基于PKC-P2X3通路探讨推拿点按法抑制神经病理性疼痛的外周敏化机制

神经病理性疼痛严重影响了病人生活和活动水平，给患者带来痛苦及沉重的经济负担。推拿镇痛效果显著且副作用小，但镇痛机制尚不明确。研究表明，P2X3受体上存在PKC结合位点，P2X3受体是一个对PKC调整敏感的表型开关，PKC信号传递导致P2X3受体激活和表达上调，是外周和中枢痛敏形成的病理基础。基于此，我们提出假说：点按法可能通过调控DRG中PKC信号传递及P2X3受体表达，同时降低DRG神经元兴奋性，调控神经信号传递，使疼痛信号上行传递抑制或中断，发挥镇痛作用。研究通过疼痛行为学、蛋白免疫印迹、免疫荧光染色及离体电生理等多学科方法，观察点按法对CCI大鼠的镇痛作用，观测点按法干预对CCI大鼠DRG神经元PKC-P2X3通路的影响，从PKC-P2X3通路阐述点按法镇痛的取效机制。为推拿手法的推广和临床应用奠定实验基础。

Neuropathic pain seriously affects the level of life and activity of the patient, and brings pain and heavy financial burden to the patient. The analgesic effect of massage is remarkable and the side effect is small, but the mechanism of analgesia is not clear. The research shows that there are PKC binding sites on P2X3 receptor, P2X3 receptor PKC is one of the adjustment of the phenotype switch sensitive, PKC signaling leads to activation of P2X3 receptors and the expression is the pathological basis of the formation of peripheral and central neuropathic pain. Based on this, we put forward the hypothesis that point pressing method may play an analgesic role by regulating the PKC signal transduction and P2X3 receptor expression in DRG, reducing DRG neuron excitability, regulating nerve signal transduction, and suppressing or interrupting the upstream transmission of pain signal. Through the study on the pain behavior, Western blotting, immunofluorescence staining and in vitro electrophysiological multidisciplinary approach, the observation point according to the law of CCI rats and its analgesic effect, according to the observation point intervention effect on PKC-P2X3 pathway in DRG neurons of CCI rat, this point by the effective mechanism to take analgesia from PKC-P2X3 pathway. Based on this, we put forward the hypothesis: according to law may transfer and P2X3 receptor expression by PKC signaling in DRG, at the same time reduce the excitability of DRG neurons, neural regulation of signal transmission, the signal transmission of uplink pain inhibition or disruption, exert its analgesic effect.