医学精品课件：穴位肥大细胞及其颗粒物在针刺镇痛中的作用.ppt

1、1纪念安徽针灸经络研究纪念安徽针灸经络研究5050周年周年 穴位肥大细胞及其颗粒物在针刺镇痛中的作用丁光宏上海市针灸经络研究中心，复旦大学针灸经络研究回顾与展望国际学术研讨会针灸经络研究回顾与展望国际学术研讨会2010.10.162Outline&穴位肥大细胞在针刺镇痛效应中的作用&穴位胶原纤维在针刺镇痛效应中的作用&穴位注射组胺的镇痛效应&手针和电针穴位信号的启动机制THE JOURNAL OF SCIENCE&HEALING,2008THE JOURNAL OF SCIENCE&HEALING,2008，4 4（3 3），），170-177170-177Animal modelAnimal

2、 model ：AA AA (acute arthritis)(acute arthritis)RatRatComplete Freunds adjuvant Acupoint selectedAcupoint selected：Zushanli Zushanli (ST36ST36)Treat effectTreat effect：Ease painEase pain，Pain Pain thresholdthresholdIDGroup Name组别组别Average SEM(%)AControl正常对照组1.90.1B1Acupuncture at ST36穴位针刺组11.60.6*B2

3、Acupuncture at Nearby-ST36旁开针刺组8.90.3*C1Injection of DSCG at ST36色甘酸钠注射组1.70.1*C2Injection of NaCl at ST36生理盐水注射组1.40.1*D1Acupuncture after DSCG at ST36色甘酸钠注射针刺组6.20.4*D2Acupuncture after NaCl at ST36生理盐水注射针刺组8.90.4*D3Acupuncture opposite side after DSCG色甘酸钠注射对侧针刺组9.30.1*各组别大鼠痛阈变化率峰值比较（各组别大鼠痛阈变化率峰值比

4、较（2020分钟时）分钟时）(n=6)(n=6)Note:*P0.05 vs.Group A;P0.01,P0.01,P0.05 vs.Group B1;P0.01,P0.05 vs.Group D1Group Name组别组别MC Degranulation Ratio(Average SEM)()SkinMuscleControl正常对照组29.21.226.31.8Acupuncture穴位针刺组48.93.9*32.23.1*Acupuncture after DSCG色甘酸钠注射针刺组33.72.828.52.3Acupuncture after NaCl生理盐水注射针刺组50.42

5、.5*29.72.3穴区组织肥大细胞脱颗粒率统计穴区组织肥大细胞脱颗粒率统计 (n=6)(n=6)Note:*P0.01,*P0.05 vs.Control Group;P0.01 vs.Acupuncture Group.Degranulationof cellsTHE JOURNAL OF SCIENCE&HEALING,2008THE JOURNAL OF SCIENCE&HEALING,2008，4 4（3 3），），170-177170-177lThe acupuncture effect is positive relationship to the degranulation o

6、f mast cell at acupoint.lWhat is key factor conduce the degranulation of mast cell during acupuncture manipulation?lOur focus is on the collagen at acupoint.2023-1-20132.collagen fibers in the acupoint during manual acupuncture To observe the function of collagen fibers in MA analgesia.7 Animal grou

7、ps setting:normal group(N):Normal healthy animal control group(M):Animal with AA injection of collagenase at Zusanli(ST36)group(C)manual acupuncture group with rotation manipulation(R)or lift-thrust manipulation(L),rotation group with collagenase pretreatment to destroy Zusanli(ST36)collagen fibers(

8、CR),lift-thrust group with collagenase pretreatment to destroy Zusanli(ST36)collagen fibers(CL),lift-thrust group pretreated with collagenase to destroy Dubi(ST35)collagen fibers(CDL)(R)(L)2023-1-20142.collagen fibers in the acupoint during manual acupuncture Analgesia effects observed in different

9、groupsGroupnPain Threshold(PT)4d Before MA(s)After MA(s)Change Rate(%)MC Degranulation Ratio(%)N89.190.65-10.62.6M85.610.48*-14.15.9C85.900.24*5.590.52-5.111.94.7R85.440.37*7.520.6538.575.74.4L86.130.82*8.501.5639.176.95.9CR85.270.62*5.390.573.310.42.4CL86.050.43*6.260.793.812.42.3注：较正常组痛阈：注：较正常组痛阈：

10、*P0.01P0.01；较处理前痛阈：；较处理前痛阈：P0.05P0.05；较捻转组；较捻转组(R)(R)痛阈变化率：痛阈变化率：P0.05P0.05；较捻转组较捻转组(L)(L)痛阈变化率：痛阈变化率：P0.05P0.05；较较正常组或模型组正常组或模型组:P0.05 P0.05；较捻转组或提插组；较捻转组或提插组:P0.05 P0.05。2023-1-20152.collagen fibers in the acupoint during manual acupuncture Analgesia effects observed in different groupsGroupnPain

11、Threshold(PT)4d Before MA(s)After MA(s)Change Rate(%)MC Degranulation Ratio(%)N89.190.65-10.62.6M85.610.48*-14.15.9C85.900.24*5.590.52-5.111.94.7R85.440.37*7.520.6538.575.74.4L86.130.82*8.501.5639.176.95.9CR85.270.62*5.390.573.310.42.4CL86.050.43*6.260.793.812.42.3注：较正常组痛阈：注：较正常组痛阈：*P0.01P0.01；较处理前痛

12、阈：；较处理前痛阈：P0.05P0.05；较捻转组；较捻转组(R)(R)痛阈变化率：痛阈变化率：P0.05P0.05；较捻转组较捻转组(L)(L)痛阈变化率：痛阈变化率：P0.05P0.05；较较正常组或模型组正常组或模型组:P0.05 P0.05；较捻转组或提插组；较捻转组或提插组:P0.05 P0.05。2023-1-20162.collagen fibers in the acupoint during manual acupuncture Analgesia effects observed in different groupsGroupnPain Threshold(PT)4d B

13、efore MA(s)After MA(s)Change Rate(%)MC Degranulation Ratio(%)N89.190.65-10.62.6M85.610.48*-14.15.9C85.900.24*5.590.52-5.111.94.7R85.440.37*7.520.6538.575.74.4L86.130.82*8.501.5639.176.95.9CR85.270.62*5.390.573.310.42.4CL86.050.43*6.260.793.812.42.3注：较正常组痛阈：注：较正常组痛阈：*P0.01P0.01；较处理前痛阈：；较处理前痛阈：P0.05P0

14、.05；较捻转组；较捻转组(R)(R)痛阈变化率：痛阈变化率：P0.05P0.05；较捻转组较捻转组(L)(L)痛阈变化率：痛阈变化率：P0.05P0.05；较较正常组或模型组正常组或模型组:P0.05 P0.05；较捻转组或提插组；较捻转组或提插组:P0.05 P0.05。collagen fibers of skin and muscleMast cells in skinGroupNormalGroupInjectControlcollagen fibers of skin and muscleMast cells in skin2.collagen fibers in the acup

15、oint during manual acupuncture Connective Tissue Research,2008Connective Tissue Research,2008，5050（2 2）:110-120:110-120Acupunc.whirling Acupunc.lift and thrust collagen fibers of skin and muscleMast cells in skincollagen fibers of skin and muscleMast cells in skin2.collagen fibers in the acupoint du

16、ring manual acupuncture Connective Tissue Research,2008Connective Tissue Research,2008，5050（2 2）:110-120:110-120 Mast cells degranulation before and after collagen destroyed2.collagen fibers in the acupoint during manual acupuncture Collagen destroyedCollagen destroyedConnective Tissue Research,2008

17、Connective Tissue Research,2008，5050（2 2）:110-120:110-120collagen fibers and mast cells in normal acupointcollagen fibers enlacement and mast cells degranulation while whirlingcollagen fibers tightened and mast cells degranulated while lifting and thrustingcollagen fibers were destroyed and mast cel

18、ls had no degranulation2.collagen fibers in the acupoint during manual acupuncture Connective Tissue Research,2008Connective Tissue Research,2008，5050（2 2）:110-120:110-1202023-1-20212.collagen fibers in the acupoint during manual acupuncture The mast cells in acupoint may translate the mechanical si

19、gnal into the biological information of neural system.The collagen and mast cells degranulation are very important to the manual acupuncture analgesia effect.Is this the same as electric acupuncture?2023-1-20222.collagen fibers in the acupoint during electroacupuncture 组别组别n 痛阈痛阈(s)痛阈变化率痛阈变化率(%)肥大细胞

20、脱颗肥大细胞脱颗粒率粒率(%)正常组8 9.190.65-10.6模型组8 5.610.48*-14.1手针组8 7.520.6538.5 75.4电针组8 8.671.0645.9 73.3胶原酶+手针组8 5.390.573.2 10.4胶原酶+电针组8 8.301.2347.6 19.0色甘酸钠+手针组8 6.000.485.8 25.1色甘酸钠+电针组8 7.340.7027.5 29.5手针及电针治疗前后手针及电针治疗前后AAAA大鼠痛阈和痛阈改变率以及穴大鼠痛阈和痛阈改变率以及穴区肥大细胞脱颗粒率的变化区肥大细胞脱颗粒率的变化注：与注：与 正常组相比较：正常组相比较：*P0.05P

21、0.05；与；与 模型组相比较：模型组相比较：P0.05P0.05；与手针组与手针组相比较：相比较：P0.05 P0.05；P0.01 P0.01；与电针组相比较：；与电针组相比较：P0.05P0.05。组别组别n 痛阈痛阈(s)基础痛阈造模后痛阈治疗后痛阈空白对照组129.040.209.380.199.270.17模型组128.900.406.480.286.580.35生理盐水对照组129.200.286.090.306.610.31手针组129.520.186.580.178.770.26组胺注射组129.210.206.270.228.500.28各组痛阈测量比较各组痛阈测量比较组别

22、组别n 痛阈痛阈(s)基础痛阈造模后痛阈治疗后痛阈空白对照组129.040.209.380.199.270.17模型组128.900.406.480.286.580.35生理盐水对照组129.200.286.090.306.610.31手针组129.520.186.580.178.770.26组胺注射组129.210.206.270.228.500.28各组痛阈测量比较各组痛阈测量比较针刺研究，针刺研究，20102010，3535（2 2）：）：99-10399-103组别组别n 痛阈痛阈(s)基础痛阈造模后痛阈治疗后痛阈空白对照组129.040.209.380.199.270.17模型组12

23、8.900.406.480.286.580.35生理盐水对照组129.200.286.090.306.610.31手针组129.520.186.580.178.770.26组胺注射组129.210.206.270.228.500.28各组痛阈测量比较各组痛阈测量比较针刺研究，针刺研究，20102010，3535（2 2）：）：99-10399-103各组足三里穴位处脱颗粒比较各组足三里穴位处脱颗粒比较组别组别N脱脱颗粒率颗粒率空白组空白组121233.5933.590.72模型组模型组121239.7139.712.09生理盐水穴位注射组生理盐水穴位注射组121236.6736.672.36手

24、针针刺组手针针刺组121257.6157.611.42组胺穴位注射组组胺穴位注射组121257.0357.032.95色甘酸钠预处理胺注射组色甘酸钠预处理胺注射组131325.4025.401.80色甘酸钠预处理针刺组色甘酸钠预处理针刺组121236.0336.032.28组胺组胺H1拮抗剂预处理针刺组拮抗剂预处理针刺组121251.5451.542.32组胺组胺H1拮抗剂组胺注射组拮抗剂组胺注射组121237.1337.131.90组胺组胺H1拮抗剂穴位注射组拮抗剂穴位注射组222232.2432.241.40P0.01 P0.01 与空白组比较（与空白组比较（vs.controlvs.co

25、ntrol）；）；P0.01 P0.01 与模型组比较（与模型组比较（vs.modelvs.model）；）；P0.01 P0.01 与与手针针刺组比较（手针针刺组比较（vs.controlvs.control）；）；P0.01 P0.01 与生理盐水穴位注射组比较；与生理盐水穴位注射组比较；P0.01 P0.01 与组胺穴位与组胺穴位注射组比较，注射组比较，P0.01 P0.01 与组胺与组胺H1H1拮抗剂穴位注射组比较。拮抗剂穴位注射组比较。针刺研究，针刺研究，20102010，3535（2 2）：）：99-10399-103各组足三里穴位处脱颗粒比较各组足三里穴位处脱颗粒比较组别组别N脱

26、脱颗粒率颗粒率空白组空白组121233.5933.590.72模型组模型组121239.7139.712.09生理盐水穴位注射组生理盐水穴位注射组121236.6736.672.36手针针刺组手针针刺组121257.6157.611.42组胺穴位注射组组胺穴位注射组121257.0357.032.95色甘酸钠预处理胺注射组色甘酸钠预处理胺注射组131325.4025.401.80色甘酸钠预处理针刺组色甘酸钠预处理针刺组121236.0336.032.28组胺组胺H1拮抗剂预处理针刺组拮抗剂预处理针刺组121251.5451.542.32组胺组胺H1拮抗剂组胺注射组拮抗剂组胺注射组121237.

27、1337.131.90组胺组胺H1拮抗剂穴位注射组拮抗剂穴位注射组222232.2432.241.40P0.01 P0.01 与空白组比较（与空白组比较（vs.controlvs.control）；）；P0.01 P0.01 与模型组比较（与模型组比较（vs.modelvs.model）；）；P0.01 P0.01 与与手针针刺组比较（手针针刺组比较（vs.controlvs.control）；）；P0.01 P0.01 与生理盐水穴位注射组比较；与生理盐水穴位注射组比较；P0.01 P0.01 与组胺穴位与组胺穴位注射组比较，注射组比较，P0.01 P0.01 与组胺与组胺H1H1拮抗剂穴位

28、注射组比较。拮抗剂穴位注射组比较。针刺研究，针刺研究，20102010，3535（2 2）：）：99-10399-103l组胺参与到了针刺麻醉的穴位局部机制组胺参与到了针刺麻醉的穴位局部机制l通过通过H1受体进一步传递针刺信号受体进一步传递针刺信号研究阐明了手针和电针穴位针刺有效信号的启动机制研究阐明了手针和电针穴位针刺有效信号的启动机制MAEAElectric A.10382.0000010384.00000seconds-0.199992-0.0999960.0000000.099996Volts 心电图91.20613493.14669095.08724697.027802mmHg动脉血

29、压0.00000036.75320173.506401110.259602mmHg心室内压-41.509399-21.509399-1.50939918.49060138.490601Volts正中神经放电-0.019582-0.0093089.7E-0040.011241Volts交感神经放电10580.00000seconds-0.447150-0.247150-0.0471500.1528500.352850Volts 心电图95.61133897.52356599.435792101.348018mmHg动脉血压0.00000036.59941373.198826109.798240mmHg心室内压-13.244812-7.244812-1.2448124.75518810.755188Volts正中神经放电-0.069308-0.039308-0.0093080.0206920.050692Volts交感神经放电