| 引用本文: |
解俊霞, 范文强, 曹玉洁, 尹婷婷, 吕沛然, 张宁, 刘力, 刘奇.膝骨关节炎患者痛敏腧穴组胺、P物质、五羟色胺的特征研究[J].湖南中医药大学学报,2025,45(6):1054-1059[点击复制] |
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| 膝骨关节炎患者痛敏腧穴组胺、P物质、五羟色胺的特征研究 |
| 解俊霞,范文强,曹玉洁,尹婷婷,吕沛然,张宁,刘力,刘奇 |
| (陕西中医药大学针灸推拿学院, 陕西 咸阳 712046;陕西中医诊疗技术装备研发协同创新中心, 陕西 咸阳 712046) |
| 摘要: |
| 目的 探讨膝骨关节炎（KOA）患者痛敏腧穴局部组胺（HA）、P物质（SP）、五羟色胺（5-HT）的特征规律。方法 招募2023年8月至2024年3月就诊于陕西中医药大学附属医院的30例KOA患者，选取膝关节局部13个腧穴依次进行2次压痛检测，取其平均值，选取压痛阈值最低的1个腧穴定为痛敏穴位；随机选择其中8位KOA患者，对比其患侧膝关节痛敏穴位（痛敏组）与另一侧同穴位（腧穴组）皮肤组织学差异和各个物质含量特征差异，取样后采用HE染色法观察两组腧穴局部皮肤组织形态学，甲苯胺蓝染色观察肥大细胞（MC）数量，免疫荧光检测HA、SP、5-HT表达情况。结果 膝周13个穴位中，痛敏组梁丘、阴谷、鹤顶、委阳4个腧穴的压痛阈值明显低于腧穴组（P＜0.05）。两组局部皮肤组织均有炎症细胞浸润，且痛敏组的嗜酸性粒细胞、嗜碱性粒细胞等炎症细胞多于腧穴组。甲苯胺蓝染色结果显示，痛敏组MC外周分布大量蓝色颗粒，呈明显激活状态。与腧穴组相比，痛敏组局部皮肤组织的MC计数显著增加（P＜0.001），HA、5-HT、SP平均荧光强度均增高（P＜0.05，P＜0.01）。结论 痛敏腧穴局部皮肤组织中的HA、SP、5-HT的含量升高，以及MC的脱颗粒和其他炎症物质的浸润，可能是共同构成腧穴痛敏化的化学基础。 |
| 关键词: 膝骨关节炎 穴位敏化 压痛阈值 组胺 五羟色胺 P物质 炎症细胞 |
| DOI：10.3969/j.issn.1674-070X.2025.06.009 |
| 投稿时间：2025-02-17 |
| 基金项目:陕西省中医药科技创新提质扩能计划（TZKN-CXRC-01）；咸阳市重大科技创新专项（L2023-ZDKJ-CYJQ-SF-004，L2023-ZDKJ-CYJQ-SF-001）；咸阳市创新服务能力支撑计划（L2023-CXNL-CXRC-009）。 |
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| Characteristics of histamine, substance P, and 5-hydroxytryptamine in pain-sensitive acupoints of patients with knee osteoarthritis |
| XIE Junxia, FAN Wenqiang, CAO Yujie, YIN Tingting, LYU Peiran, ZHANG Ning, LIU Li, LIU Qi |
| (School of Acupuncture-moxibustion and Tuina, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi 712046, China;Shaanxi Collaborative Innovation Center for Research and Development of TCM Diagnosis, Treatment Technology, and Equipment, Xianyang, Shaanxi 712046, China) |
| Abstract: |
| Objective To investigate the characteristic patterns of local histamine (HA), substance P (SP), and 5-hydroxytr-yptamine (5-HT) in pain-sensitive acupoints of patients with knee osteoarthritis (KOA).Methods Thirty KOA patients admitted to the Affiliated Hospital of Shaanxi University of Chinese Medicine from August 2023 to March 2024 were recruited. Thirteen acupoints around the knee joint were selected, and each acupoint was subjected to two consecutive pressure pain threshold (PPT) measurements, with the mean value taken. The acupoint with the lowest PPT was identified as the pain-sensitive acupoint. Eight KOA patients were randomly selected to compare the skin histological differences and variations in the content of various substances between the pain-sensitive acupoints (pain-sensitive group) on the affected knee and the corresponding acupoints (acupoint group) on the contralateral side. After sampling, HE staining was used to observe local skin histomorphology of the acupoints in the two groups. Toluidine blue staining was employed to quantify mast cells (MCs), and immunofluorescence was utilized to determine the expression levels of HA, SP, and 5-HT.Results Among the 13 acupoints around the knee, the pressure pain thresholds of Liangqiu (ST34), Yinggu (KI10), Heding (EX-LE2), and Weiyang (BL39) acupoints in the pain-sensitive group were significantly lower than those in the acupoint group (P<0.05). Inflammatory cell infiltration was observed in the local skin tissue of both groups, with a higher number of eosinophils and basophils in the pain-sensitive group compared with the acupoint group. Toluidine blue staining revealed a large number of blue particles distributed around the MCs in the pain sensitive group, indicating marked activation. Compared with the acupoint group, the MC count in the local skin tissue of the pain-sensitive group significantly increased (P<0.001), and the mean fluorescence intensities of HA, 5-HT, and SP all increased (P<0.05, P<0.01).Conclusion Elevated contents of HA, SP, and 5-HT in the local skin tissue at pain-sensitive acupoints, along with the degranulation of MCs and infiltration of other inflammatory substances, may collectively contribute to the chemical basis for acupoint sensitization. |
| Key words: knee osteoarthritis acupuncture sensitization pressure pain threshold histamine 5-hydroxytryptamine substance P inflammatory cells |
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