Department of Anesthesiology, Pain Medicine & Critical Care Medicine, Aviation General Hospital of China Medical University & Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China.
Pain Physician. 2016 Mar;19(3):E435-47.
Electroacupuncture (EA) is widely applied to treat neuropathic pain. Brachial plexus neuralgia (BPN) is a common form of chronic persistent pain. Few studies have evaluated the analgesic effects and mechanism of EA using the novel animal model of BPN.
To observe the curative effects of repeated EA on curing BPN induced by administration of cobra venom to the lower trunk of the right brachial plexus.
Controlled animal study.
Department of Anesthesiology, Pain Medicine & Critical Care Medicine, Aviation General Hospital of China Medical University.
Sixty-six adult male Sprague-Dawley rats were equally and randomly divided into the following groups: normal control (NC), brachial plexus neuralgia (BPN), BPN with sham EA stimulation, BPN with EA stimulation starting on postoperative day 1 (EA1), and BPN with EA stimulation starting on postoperative day 12 (EA12). The BPN model was established by administration of cobra venom to the lower trunk of the right brachial plexus. On postoperative day 1 or day 12, EA (constant aquare wave, 2 Hz and 100 Hz alternating frequencies, intensities ranging from 1 - 1.5 - 2 mA) was applied to the right "Shousanli" (LI10) and "Quchi" (LI11) acupoints for 30 minutes, once every other day for 12 times in both groups. Mechanical withdrawal thresholds (MWT) were tested with von Frey filaments. Video recordings were conducted to analyze the spontaneous exploratory behaviors. Moreover, the organizational and structural alterations of the right brachial plexus and cervical cord (C8-T1) were examined via light and electron microscopy.
Following the production of the BPN model, the MWT of both ipsilateral and contralateral paws demonstrated a profound decrease (P < 0.05). But after EA interventions, the MWT showed a significant increase (P < 0.05). In comparison to the EA12 group, the analgesic effects of the EA1 group were more significant, and similar results were observed in exploratory behaviors. However, grooming behaviors did not demonstrate significant differences. Meanwhile, on day 12 after surgery it was observed under light microscopy that the inflammatory response in the right brachial plexus and cervical cord (C8-T1) were significantly attenuated after EA stimulation. Furthermore, the demyelination of the brachial plexus and cervical cord (C8-T1) were also reversed.
Limitations include the fact that there was demyelination of the cervical cord (C8-T1) in the control group because of inappropriate manipulation.
Repeated EA contributes significant analgesic effects in the treatment of BPN.
电针（EA）广泛应用于治疗神经性疼痛。臂丛神经痛（BPN）是一种常见的慢性持续性疼痛。很少有研究使用新型臂丛神经下干结扎的动物模型来评估 EA 的镇痛效果和机制。
观察重复电针对右臂丛神经下干注入眼镜蛇毒液引起的 BPN 的治疗作用。
对照动物研究。
中国医科大学航空总医院麻醉科、疼痛医学与危重病医学科。
将 66 只成年雄性 Sprague-Dawley 大鼠等分为以下几组：正常对照组（NC）、臂丛神经痛组（BPN）、臂丛神经痛假电针刺激组（BPN+SEA）、术后第 1 天开始电针刺激组（EA1）和术后第 12 天开始电针刺激组（EA12）。通过向右侧臂丛神经下干注射眼镜蛇毒液建立 BPN 模型。术后第 1 天或第 12 天，电针（连续方波，2 Hz 和 100 Hz 交替频率，强度范围为 1-1.5-2 mA）应用于右侧“手三里”（LI10）和“曲池”（LI11）穴位 30 分钟，每隔一天一次，两组均进行 12 次。用 von Frey 细丝测试机械退缩阈值（MWT）。进行视频记录以分析自发探索行为。此外，用光镜和电镜观察右侧臂丛神经和颈段（C8-T1）的组织学和结构改变。
BPN 模型制作后，双侧后肢的 MWT 均明显降低（P < 0.05）。但电针干预后，MWT 明显升高（P < 0.05）。与 EA12 组相比，EA1 组的镇痛效果更为显著，在探索行为中也观察到类似的结果。然而，梳理行为没有表现出显著差异。同时，术后第 12 天，光镜下观察到电针刺激后右侧臂丛神经和颈段（C8-T1）的炎症反应明显减轻。此外，臂丛神经和颈段（C8-T1）的脱髓鞘也得到逆转。
局限性在于由于操作不当，对照组颈段（C8-T1）有脱髓鞘现象。
重复电针治疗臂丛神经痛有显著的镇痛作用。
