以痛温触觉障碍恢复为核心探究推拿促进SNI大鼠感觉功能障碍恢复的机理

前期研究主要结论如下：推拿可以①改善周围神经损伤大鼠痛温觉行为学指标；②促进NTFs表达；③保护神经元；④修复神经髓鞘；⑤防止肌肉萎缩；初步确立推拿治疗本病的科学性。为进一步研究推拿对周围神经损伤浅感觉恢复的影响及机理，本课题继续以坐骨神经损伤为例研究周围神经损伤，采用推拿手法模拟仪定性定量模拟手法，对SNI模型大鼠进行干预。将行为学作为疗效评价指标，采用光镜、电镜观察与痛觉相关神经胶质细胞；与温度觉相关角质细胞；与触觉相关梅克尔细胞的形态学变化，运用免疫组化及分子生物学技术，在外周至脊髓感觉通路上选择皮肤、背根节、脊髓背角为靶点，检测疼痛指标（Iba1、GFAP、P2Y12、p38MAPK、NMDA受体、JNK等）；温度觉指标（TRPV1、TRPM8等）；触觉指标（Piezo2等）；探寻推拿促进周围神经损伤痛、温、触觉恢复的可能机理，最终解释推拿能够治疗痛、凉、木这一科学问题。

As shown by research on the mechanism of early stage tuina treatment for peripheral nerve injury, Tuina can: ①improve the nociceptive and thermal behavioral indicators in peripheral nerve damaged rats ②increase neurotrophic factor expression ③protect neurons ④repair myelin sheath morphology ⑤prevent muscular atrophy. This research tentatively confirms Tuina’s scientific foundation for treatment of this condition. As further research of the mechanism of Tuina treatment and its effect on superficial sensation after peripheral nerve injury, this study will continue to use sciatic nerve injury as the model to study peripheral nerve injury, as well as utilizing an analog Tuina-technique simulator to simulate Tuina techniques while maintaining qualitative and quantitative controls. Intervention will be carried out on rats injured via clamping of their sciatic nerves. Behavioral and functional indicators will be used as indicators to evaluate treatment efficacy. Light and electron microscopy will be used to observe morphological changes in glial cells related to nociception, skin keratinocytes involved in thermal sensation, and merkel cells related to tactile sensation. Key regions along sensory pathways from the periphery to the spinal cord will be examined (skin --- dorsal root ganglion---ending in the dorsal horn). Immunohistochemical techniques and molecular biological methods will be utilized to test for nociceptive indicators (Iba1, GFAP, P2Y12, p38MAPK, NMDA receptor, JNK, et al), thermal sensation indicators (TRPV1, TRPM8, et al) and tactile indicators (Piezo2, et al). The eventual aim being to explore the possible mechanism of Tuina in the recovery of nociceptive, thermal, and mechanical sensations after peripheral nerve injury and to eventually answer the scientific question of how Tuina can treat pain, coldness and numbness.