| 摘要: |
| 目的:研究点按委中穴对多裂肌损伤大鼠局部组织结构变化影响，基于核因子E2相关因子2(Nrf2)信号通路探讨点穴治疗腰肌损伤的作用机制。方法:将40只SD大鼠随机分为空白组、模型组、点穴组、抑制剂组，每组10只，局部注射布比卡因建立大鼠骨骼肌损伤模型，后两组给予压力传感器点穴治疗，共治疗2周。抑制剂组在点穴前注射Nrf2通路抑制剂鸦胆子苦醇(BRU)，干预结束后，检测各组超声下腰椎多裂肌结构差异，并取双侧多裂肌组织及血清，观察各组肌肉HE染色，血清炎症因子白细胞介素(IL)-18、IL-1β水平，并检测肌酸激酶(CK)、环氧合酶-2(COX-2)、半胱氨酸蛋白酶(Caspase-3)、机械生长因子(MGF)、胞浆蛋白(Keap1)、Nrf2、结蛋白(Desmin)的蛋白和mRNA表达量。结果:与空白组比较，模型组腰肌超声局部组织肿胀，肌纤维损伤明显，HE染色示肌纤维损伤水肿明显，血清炎症因子水平升高，COX-2、CK、Caspase-3蛋白和mRNA表达升高(P ＜0.01)，Keap1、Nrf2、Desmin蛋白和mRNA表达升高(P ＜0.01)，MGF蛋白和mRNA表达未见明显差异(P ＞0.05)。与模型组比较，点穴组腰肌超声局部肿胀较轻，HE染色见炎症水肿较轻，血清炎症因子水平降低，COX-2、CK、Caspase-3蛋白和mRNA表达降低，MGF、Keap1、Nrf2、Desmin蛋白和mRNA表达升高(P ＜0.01)。与点穴组比较，抑制剂组的腰肌超声局部肿胀严重，HE染色见炎症水肿明显，血清炎症因子水平较高，COX-2、CK、Caspase-3蛋白和mRNA表达升高(P ＜0.01)，MGF、Keap1、Nrf2、Desmin蛋白和mRNA表达降低，差异有统计学意义(P ＜0.01)。结论:点按委中穴可一定程度改善腰肌损伤大鼠多裂肌炎症损伤病理状态，恢复受损组织结构。点穴刺激MGF表达并激活Nrf2通路，下调肌细胞修复性蛋白表达，可能是点按委中穴治疗腰肌损伤的作用机制之一。 |
| 关键词: 点穴 委中穴 Keap1-Nrf2通路 多裂肌损伤 |
| DOI：10.3969/j.issn.1007-6948.2025.05.025 |
| 投稿时间：2025-03-07 |
| 基金项目:国家自然科学基金(81973971)；天津市中医药管理局中医药重点领域科技项目(2023015)；天津市中医药管理局中医中西医结合科研课题(2021201)；天津医院科技基金项目(Tjyy2107) |
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| Effect of pressing Weizhong acupoint on the repair of lumbar muscle injury in rats was explored based on the Keap1-Nrf2 pathway |
| ZHANG Qi,MA Xin-long,ZHAO Na |
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| Abstract: |
| Objective To investigate the effects on the structural changes of local tissues in rats with multifidus muscle injury by adopting the therapeutic method of regular acupressure at Weizhong acupoint and explore the mechanism of acupoint therapy for lumbar muscle injury based on the Nrf2 signaling pathway. Methods 40 SD rats were randomly divided into control group, model group, acupoint group, and the inhibitor group(n=10). Upon the successful modeling, the latter two groups received acupoint intervention using pressure sensors for a total of two weeks, while the control and model groups were not intervened. The inhibitor group was injected with the Nrf2 pathway inhibitor brusatol (BRU) before acupuncture. After the intervention, structural differences in the lumbar multifidus muscle were detected via ultrasound. Bilateral multifidus muscle tissues and serum were collected to observe muscle HE staining and serum inflammatory factors IL-18, IL-1β. Furthermore, the levels of creatine kinase (CK), cyclooxygenase-2 (COX-2), caspase-3, and mechano growth factor (MGF), as well as cytoplasmic protein (Keap1), nuclear factor erythroid 2-related factor 2 (Nrf2), and desmin protein and mRNA expression levels were measured. Results Compared with the control group, the model group showed local muscle swelling on ultrasound, and significant muscle fiber damage (P <0.01). HE staining revealed obvious muscle fiber damage and edema, and serum inflammatory factor levels were elevated. The expression of CK, COX-2, Caspase-3 proteins, and mRNA was increased (P <0.01), and the expression of Keap1, Nrf2, and Desmin proteins and mRNA was also elevated (P <0.01). No significant difference was observed in the expression of MGF protein and mRNA (P >0.05).Compared with the model group, the acupoint group showed lighter local muscle swelling on ultrasound, less inflammation and edema in HE staining, lower levels of serum inflammatory factors, and reduced expression of CK, COX-2, and Caspase-3 proteins and mRNA. The expression of MGF, Keap1, Nrf2, and Desmin proteins and mRNA was increased (P <0.01). Compared with the acupoint group, the inhibitor group showed more severe local muscle swelling on ultrasound, pronounced inflammation and edema in HE staining, higher levels of serum inflammatory factors, and increased expression of CK, COX-2, and Caspase-3 proteins and mRNA (P <0.01). The expression of Keap1, Nrf2, and Desmin proteins and mRNA was decreased (P <0.01). Conclusion Acupressure at the Weizhong point can improve the pathological state of inflammatory damage in the multifidus muscle of rats with lumbar muscle injury to some extent and restore the damaged tissue structure. Acupressure stimulation increases the expression of MGF and activates the Nrf2 pathway, downregulating the expression of myocyte repair proteins. This may be one of the mechanisms by which acupressure at the Weizhong point exerts its therapeutic effects on lumbar muscle injury. |
| Key words: Acupressure Weizhong acupoint Keap1-Nrf2 pathway multifidus muscle injury |
