寒湿型LDH疼痛-负面情绪的机制研究

闵文; 谭峰; 谭登; 成舟; 韩龙; 方彭华; 黄桂成

寒湿型LDH疼痛-负面情绪的机制研究

闵文¹,
谭峰¹,
谭登¹,
成舟¹,
韩龙¹,
方彭华²,
黄桂成^1,

1.
南京中医药大学第一临床医学院，江苏南京 210023
2.
南京中医药大学翰林学院，江苏泰州 225300

计量
- 文章访问数: 713
- HTML全文浏览量: 4
- PDF下载量: 745
- 被引次数: 0
出版历程
- 刊出日期: 2018-11-10

Research on the Mechanism of Pain and Negative Emotion in Cold-Dampness-Type Lumbar Disc Herniation

1.
The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210023, China
2.
Hanlin College, Nanjing University of Chinese Medicine, Taizhou, 225300, China

摘要

摘要: 目的探讨寒湿型腰椎间盘突出症(LDH)疼痛-负面情绪的潜在机制。方法收集LDH手术患者23例，根据中医辨证标准分为寒湿组、非寒湿组，获取血清样本各11个和12个，病变椎间盘样本各11个和7个。另收集10例健康体检者血清样本为正常组。ELISA法检测血清白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、5-羟色胺(5-HT)、降钙素相关基因肽(CGRP)、神经肽Y(NPY)、β-内啡肽(β-EP)、P物质(SP)等水平；qPCR、Western blot法检测病变椎间盘5-HT、CGRP、NPY、β-EP等mRNA和蛋白表达。结果与非寒湿组比较，寒湿组年龄、病程、疼痛和麻木积分无明显差异，但失眠、焦虑积分明显升高(P<0.05)。血清学检测发现，与正常组比较，寒湿组和非寒湿组均出现CGRP显著降低和NPY显著升高(P<0.01)的共性趋势，而寒湿组β-EP也出现特征性显著升高(P<0.01)；与非寒湿组比较，寒湿组CGRP降低(P<0.05)，而β-EP显著升高(P<0.01)。椎间盘各因子mRNA和蛋白表达比较发现，与非寒湿组比较，寒湿组CGRP mRNA和蛋白表达升高(P<0.05)，β-EP mRNA和NPY蛋白表达降低(P<0.05)。结论与非寒湿证型比较，寒湿型LDH疼痛-负面情绪关系更为密切；CGRP、NPY、β-EP差异性表达于外周血和病变椎间盘，提示上述因子是介导疼痛-负面情绪的重要因子。
- 寒湿型 /
- 腰椎间盘突出症 /
- 疼痛 /
- 负面情绪 /
- 机制
Abstract: OBJECTIVE To investigate the potential mechanism of pain and negative emotion in cold-dampness-type lumbar disc herniation (LDH). METHODS 23 cases of LDH operation were collected. According to the dialectical standard of Chinese medicine， the patients were divided into cold dampness group and non cold dampness group， 11 and 12 serum samples were respectively obtained， 11 and 7 of the diseased intervertebral discs were respectively collected. The serum samples of 10 healthy persons were collected as normal group. The levels of serum interleukin-1β (IL-1β)， tumor necrosis factor-α (TNF-α)， 5- serotonin (5-HT)， calcitonin related gene peptide (CGRP)， neuropeptide Y (NPY)， β-endorphin (β-EP)， P substance (SP) were detected by ELISA. The qPCR and Western blot were used to detect the mRNA and protein expression of 5-HT， CGRP， NPY and β-EP in diseased intervertebral discs. RESULTS Compared with the non cold dampness group， there was no significant difference in age， course of disease， pain and numbness score in cold dampness group， but the score of insomnia and anxiety increased significantly (P<0.05). Serological test showed that there was a common trend of significant decrease of CGRP and significant increase of NPY (P<0.01) in both the cold dampness group and the non cold dampness group compared with the normal group， while the β-EP in the cold dampness group was also significantly increased (P<0.01). Compared with the non cold dampness group， the CGRP decreased in the cold dampness group (P<0.05)， and the β-EP increased significantly (P<0.01). Compared with the non cold dampness group， the expression of CGRP mRNA and protein increased in the cold dampness group (P<0.05)， and the expression of β-EP mRNA and NPY protein decreased (P<0.05) in the cold dampness group. CONCLUSION Compared with the non cold dampness syndrome， the cold-dampness LDH has a closer relationship between pain and negative emotions. CGRP， NPY， and β-EP were differentially expressed in peripheral blood and diseased intervertebral discs， suggesting that these factors play a important role in mediating pain and negative emotions.
- cold-dampness-type /
- lumbar disc herniation /
- pain /
- negative emotion /
- mechanism

HTML全文

参考文献(14)

[1]	韦程寿. 腰椎间盘突出症疼痛发生机制的研究及治疗近况[J]. 世界最新医学信息文摘，2015，15(20)：128-129.
[2]	陈龙梅，王珩. 腰椎间盘突出症患者抑郁、焦虑状况及影响因素分析[J]. 中国疼痛医学杂志，2014，20(6)：437-440.
[3]	王锦. 腰椎间盘突出患者围手术期的心理变化及干预[J]. 中国健康心理学杂志，2018，26(3)：337-340.
[4]	成舟.燠土胜水法治疗寒湿型腰椎间盘突出症的临床疗效观察[D].南京：南京中医药大学，2018.
[5]	URBAN-KOWALCZYK M， SMIGIELSKIB J， STRZELECKIA D. Olfactory identification in patients with schizophrenia-influence of B-endorphin and Cgrp concentration[J]. Eur Psych， 2015， 30(S1)：899.
[6]	陈媛儿，徐晓燕，冯莺，等. 腰椎间盘突出症辨证分型评估表的编制及应用研究[J]. 中华护理杂志，2018，53(2)：207-211.
[7]	张波，孙国栋，王军涛，等. 三维平衡正脊手法配合针灸治疗腰椎间盘突出症临床研究[J]. 山东中医杂志，2018，37(2)：129-131.
[8]	周艳. 带状疱疹后神经痛患者血清CGRP水平与疼痛、抑郁的关系[J]. 山东医药，2016，56(46)：88-90.
[9]	熊海霞. 神经肽Y的研究进展[J]. 安徽农业科学，2013，41(9)：3915-3916.
[10]	宋志刚，牛小育. 腰椎间盘突出症患者血清指标与疼痛程度的关系研究[J].河北医学，2015，21(12)：1947-1949.
[11]	王峰，崔玉蓬. 腰椎间盘突出症患者椎间盘组织炎性因子、TGF-β1、PGE2表达及意义[J]. 山东医药，2016，56(32)：56-58.
[12]	寇振媛，许毓英. 情志因素对不同年龄组心房纤颤患者血清中神经肽Y与心钠素的影响[J]. 辽宁中医杂志，2015，42(4)：680-682.
[13]	马伟涛，张富运. 不同牵引方法配合药物治疗对腰椎间盘突出症患者疼痛、β-内啡肽及P物质的影响[J]. 山西职工医学院学报，2018，28(2)：28-30.
[14]	ZHANG Y， LIU C， ZHAO Y， et al. The effects of calorie restriction in depression and potential mechanisms[J]. Curr Neuropharmacol， 2015， 13(4)：536-542.