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护理配合及川芎嗪应用在全膝关节置换术患者术后疼痛中的作用及机制

Role and mechanism of nursing cooperation and tetramethylpyrazine application in post-operative pain in patients undergoing total knee arthroplasty.

作者信息

Liu Chang, Liu Rui, Tang Meiling, Yang Xinxin, Gong Xiuping

机构信息

Surgery Center, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China.

Department of Hyperbaric Oxygen Therapy, Harbin Children's Hospital, Harbin, Heilongjiang 150010, P.R. China.

出版信息

Exp Ther Med. 2019 Mar;17(3):2366-2372. doi: 10.3892/etm.2019.7203. Epub 2019 Jan 25.

Abstract

The aim of the present study was to investigate the effect of nursing cooperation on the post-operative complication of pain following total knee arthroplasty (TKA) and to explore the effects of tetramethylpyrazine (TMP) application on post-TKA pain. A total of 26 patients who received TKA between June 2014 and March 2016 were enrolled in this study. Nursing cooperation was provided to the patients during the TKA surgery, and pain was evaluated based on the visual analog scale (VAS). In addition, 40 male Sprague Dawley rats were used for the TKA model construction. The rats were randomly separated into 4 groups (sham, TKA, TKA+TMP and TKA+TMP+Interferon γ). Pain tolerance in rats was evaluated by mechanical stimulation. Inflammatory cytokine levels in TKA rat tissue were detected using ELISA. mRNA and protein expression of Janus kinase/signal transducer and activator of transcription 3 (JAK/STAT3) was detected using reverse transcription-polymerase chain reaction and western blot analysis, respectively. The results indicated that nursing cooperation serves a critical function during TKA and was associated with a lower level of pain compared with the control (P<0.05). Furthermore, TMP treatment reduced the level of inflammatory cytokines in the rat tissues, including interleukin (IL)-6, IL-10 and tumor necrosis factor-α in post-TKA (P<0.01). TMP was indicated to alleviate pain in post-TKA through suppressing the JAK/STAT3 signaling pathway. The results of the present study suggest that nursing cooperation is critical to TKA, and TMP may alleviate post-TKA pain through inhibiting the JAK/STAT3 signaling pathway.

摘要

本研究的目的是探讨护理配合对全膝关节置换术(TKA)后疼痛并发症的影响,并探究川芎嗪(TMP)应用对TKA术后疼痛的作用。2014年6月至2016年3月期间接受TKA的26例患者纳入本研究。在TKA手术期间为患者提供护理配合,并根据视觉模拟量表(VAS)评估疼痛。此外,40只雄性Sprague Dawley大鼠用于构建TKA模型。将大鼠随机分为4组(假手术组、TKA组、TKA+TMP组和TKA+TMP+干扰素γ组)。通过机械刺激评估大鼠的疼痛耐受性。采用酶联免疫吸附测定法检测TKA大鼠组织中的炎性细胞因子水平。分别采用逆转录-聚合酶链反应和蛋白质免疫印迹分析检测Janus激酶/信号转导子和转录激活子3(JAK/STAT3)的mRNA和蛋白表达。结果表明,护理配合在TKA过程中起关键作用,与对照组相比疼痛程度较低(P<0.05)。此外,TMP治疗降低了大鼠组织中炎性细胞因子的水平,包括TKA术后的白细胞介素(IL)-6、IL-10和肿瘤坏死因子-α(P<0.01)。TMP被证明可通过抑制JAK/STAT3信号通路减轻TKA术后疼痛。本研究结果表明,护理配合对TKA至关重要,TMP可能通过抑制JAK/STAT3信号通路减轻TKA术后疼痛。

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