摘要目的 探讨炎性痛-吗啡耐受大鼠背根神经节降钙素基因相关肽(CGRP)、P物质(SP)及脑源性神经营养因子(BDNF)表达的变化及电针对吗啡耐受的影响.方法 取鞘内置管成功的25只大鼠,于左后足踝关节腔注射完全弗氏佐剂50μl致炎,致炎后第4天开始鞘内给药.随机分为5组(n=5):A组鞘内给予生理盐水10μl,2次/d,连续7 d;B组鞘内给予吗啡10 μg/kg(10μl),2次/d,仅给药1 d;C组鞘内给予吗啡10 μg/kg(10μl),2次/d,连续7 d;D组鞘内给药方法同C组,同时每日首次给药后用电针刺激仪电针大鼠阳陵泉穴和足三里穴,刺激强度2 mA,刺激频率2 Hz,波宽0.6ms,刺激时间30 min;E组电针刺激频率15Hz,波宽0.4 m,余同D组.于致炎前、鞘内给药前1 d、给药后1、2、3、4、5、6、7 d(T0-8)时测定大鼠后肢热缩足潜伏期(PWL).给药7 d后取L4～L6背根神经节,采用RT-PCR法测定CGRP、SP、BDNF的mRNA表达.结果 与T0时比较,各组T1时PWL缩短(P＜0.05);与T1时比较,B组～E组T2时PWL延长(P＜0.05);与T2时比较,B组～E组T3-8时PWL缩短(P＜0.05).与A组比较,B组～E组PWL延长,C组CGRP mRNA、SP mRNA、BDNF mRNA表达上调(P＜0.05);与B组比较,C组～E组PWL延长(P＜0.05);与C组比较,D组和E组PWL延长,CGRP mRNA、SP mRNA、BDNF mRNA表达下调(P＜0.05);与D组比较,E组PWL缩短,CGRP mRNA、SPmRNA、BDNF mRNA表达上调(P＜0.05).结论 大鼠背根神经节内CGRP mRNA、SPmRNA、BDNF mRNA表达上调参与了吗啡镇痛耐受的形成;电针治疗可抑制吗啡镇痛耐受的形成,机制可能与抑制背根神经节内CGRP mRNA、SP mRNA、BDNF mRNA表达有关.

abstractsObjective To investigate the changes in the expression of calcitonin gene-related peptide (CGRP), substance P (SP) and brain-derived neurotrophic factor (BDNF) in dorsal root ganglion (DRG) and the effect of electroacupuncture (EA) on morphine tolerance in rats with chronic inflammatory pain (CIP) and morphine tolerance. Methods Twenty-five 8-month-old male SD rats weighing 230-250 g in which intrathecal (IT)catheters were successfully implanted without complications were randomly divided into 5 groups ( n = 5 each):groupA CIP + normal saline (NS) 10 μl IT twice a day for 7 consecutive days; group B CIP + morphine 10 μg/kg ( 10 μl) IT twice for the first day only; group C CIP + morphine 10 μg/kg ( 10 μl) IT twice a day for 7 consecutive days; group D CIP + EA (intensity 2 mA, frequency 2 Hz, wave length 0.6 ms) + morphine 10 μ g/kg (10 μl) IT twice a day for7 consecutive days; group E CIP + EA (intensity 2 mA, frequency 15 Hz,wave length 0.4 ms) + morphine 10μg/kg (10 μl) IT twice a day for7 consecutive days. CIP was induced by injecting complete Freund's adjuvant (CFA) into the ankle joint of the left hindlimb. IT morphine or NS was started on the 4th day after induction of CIP. EA of Yanglingquan and Zusanli lasting 30 min was performed once a day after first IT administration of morphine for 7 days. Paw withdrawal latency (PWL) to a thermal nociceptive stimulus was measured before induction of CIP, 1 day before (baseline) and at day 1-7 after administration (T0-8) . The animals were sacrificed after the last PWL measurement. The DRGs of the lumbar segment (L4-6) were removed for determination of CGRP, SP and BDNF mRNA expression using RT-PCR. Results PWL was significantly shorter at T1 than at T0 in all groups, and at T3-8 than at T2 in group B-E, while longer at T2 than at T1 in group B-E ( P ＜0.05). PWL was significantly longer in group B-E and CGRP, SP and BDNF mRNA expression higher in group C than in group A ( P ＜ 0.05). PWL was significantly longer in group C-E than in group B ( P ＜ 0.05). PWL was significantly longer and CGRP, SP and BDNF mRNA expression lower in group D and E than in group C ( P ＜0.05). PWL was significantly lower and CGRP, SP and BDNF mRNA expression higher in group E than in group D ( P ＜ 0.05). Conclusion Up-regulation of the expression of CGRP, SP and BDNF mRNA in DRG is involved in the devepopment of morphine tolerance. EA can inhibit the devepopment of morphine tolerance by inhibiting the expression of CGRP2 SP and BDNF mRNA.