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激光针刺在切口疼痛模型中的镇痛作用及分子变化:与电针诱导效应的比较

Laser acupuncture-induced analgesic effect and molecular alterations in an incision pain model: a comparison with electroacupuncture-induced effects.

作者信息

Zeng Yen-Jing, Lin Yu-Hsiang, Wang You-Cheng, Chang Ju-Hsin, Wu Jih-Huah, Hsu Sheng-Feng, Tsai Shih-Ying, Lin Ching-Huang, Wen Yeong-Ray

机构信息

Graduate Institute of Clinical Medicine, College of Medicine, China Medical University, Taichung, Taiwan.

Microelectronic and Optoelectronic Engineering Department of Electronic Engineering, National Yunlin University of Science and Technology, Yunlin, Taiwan.

出版信息

Lasers Med Sci. 2018 Feb;33(2):295-304. doi: 10.1007/s10103-017-2367-7. Epub 2017 Nov 4.

Abstract

Low-level laser acupuncture (LLLA) produces photobiomodulation through acupuncture point and is an alternative to low-level laser therapy. Although the analgesic effect of LLLA on chronic pain has been proven, its effect on acute postincisional pain has yet to be investigated. A plantar incision (PI) model was used to mimic human postsurgical pain. Male adult rats received GaAlAs laser irradiation at the right ST36 acupoint immediately after operation and on the following 4 days. Three laser treatment groups (two red laser groups with a 30- or 15-min treatment duration and one 30-min near-infrared laser group) were compared with sham LLLA and naive groups and an electroacupuncture (EA) group (separate study). Behavioral withdrawal thresholds of both hind paws were measured before and after incision. Expression of mitogen-activated protein kinases (p-ERK and p-p38), inducible nitric oxide synthase (iNOS), and tumor necrosis factor (TNF) in the spinal cord was analyzed. All three LLLA treatments attenuated post-PI tactile allodynia in the ipsilateral paw, but only the 30-min red laser treatment affected the contralateral paw and had similar efficacy to that of EA. All laser treatments barely reduced heat hyperalgesia in both hind paws. At 3 days after PI, the 30-min red laser group showed reversed increases of PI-induced p-ERK, p-p38, and iNOS but not TNF expression in the spinal cord. Repetitive LLLA treatments ameliorated PI-induced mechanical pain. The inhibition of multiple sensitization signals highlights the unique clinical role of LLLA. Thus, LLLA is an alternative to EA as an adjuvant for postoperative pain control.

摘要

低强度激光针刺疗法(LLLA)通过穴位产生光生物调节作用,是低强度激光疗法的一种替代方法。尽管LLLA对慢性疼痛的镇痛效果已得到证实,但其对术后急性疼痛的影响尚未得到研究。采用足底切口(PI)模型模拟人类术后疼痛。雄性成年大鼠在术后立即及随后4天接受GaAlAs激光照射右侧足三里穴位。将三个激光治疗组(两个分别为30分钟或15分钟治疗时长的红光激光组和一个30分钟近红外激光组)与假LLLA组、空白组以及一个电针(EA)组(单独研究)进行比较。在切口前后测量双后爪的行为退缩阈值。分析脊髓中丝裂原活化蛋白激酶(p-ERK和p-p38)、诱导型一氧化氮合酶(iNOS)和肿瘤坏死因子(TNF)的表达。所有三种LLLA治疗均减轻了同侧爪PI后的触觉异常性疼痛,但只有30分钟红光激光治疗对侧爪有影响,且与EA的疗效相似。所有激光治疗对双后爪的热痛觉过敏几乎没有减轻作用。在PI后3天,30分钟红光激光组显示脊髓中PI诱导的p-ERK、p-p38和iNOS表达的增加出现逆转,但TNF表达未逆转。重复的LLLA治疗改善了PI诱导的机械性疼痛。对多种敏化信号的抑制突出了LLLA独特的临床作用。因此,LLLA可作为EA的替代方法用于术后疼痛控制的辅助治疗。

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