Ceyhan Dilek, Kocman Atacan Emre, Yildirim Engin, Ozatik Orhan, Aydin Sule, Kose Aydan
Osmangazi University, Medical Faculty, Department of Anesthesiology and Reanimation, Eskisehir, Turkey.
Turk Neurosurg. 2018;28(2):288-295. doi: 10.5137/1019-5149.JTN.19824-17.0.
Nerve entrapment syndromes are the most common causes of neuropathic pain. Surgical decompression is the preferred method of treatment. The aim of this study was to compare the efficacy of curcumin, tramadol and chronic constriction release treatment (CCR), individually or together, in a rat model of sciatic nerve injury.
Eighty male rats were divided into eight study groups. Group 1 was the sham group. Group 2 was the control group with established chronic constriction injury (CCI). CCI was also established in Groups 3?8. Group 3 underwent chronic constriction release (CCR). Groups 4 and 5 received curcumin and tramadol. Groups 6 and 7 also received curcumin (100 mg/kg daily, oral) and tramadol (10 mg/kg daily, intraperitoneal, 14 days) after CCR, respectively. Combined curcumin-tramadol treatment was applied to Group 8. Behavioral tests (thermal hyperalgesia, dynamic plantar, cold plate test) were performed on days 0,3,7,13,17, and 21. Tissue tumor necrosis factor-? (TNF-?) and interleukin-10 (IL-10) levels were analyzed in the nerve and dorsal root ganglion (DRG) samples on day 21. Histopathological examination was performed on the nervous tissue and DRG.
Tramadol-CCR and tramadol-curcumin significantly attenuated mechanical allodynia and thermal hyperalgesia. In the CCI-CCR-tramadol treatment group, TNF-? levels were significantly lower in the sciatic nerve tissue, and DRG and IL-10 levels were significantly higher in the sciatic nerve tissue.
CCI-CCR-tramadol treatment is highly effective in the symptomatic treatment of neuropathic pain. CCR-curcumin is associated with less degeneration and high levels of regeneration in the nerve tissue.
神经卡压综合征是神经性疼痛最常见的病因。手术减压是首选的治疗方法。本研究的目的是比较姜黄素、曲马多和慢性缩窄解除术（CCR）单独或联合应用于大鼠坐骨神经损伤模型中的疗效。
80只雄性大鼠分为8个研究组。第1组为假手术组。第2组为已建立慢性缩窄损伤（CCI）的对照组。第3至8组也建立了CCI。第3组接受慢性缩窄解除术（CCR）。第4组和第5组分别给予姜黄素和曲马多。第6组和第7组在CCR后也分别给予姜黄素（每日100mg/kg，口服）和曲马多（每日10mg/kg，腹腔注射，共14天）。第8组采用姜黄素-曲马多联合治疗。在第0、3、7、13、17和21天进行行为学测试（热痛觉过敏、动态足底、冷板试验）。在第21天分析神经和背根神经节（DRG）样本中的组织肿瘤坏死因子-α（TNF-α）和白细胞介素-10（IL-10）水平。对神经组织和DRG进行组织病理学检查。
曲马多-CCR和曲马多-姜黄素显著减轻机械性异常性疼痛和热痛觉过敏。在CCI-CCR-曲马多治疗组中，坐骨神经组织中的TNF-α水平显著降低，坐骨神经组织中的DRG和IL-10水平显著升高。
CCI-CCR-曲马多治疗对神经性疼痛的对症治疗非常有效。CCR-姜黄素与神经组织中较少的退变和高水平的再生相关。
