Zhang Xi, Su Shengyong
Guangxi University of CM, Nanning 530000, China; Department of Acupuncture and Moxibustion, First Affiliated Hospital of Guangxi University of CM, Nanning 530023.
Department of Acupuncture and Moxibustion, First Affiliated Hospital of Guangxi University of CM, Nanning 530023.
Zhongguo Zhen Jiu. 2024 Oct 12;44(10):1165-71. doi: 10.13703/j.0255-2930.20230827-k0002.
To observe the effects of wheat-grain moxibustion on autophagy and endoplasmic reticulum stress (ERS) in the spinal cord and nerve root tissues of rats with cervical spondylotic radiculopathy (CSR), and to explore the potential mechanisms by which wheat-grain moxibustion alleviates neuropathic pain in CSR.
Forty-eight SPF-grade SD rats were randomly divided into a sham operation group, a model group, a wheat-grain moxibustion group, and a wheat-grain moxibustion + 3-methyladenine (3MA) group, with 12 rats in each group. The CSR model was established in the model group, the wheat-grain moxibustion group, and the wheat-grain moxibustion + 3MA group using the spinal canal insertion method. From the third day after successful modeling, the wheat-grain moxibustion group received wheat-grain moxibustion at "Dazhui" (GV 14), once daily, six cones each session. The wheat-grain moxibustion + 3MA group received intraperitoneal injection of 3MA (2.5 mg/kg), followed by the same wheat-grain moxibustion intervention as the wheat-grain moxibustion group. Interventions were performed once daily for seven consecutive days. The gait disturbance scores and peripheral nerve mechanical pain thresholds were observed before and after the intervention. Western blot was used to detect the expression of ERS apoptosis factors C/EBP-homologous protein (CHOP) and Caspase-12, as well as autophagy substrate P62 in spinal cord and nerve root tissues. Transmission electron microscopy was used to observe autophagosomes and cellular ultrastructure in spinal cord and nerve root tissues.
After modeling, compared with the sham operation group, gait disturbance scores were increased (<0.05) and peripheral nerve mechanical pain thresholds were decreased (<0.05) in the model group, the wheat-grain moxibustion group, and the wheat-grain moxibustion + 3MA group. After intervention, compared with the sham operation group, gait disturbance scores were increased (<0.05) and peripheral nerve mechanical pain thresholds were decreased (<0.05) in the model group; compared with the model group, gait disturbance score was decreased (<0.05) and peripheral nerve mechanical pain threshold was increased (<0.05) in the wheat-grain moxibustion and the wheat-grain moxibustion + 3MA group; compared with the wheat-grain moxibustion + 3MA group, gait disturbance score was decreased (<0.05) and peripheral nerve mechanical pain threshold was increased (<0.05) in the wheat-grain moxibustion group. Compared with the sham operation group, the expression of CHOP and Caspase-12 proteins in spinal cord and nerve root tissues was increased in the model group (<0.05); compared with the model group and the wheat-grain moxibustion + 3MA group, the expression of CHOP, Caspase-12, and P62 proteins in spinal cord and nerve root tissues was decreased in the wheat-grain moxibustion group (<0.05). Compared with the model group and the wheat-grain moxibustion + 3MA group, the number of autophagosomes in spinal cord and nerve root tissues was increased in the wheat-grain moxibustion group, and the cellular ultrastructure was clear and intact, similar to the sham operation group.
Wheat-grain moxibustion at "Dazhui" (GV 14) could effectively alleviate neuropathic pain in CSR model rats. The analgesic mechanism may be related to promoting autophagy, inhibiting ERS, reducing ERS-mediated apoptosis, and repairing damaged nerves.
观察麦粒灸对神经根型颈椎病（CSR）大鼠脊髓和神经根组织自噬及内质网应激（ERS）的影响，探讨麦粒灸缓解CSR神经病理性疼痛的潜在机制。
将48只SPF级SD大鼠随机分为假手术组、模型组、麦粒灸组和麦粒灸+3-甲基腺嘌呤（3MA）组，每组12只。采用椎管插入法在模型组、麦粒灸组和麦粒灸+3MA组建立CSR模型。造模成功后第3天起，麦粒灸组于“大椎”（GV 14）穴行麦粒灸，每日1次，每次6壮。麦粒灸+3MA组腹腔注射3MA（2.5 mg/kg），随后给予与麦粒灸组相同的麦粒灸干预。连续干预7天，每日1次。观察干预前后大鼠步态障碍评分及外周神经机械性痛阈。采用蛋白质免疫印迹法检测脊髓和神经根组织中ERS凋亡因子C/EBP同源蛋白（CHOP）、半胱天冬酶-12（Caspase-12）以及自噬底物P62的表达。采用透射电子显微镜观察脊髓和神经根组织中的自噬体及细胞超微结构。
造模后，模型组、麦粒灸组和麦粒灸+3MA组大鼠步态障碍评分升高（<0.05），外周神经机械性痛阈降低（<0.05），与假手术组比较差异有统计学意义。干预后，模型组大鼠步态障碍评分升高（<0.05），外周神经机械性痛阈降低（<0.05），与假手术组比较差异有统计学意义；麦粒灸组和麦粒灸+3MA组大鼠步态障碍评分降低（<0.05），外周神经机械性痛阈升高（<0.05），与模型组比较差异有统计学意义；麦粒灸组大鼠步态障碍评分低于麦粒灸+3MA组（<0.05），外周神经机械性痛阈高于麦粒灸+3MA组（<0.05）。与假手术组比较，模型组脊髓和神经根组织中CHOP、Caspase-12蛋白表达升高（<0.05）；与模型组和麦粒灸+3MA组比较，麦粒灸组脊髓和神经根组织中CHOP、Caspase-12及P62蛋白表达降低（<0.05）。与模型组和麦粒灸+3MA组比较，麦粒灸组脊髓和神经根组织中自噬体数量增多，细胞超微结构清晰完整，与假手术组相似。
“大椎”（GV 14）穴麦粒灸可有效缓解CSR模型大鼠的神经病理性疼痛。其镇痛机制可能与促进自噬、抑制ERS、减少ERS介导的细胞凋亡以及修复受损神经有关。
