| 引用本文: |
仪凡, 王锡友, 刘志凤, 于长禾, 李凤林, 张洋, 张明阳, 郭俊明, 孙博奥.舒筋四法对肌筋膜疼痛综合征大鼠骨骼肌能量代谢的影响[J].湖南中医药大学学报,2026,46(6):1136-1143[点击复制] |
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| 舒筋四法对肌筋膜疼痛综合征大鼠骨骼肌能量代谢的影响 |
| 仪凡,王锡友,刘志凤,于长禾,李凤林,张洋,张明阳,郭俊明,孙博奥 |
| (北京中医药大学东直门医院推拿疼痛科, 北京 100700;北京中医药大学第一临床医学院, 北京 100700) |
| 摘要: |
| 目的 探究舒筋四法对肌筋膜疼痛综合征（MPS）大鼠骨骼肌能量代谢的影响。方法 将42只SD大鼠随机分为空白组（6只）和造模组（36只），造模组通过钝性打击结合离心运动建立MPS模型，取造模成功的30只大鼠再次随机分为模型组、揉法组、拨法组、㨰法组、牵拉法组，每组6只，各治疗组分别给予对应的舒筋四法（即揉法、拨法、㨰法、牵拉法）干预。采用红外热成像仪检测患侧腓肠肌体表温度变化，采用生化法检测腓肠肌组织Na+-K+-ATP酶和Ca2+-Mg2+-ATP酶的含量，采用透射电镜观察腓肠肌组织线粒体形态、结构，采用Western blot检测腓肠肌组织磷酸化腺苷酸活化蛋白激酶（p-AMPK）和过氧化物酶体增殖物激活受体γ共激活因子1α（PGC-1α）水平。结果 干预后，模型组腓肠肌体表温度低于空白组（P<0.05），Na+-K+-ATP酶含量低于空白组（P<0.05），Ca2+-Mg2+-ATP酶含量与空白组比较差异无统计学意义（P>0.05）；揉法组、拨法组、㨰法组腓肠肌体表温度相比干预前明显上升（P<0.05），Na+-K+-ATP酶含量高于模型组（P<0.05）；揉法组、拨法组、㨰法组、牵拉法组Ca2+-Mg2+-ATP酶含量高于模型组但差异无统计学意义（P>0.05）。透射电镜结果显示：模型组线粒体明显肿胀，嵴结构消失，膜边界模糊，基质稀疏；揉法组、拨法组、㨰法组线粒体形态相对规则，嵴结构清晰、致密排列，膜结构完整；牵拉法组线粒体形态不规则，嵴结构稀疏、排列不清，基质相对稀疏。干预后，模型组p-AMPK、PGC-1α蛋白相对表达低于空白组（P<0.05）；揉法组、拨法组、㨰法组、牵拉法组p-AMPK蛋白相对表达高于模型组（P<0.05），揉法组、拨法组、㨰法组PGC-1α蛋白相对表达高于模型组（P<0.05）。结论 舒筋四法中揉法、拨法与㨰法对MPS骨骼肌能量代谢具备综合改善作用，可升高局部体表温度、修复线粒体形态结构，上调Na+-K+-ATP酶含量，并促进p-AMPK、PGC-1α蛋白表达。 |
| 关键词: 肌筋膜激痛点 推拿 舒筋四法 能量代谢 腺苷三磷酸 腺苷酸活化蛋白激酶 |
| DOI：10.3969/j.issn.1674-070X.2026.06.006 |
| 投稿时间：2026-01-12 |
| 基金项目:国家自然科学基金项目（82305427）；中央高水平医院临床科研业务费（CZ015）。 |
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| Effects of the four tendon-relaxing manipulations on skeletal muscle energy metabolism in rats with myofascial pain syndrome |
| YI Fan, WANG Xiyou, LIU Zhifeng, YU Changhe, LI Fenglin, ZHANG Yang, ZHANG Mingyang, GUO Junming, SUN Bo'ao |
| (Department of Tuina and Pain Management, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China;The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing 100700, China) |
| Abstract: |
| Objective To investigate the effects of the four tendon-relaxing manipulations on skeletal muscle energy metabolism in rats with myofascial pain syndrome (MPS). Methods A total of 42 SD rats were randomly divided into blank group (n=6) and modeling group (n=36). The MPS model was established via blunt impact combined with eccentric exercise. Thirty successfully modeled rats were randomly subdivided into model group, kneading manipulation group, plucking manipulation group, rolling manipulation group, and stretching manipulation group, with 6 rats in each group. Each treatment group received corresponding intervention with the four tendon-relaxing manipulations (kneading, plucking, rolling, and stretching). An infrared thermal imager was used to measure changes in the surface temperature of the gastrocnemius muscle on the affected side. Biochemical assays were performed to determine the levels of Na+-K+-ATPase and Ca2+-Mg2+-ATPase in the gastrocnemius tissues. Transmission electron microscopy was used to observe the morphology and structure of mitochondria in the gastrocnemius tissues. Western blot was used to measure the levels of phosphorylated adenosine monophosphate activated protein kinase (p-AMPK) and peroxisome proliferator activated receptor γ coactivator-1α (PGC-1α) in the gastrocnemius tissues. Results After intervention, the surface temperature of the gastrocnemius muscle in the model group was lower than that in the blank group (P<0.05), and the Na+-K+-ATPase level was also lower than that in the blank group (P<0.05). No statistically significant difference was found in Ca2+-Mg2+-ATPase level between the model group and the blank group (P>0.05). Compared with before intervention, the surface temperature of the gastrocnemius muscle in the kneading, plucking, and rolling manipulation groups increased significantly after intervention (P<0.05), and Na+-K+-ATPase levels in these groups were higher than those in the model group (P<0.05). The Ca2+-Mg2+-ATPase levels in the kneading, plucking, rolling, and stretching manipulation groups were higher than those in the model group, but the differences were not statistically significant (P>0.05). Transmission electron microscopy results showed that in the model group, mitochondria were markedly swollen, cristae structures disappeared, membrane boundaries were blurred, and the matrix was sparse; in the kneading, plucking, and rolling manipulation groups, mitochondrial morphology was relatively regular, with clear and densely arranged cristae and intact membrane structures; in the stretching manipulation group, mitochondrial morphology was irregular, cristae were sparse and poorly arranged, and the matrix was relatively sparse. After intervention, the relative protein expression levels of p-AMPK and PGC-1α in the model group were lower than those in the blank group (P<0.05). The relative expression of p-AMPK protein in the kneading, plucking, rolling, and stretching manipulation groups was higher than that in the model group (P<0.05), and the relative expression of PGC-1α protein in the kneading, plucking, and rolling manipulation groups was higher than that in the model group (P<0.05). Conclusion Among four tendon-relaxing manipulations, kneading, plucking, and rolling manipulations have comprehensive improving effects on skeletal muscle energy metabolism in MPS. These can raise local surface temperature, restore mitochondrial morphology and structure, up-regulate Na+-K+-ATPase levels, and promote the protein expression of p-AMPK and PGC-1α. |
| Key words: myofascial trigger point tuina four tendon-relaxing energy metabolism adenosine triphosphate adenosine monophosphate-activated protein kinase |
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