【摘要】：目的:觀察不同電壓脈沖射頻(pulsed Radiofrequency,PRF)對(duì)慢性坐骨神經(jīng)壓迫損傷(chronic constriction injury of the sciatic nerve,CCI)大鼠模型下丘腦β-內(nèi)啡肽含量的影響,探討脈沖射頻的鎮(zhèn)痛機(jī)制。方法:雄性SD大鼠72只建立CCI疼痛模型后,隨機(jī)分為4組(n=18):假刺激組H0、PRF低電壓組H1(45v)、PRF中電壓組H2(55v),PRF高電壓組H3(65v)。PRF組:制模后7 d對(duì)其坐骨神經(jīng)結(jié)扎近端行PRF,脈寬20ms,脈沖頻率2 Hz,持續(xù)時(shí)間2 min,治療電壓分別為45v、55v、65v。假刺激組:制模7d后,在其相同位置放置射頻電極,但無脈沖治療,持續(xù)時(shí)間2min。制模前(T0)、制模后7 d(T1)、PRF后1(T2)、7(T3)和14 d(T4)測(cè)定大鼠疼痛行為學(xué)熱痛閾(paw thermal withdrawal latency,PWTL)的變化。PRF后1、7和14 d,每組各處死6只大鼠,測(cè)定不同時(shí)間點(diǎn)大鼠下丘腦中β-內(nèi)啡肽表達(dá)量及電鏡觀察神經(jīng)微觀結(jié)構(gòu)變化。結(jié)果:PRF組在治療后1、7和14d,與假刺激組比較,熱痛閾均明顯提高(P0.01)。其中術(shù)后第7d,中、高電壓組熱痛閾均明顯高于低電壓組,差異有統(tǒng)計(jì)學(xué)(P0.01);在實(shí)驗(yàn)結(jié)束時(shí),與假刺激組對(duì)照,術(shù)后第1d,7d和14d,低、中、高電壓組大鼠下丘腦β-內(nèi)啡肽含量明顯升高(P0.01);術(shù)后第7、14d,與低電壓組相比,中、高組大鼠下丘腦β-內(nèi)啡肽含量明顯升高(P0.01);術(shù)后第14d,高電壓組與中電壓組差異顯著(P0.05);在電鏡觀察下與假刺激組比較,經(jīng)PRF干預(yù)后的坐骨神經(jīng)損傷輕微。結(jié)論:1.電壓45V、55V、65V的2Hz脈沖射頻均可引起CCI大鼠熱痛閾的升高,可能與其增加下丘腦β-內(nèi)啡肽的含量有關(guān)。同時(shí)針尖溫度波動(dòng)小,推測(cè)不同電壓的場(chǎng)強(qiáng)效應(yīng)可能是PRF發(fā)揮鎮(zhèn)痛作用的機(jī)理之一。2.PRF電壓大于55V時(shí),痛閾值降低沒有進(jìn)一步改善。然而β-內(nèi)啡肽含量有所升高,可能會(huì)延長疼痛緩解的時(shí)間。
[Abstract]:Aim: to observe the effect of pulsed pulse radio frequency (pulsed) on the content of 尾 -endorphin in hypothalamus of rats with chronic sciatic nerve compression injury (chronic constriction injury of the sciatic nerveCCI), and to explore the analgesic mechanism of pulse radio frequency (PRF). Methods: 72 male Sprague-Dawley rats were used to establish CCI pain model. The rats were randomly divided into 4 groups (n / 18): sham stimulation group (H0), low voltage group (H _ 1 (45 v), medium voltage group H _ 2 (55 v) and high voltage group H _ 3 (65 v). PRF was performed on the proximal end of sciatic nerve ligation 7 days after modeling, pulse width was 20 Ms, pulse frequency was 2 Hz, duration was 2 min. Sham stimulation group: after 7 days, the radiofrequency electrode was placed in the same position, but there was no pulse therapy for 2 min. Before (T0), 1 (T2) 7 (T3) and 14 d (T4) after PRF, the changes of pain behavioral threshold (paw thermal withdrawal latencyPWTL were measured at 1 and 14 days after PRF. Six rats were killed in each group. The expression of 尾-endorphin in hypothalamus of rats was measured at different time points and the changes of nerve microstructure were observed by electron microscope. Results compared with the sham stimulation group, the thermal pain threshold of the 1: PRF group was significantly higher than that of the sham stimulation group on the 7th and 14th day after treatment (P0.01). The thermal pain threshold in the high voltage group was significantly higher than that in the low voltage group on the 7th day after operation (P0.01), and at the end of the experiment, compared with the sham stimulation group, it was lower and middle at the 1st day and 14th day after operation. The content of 尾 -endorphin in hypothalamus of rats in high voltage group was significantly higher than that in low voltage group (P0.01), and at the 7th day after operation, the content of 尾 -endorphin in hypothalamus was significantly higher than that in low-voltage group. The content of 尾 -endorphin in hypothalamus was significantly increased in high group (P0.01), the difference between high voltage group and medium voltage group was significant (P0.05) on the 14th day after operation. Compared with sham stimulation group under electron microscope, the sciatic nerve injury after PRF intervention was slight. Conclusion 1. The increase of thermal pain threshold in CCI rats could be attributed to the increase of 尾 -endorphin content in hypothalamus. At the same time, the temperature fluctuation of the needle tip is small. It is speculated that the field intensity effect of different voltage may be one of the mechanisms of analgesic effect of PRF. 2. When the voltage of PRF is greater than 55 V, the pain threshold is not further improved. However, increased beta-endorphin levels may prolong pain relief.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R402

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