Puerarin alleviates burn-related procedural pain mediated by P2X3 receptors
Puerarin alleviates burn-related procedural pain mediated by P2X3 receptors
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DOI：
10.1007/s11302-011-9248-5
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发表时间：
2011-12-01
影响因子：
3.5
通讯作者：
Liang, Shangdong
中科院分区：
文献类型：
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作者：
Li, Xin;Zhang, Jun;Liang, Shangdong
疼痛是烧伤后的主要问题。烧伤敷料更换引起的手术疼痛在患者中很常见，其管理是急性烧伤治疗的关键部分。烧伤疼痛很可能是最难治疗的急性疼痛形式。ATP有助于炎症，ATP通过作用于P2X（3）受体参与外周疼痛信号传导。葛根素是从传统中药中提取的，可能作用于P2X（3）受体机制。视觉疼痛量表（VAS）已被证明是疼痛强度和治疗效果的敏感指标。烧伤后外周血单个核细胞（PBMC）参与伤害性感受或疼痛。将烧伤患者随机分为生理盐水（NS）组和葛根素治疗组，测定疼痛（VAS评分）和炎症（PBMCs）。烧伤疼痛会产生应激反应，因此测定了烧伤患者的血糖、胰岛素和皮质醇水平。同时检测P2X（3）蛋白和mRNA的表达。葛根素治疗组VAS评分低于NS组。葛根素治疗组换药后血糖、胰岛素和皮质醇水平较NS组显著降低。NS组P2X（3）蛋白和mRNA表达水平均高于葛根素组。葛根素可拮抗烧伤后炎症因子（如ATP），降低烧伤后PBMCs中P2X（3）蛋白和mRNA的表达，从而降低VAS评分。因此，葛根素对与P2X（3）受体相关的烧伤患者换药过程中的疼痛具有镇痛作用。
Pain is a major problem after burns. Procedural pain evoked by burn dressing changes is common in patients, and its management is a critical part of treatment in acute burn injuries. Burn pain is very likely the most difficult form of acute pain to treat. ATP contributes to inflammation, and ATP is implicated in peripheral pain signaling via actions upon P2X(3) receptors. Puerarin is extracted from a traditional Chinese medicine and may act on P2X(3) receptor mechanisms. The Visual Analogue Scale (VAS) has been shown to be a sensitive indicator of pain intensity and treatment effects. Peripheral blood mononuclear cells (PBMCs) are involved in nociception or pain after burn injury. Burn patients were randomly divided into normal saline (NS) group (salt solution is saline) and puerarin-treated group and pain (Visual Analogue Scale scores) and inflammation (PBMCs) measured. Burn pain produces a stress response, so blood glucose, insulin, and cortisol levels in burn patients were determined. Furthermore, the expression of P2X(3) protein and mRNA in PBMCs was detected. The VAS scores in the puerarin-treated group were lower than those in NS group. The blood glucose, insulin, and cortisol levels in the puerarin-treated group at post-dressing changes were significantly decreased in comparison with those in NS group. The expression levels of P2X(3) protein and mRNA in PBMCs of burn patients in NS group were significantly increased in comparison with those in the puerarin-treated group. Puerarin can antagonize inflammatory factors (such as ATP) and decrease the upregulated expressions of P2X(3) protein and mRNA in PBMCs after burns to decrease VAS. Thus, puerarin had an analgesic effect on procedural pain in dressing changes of burn patients related to P2X(3) receptors.