with MPS by down-regulation of the expression of SP,NGF,IL-1 β and TNF-α in local muscle tissue.%目的 研究银质针导热疗法对肌筋膜疼痛综合征(MPS)大鼠的疗效及对局部肌组织和血清SP、NGF、IL-1β、TNF-α表达的影响.方法 SD大鼠24只,随机均分为对照组、模型组和治疗组.模型组和治疗组用打击结合离心运动方法建立MPS模型,治疗组给予银质针导热治疗.观察大鼠步态、肌电图、热痛敏、肌组织和血清SP、NGF、IL-1β、TNF-α浓度、局部肌组织病理变化.结果 (1)大鼠步态:MPS模型制备完成时(T1),对照组无右后肢跛行,模型组和治疗组大鼠全部出现右后肢跛行.银质针导热治疗第3周时(T2),模型组右后肢跛行发生率100％(8/8只),治疗组右后肢跛行率12.5％(1/8只).(2)肌电图:T1时,模型组和治疗组与对照组比较,右股内肌自发性电活动(SEA)频率显著增加(P＜0.01);T2时,治疗组与模型组比较SEA频率显著降低(P＜0.01).(3)热痛敏:T1时,模型组和治疗组与对照组比较,热缩足潜伏期时间(TWL)显著缩短(P＜ 0.01);T2时,治疗组与模型组比较TWL显著延长(P＜0.01).(4)T2时,模型组与对照组比较,SP、NGF、IL-1β、TNF-α表达均显著增高(P＜0.01),治疗组与模型组比较均显著下降(P＜0.01).(5)T2时,模型组与对照组比较,血清SP、NGF、IL-1β、TNF-α浓度均显著增高(P＜0.01),治疗组与模型组比较均显著下降(P＜ 0.01).(6)局部肌组织病理切片:对照组肌细胞形态规则,肌纤维排列整齐;模型组见增大的梭形结节,肌纤维结构紊乱、肌膜增厚;治疗组肌纤维形态较规则,并见较多新生血管.结论 银质针导热疗法对MPS大鼠有显著疗效,其机制可能与下调局部肌组织SP、NGF、IL-1β、TNF-α的表达有关.
