Development Of An Acupuncture/Microdialysis Needle For Patient Assessment
开发用于患者评估的针灸/微透析针
基本信息
- 批准号:7593824
- 负责人:
- 金额:$ 2.33万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:
- 资助国家:美国
- 起止时间:至
- 项目状态:未结题
- 来源:
- 关键词:Acupuncture procedureAreaBiochemicalBiochemical ProcessBiocompatibleBiological MarkersBlood capillariesBlood gasCapillary ElectrophoresisChemicalsChinese PeopleClinicalCollectionDevelopmentDevicesDialysis procedureElectrochemistryElectrolytesEthersEthyl EtherEventExhibitsFire - disastersFlushingGasesHormonesImmunochemistryIn SituInflammatoryIonsKetonesLightLiquid substanceLocalizedMeasuresMedicineMembraneMicrodialysisMuscleMuscle TensionMyalgiaMyofascial Pain SyndromesNeedlesNeuropeptidesOperative Surgical ProceduresPainPatientsPharmaceutical PreparationsPhasePhysical DialysisPolishesProtocols documentationReactionRecruitment ActivityResearch Ethics CommitteesSamplingSecondary toSeriesShoulderSolidSpecialistStainless SteelSteelSurfaceSystemTechniquesTestingTherapeuticTimeTissue SampleTubeTwin Multiple BirthVariantWorkbasecapillarycytokinedesignsensorstemtrigger pointvolunteer
项目摘要
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. Our group 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 an 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 Ultramicro Analytical Immunochemistry group, 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, with 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.
Studies are ongoing to determine if the biochemical and immunological changes seen during dry-needling of active trigger points is unique for the trigger point itself. A series of subjects was tested in which the needle was inserted not only into the actual trigger point itself but also into an unrelated muscle, i.e., the calf muscle. These studies are still underway, but early analysis suggests that patients with active trigger points have a generally higher level of inflammatory biomarkers independent of the muscle sampled. Additionally, plans are underway to investigate the potential of the needle to deliver medications via the microdialysis tip to defined anatomical areas, especially muscle trigger points.
肌筋膜疼痛与疼痛触发点的形成或肌肉块内表现出压痛和异常紧绷的限定区域有关。 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。 本课题组设计并研制了一种空心针杆,可插入双管微透析器。 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。 针的另一端固定有一个手柄,操作者可以用类似于实心针灸针的方式操作针。 研究招募了三组患者,其中两组患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。 收集样品并分析各种分析物,如血气,细胞因子,激素,神经肽和电解质的超微分析免疫化学组,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)。 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,正常组在整个治疗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。 这些浓度在诱发抽搐反应或触发点激发期间恢复正常。 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。
目前正在进行研究,以确定在干针活动触发点期间观察到的生物化学和免疫学变化是否是触发点本身特有的。 对一系列受试者进行了测试,其中针不仅插入实际触发点本身,而且插入不相关的肌肉,即,小腿肌肉 这些研究仍在进行中,但早期分析表明,具有活跃触发点的患者通常具有较高水平的炎症生物标志物,与肌肉样本无关。 此外,正在计划研究针头通过微透析尖端将药物输送到定义的解剖区域,特别是肌肉触发点的潜力。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Terry M. Phillips其他文献
Clinical Applications of Capillary Electrophoresis: Methods and Protocols
- DOI:
10.1007/978-1-4939-9213-3 - 发表时间:
2019 - 期刊:
- 影响因子:0
- 作者:
Terry M. Phillips - 通讯作者:
Terry M. Phillips
Immunoaffinity capillary electrophoretic analysis of cyclosporin in tears.
泪液中环孢菌素的免疫亲和毛细管电泳分析。
- DOI:
- 发表时间:
1994 - 期刊:
- 影响因子:0
- 作者:
Terry M. Phillips;J. Chmielinska - 通讯作者:
J. Chmielinska
Protein A-coated glass beads. Universal support medium for high-performance immunoaffinity chromatography.
蛋白 A 包被的玻璃珠。
- DOI:
10.1016/s0021-9673(01)81651-4 - 发表时间:
1985 - 期刊:
- 影响因子:0
- 作者:
Terry M. Phillips;W. Queen;N. More;A. M. Thompson - 通讯作者:
A. M. Thompson
Immunoaffinity measurement of recombinant granulocyte colony stimulating factor in patients with chemotherapy-induced neutropenia.
化疗引起的中性粒细胞减少症患者重组粒细胞集落刺激因子的免疫亲和力测量。
- DOI:
- 发表时间:
1994 - 期刊:
- 影响因子:0
- 作者:
Terry M. Phillips - 通讯作者:
Terry M. Phillips
Zinc modulates mononuclear cellular calcitriol metabolism in peritoneal dialysis patients.
锌调节腹膜透析患者的单核细胞骨化三醇代谢。
- DOI:
10.1038/ki.1996.198 - 发表时间:
1996 - 期刊:
- 影响因子:19.6
- 作者:
P. Kimmel;P. Kimmel;Terry M. Phillips;Terry M. Phillips;S. Lew;S. Lew;C. Langman;C. Langman - 通讯作者:
C. Langman
Terry M. Phillips的其他文献
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7319241 - 财政年份:
- 资助金额:
$ 2.33万 - 项目类别:
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骨质疏松症女性多种分析物的评估
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7146066 - 财政年份:
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$ 2.33万 - 项目类别:
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超灵敏毛细管电泳的开发
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7013039 - 财政年份:
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$ 2.33万 - 项目类别:
Assessment Of Multiple Analytes In Women With Osteoporosis And Depression
评估患有骨质疏松症和抑郁症的女性的多种分析物
- 批准号:
8175398 - 财政年份:
- 资助金额:
$ 2.33万 - 项目类别:
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