基于PI3K/Akt信号通路调控NCX表达探讨腹部推拿抑制溃疡性结肠炎外周敏化的作用机制

溃疡性结肠炎（UC）是引起腹痛的临床常见病之一，腹部推拿对UC具有较好的镇痛效果，但其作用机制不明。研究表明，外周敏化是UC疼痛的重要机制，背根神经节(DRG)中PI3K/Akt通路调控钠钙交换体（NCX），介导DRG神经元细胞外的钙内流，致胞内钙浓度增加，引起外周敏化。我们前期发现：腹部推拿对UC具有较好的镇痛作用，且能抑制UC大鼠DRG神经元细胞钙的内向电流、降低细胞内钙浓度水平，抑制其外周敏化。鉴于此，我们推测：腹部推拿可能通过抑制DRG中PI3K/Akt信号通路，弱化NCX表达，降低DRG神经元细胞内钙浓度，抑制其外周敏化，从而对UC起到镇痛作用。本研究拟用疼痛行为学、免疫生物学、电生理学等多学科技术，观察腹部推拿对UC大鼠DRG中PI3K/Akt通路调控NCX的作用，及对DRG神经元胞内钙浓度的影响，从而揭示腹部推拿对UC的外周镇痛机制，为其临床应用提供理论依据及奠定实验基础。

Ulcerative colitis (UC) is one of the common clinical diseases causing abdominal pain. Abdominal massage has a good analgesic effect on UC, but its mechanism is unknown. The studies are showed that peripheral sensitization is an important mechanism of UC pain. PI3K/Akt pathway in DRG regulates sodium calcium exchanger (NCX), mediating calcium influx of DRG neurons, increasing intracellular calcium concentration,to cause peripheral sensitization. In the early stage, we found that abdominal massage has a good analgesic effect on UC.and we found that abdominal massage could inhibit the inward current of calcium in DRG neurons of UC model rats, reducing the level of intracellular calcium, to inhibit its peripheral sensitization. In view of this, we speculate that abdominal massage may play an analgesic role in UC by inhibiting PI3K / Akt signaling pathway in DRG, weakening NCX expression, reducing intracellular calcium concentration of DRG neurons and inhibiting peripheral sensitization. In this study, animal pain behavior, immunobiology, electrophysiology and other multi-disciplinary techniques will be used to observe the effect of abdominal massage on the regulation of NCX by PI3K/Akt signaling pathway in DRG of UC rats and the effect of intracellular calcium concentration of DRG neurons,so as to reveal the peripheral analgesic mechanism of abdominal massage on UC and provide theoretical basis and experimental basis for its clinical application.