Development Of An Acupuncture/Microdialysis Needle

针灸/微透析针的开发

• 批准号: 7146067
• 负责人: Terry M. Phillips
• 金额: --
• 依托单位: OFFICE OF THE DIRECTOR, NATIONAL INSTITUTES OF HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/7146067
• 关键词: acupuncture /acupressure; biomedical equipment development; capillary electrophoresis; clinical research; cytokine; electrolytes; human subject; human tissue; microdialysis; neuropeptides; oral facial pain; respiratory gas

Myofascial pain is associated with the formation of pain "trigger" points or defined areas within a muscle block that exhibit tenderness and abnormal tightness. Acupuncture is an alternative approach to releasing trigger points, thus relieving pain and the associated muscle tension in many cases. Although this therapeutic approach is efficacious there is little scientific evidence to support the clinical relief shown following treatment. DBEPS designed and developed an acupuncture needle with a hollow stem through which a twin tube microdialyzer could be inserted. The exterior bore of the needle was 28 - 30 gauge stainless surgical steel, with one end beveled into a blunt, non-cutting tip by micro-polishing. A 100,000 m.w. cutoff dialyzer membrane was attached to a 30-gauge poly-ether-ether-ketone (PEEK) biocompatible tubing and a 33-gauge PEEK tubing inserted into the first tube, thus forming a inlet and return flow-path terminating in the dialyzer membrane. This apparatus was fixed inside the stainless steel tubing so that the dialyzer surface was flush with the hole in the needle tip. A handle was fixed to the other end of the needle allowing the operator to manipulate the needle in a similar manner to a solid acupuncture needle. Three groups of patients, two with various degrees of muscle pain and tension plus controls, were recruited to the study. The acupuncture needle was inserted in the shoulder muscle by a skilled acupuncture specialist and samples taken, via microdialysis, from the needle tip. The samples were collected and analyzed for a variety of analytes such as blood gases, cytokines, hormones, neuropeptides, and electrolytes by the DBEPS Ultramicro Analytical Immunochemistry Resource, using established techniques (capillary electrophoresis, capillary electrochromatography, micro-ion selective electrochemistry and micro gas sensors). This project is recruiting subjects under an IRB-approved protocol and has completed the first phase of the protocol. There were clear differences between the three test groups, the normal group demonstrating little to no variation over the entire treatment time. The latent group demonstrated moderate concentrations of pain-associated neuropeptides as well as inflammatory cytokines. These concentrations returned to normal during the elicitation of a ?twitch? reaction or firing of the trigger point. Additionally, the subjects unanimously stated that they felt pain relief and loss of muscle discomfort following treatment. The severe group demonstrated relatively high, localized concentrations of pain-associated neuropeptides and inflammatory cytokines, which became reduced but not completely removed during the treatment. Although some pain relief was noted, the majority of the subjects continued to feel some degree of muscle tension and light pain. Further studies are in progress to examine the effects of repeat treatments and chemical changes in these subjects as compared to normals.

肌筋膜疼痛与疼痛“触发”点或肌肉块内表现出压痛和异常紧绷的限定区域的形成有关。针灸是释放触发点的另一种方法，从而在许多情况下缓解疼痛和相关的肌肉紧张。尽管这种治疗方法有效，但几乎没有科学证据支持治疗后显示的临床缓解。DBEPS设计并开发了一种具有中空杆的针灸针，通过该中空杆可以插入双管微透析器。针的外孔是28 - 30号不锈钢外科钢，一端通过微抛光成斜面成为钝的非切割尖端。10万兆瓦将截止透析器膜连接到30号聚醚醚酮（PEEK）生物相容性管和插入第一管的33号PEEK管，从而形成终止于透析器膜的入口和返回流路。将该装置固定在不锈钢管内，使透析器表面与针尖上的孔齐平。手柄固定在针的另一端，允许操作者以类似于实心针灸针的方式操纵针。研究招募了三组患者，其中两组有不同程度的肌肉疼痛和紧张，另一组为对照组。由熟练的针灸专家将针灸针插入肩部肌肉，并通过微透析从针尖上采集样品。通过DBEPS Ultramicro Analytical Immunochemistry Resource，使用已建立的技术（毛细管电泳、毛细管电色谱、微离子选择性电化学和微气体传感器）收集并分析样品中的各种分析物，如血气、细胞因子、激素、神经肽和电解质。该项目正在根据IRB批准的方案招募受试者，并已完成方案的第一阶段。三个试验组之间存在明显差异，正常组在整个给药时间内几乎没有变化。潜伏组表现出中等浓度的疼痛相关神经肽以及炎性细胞因子。这些浓度恢复正常的启发过程中？抽搐？触发点的反应或发射。此外，受试者一致表示，他们在治疗后感到疼痛缓解和肌肉不适减轻。重度组表现出相对较高的疼痛相关神经肽和炎性细胞因子的局部浓度，这些浓度在治疗期间降低但未完全消除。虽然注意到疼痛有所缓解，但大多数受试者仍感到一定程度的肌肉紧张和轻微疼痛。进一步的研究正在进行中，以检查与正常人相比，重复治疗对这些受试者的影响和化学变化。