基于HMGB1调控小胶质细胞极化状态探讨推拿对CNP大鼠的镇痛机制研究

炎症是慢性神经病理性疼痛（CNP）发生发展的主要原因之一，小胶质细胞极化状态下炎症因子消长平衡决定炎症物质多寡，低表达HMGB1可以抑制促炎因子释放。我们前期研究发现推拿可以减少脊髓背角炎症因子IL-1β释放从而减轻疼痛，HMGB1表达量与疼痛程度呈递增关系，但两者之间相互关系有待进一步研究。据此我们提出假说：基于“不通则痛”和“不荣则痛”理论的枢经镇痛推拿可能通过下调HMGB1的表达进而调控小胶质细胞极化状态，减少炎症因子释放，达到镇痛效果。为验证研究假说，我们建立SNL大鼠模型，观察推拿后大鼠热痛阈和机械痛阈以明确推拿镇痛效果。通过检测CNP大鼠小胶质细胞极化状态情况，及下调HMGB1后大鼠脊髓小胶质细胞极化状态情况及IL-1β、IL-10水平，以期从拮抗小胶质细胞极化状态为CNP的防治提供新策略。

Inflammation is one of the main reasons for the occurrence and development of chronic neuropathic pain, the balance of inflammatory factors in the polarized state of microglia determines the number of inflammatory substances, low expression of HMGB1 can inhibit the release of pro-inflammatory factors. Our previous study found that massage can reduce the release of inflammatory factor IL-1β in the spinal dorsal horn to relieve pain, and there was an increasing relationship between the expression of HMGB1 and the degree of pain, but the relationship between needs further research. Therefore we propose a hypothesis: based on the traditional Chinese medicine theories of “when your body feels pain, it means the balance in your body is disrupted. Conversely, you will not feel any discomfort when your body’s Qi is flowing smoothly through the meridians”(Bu tong ci tong ,bu rong ci tong ), Axis Meridians Massage may regulate the polarization of microglia by down-regulating the expression of HMGB1, reduce the release of inflammatory factors, and achieve an analgesic effect. To verify the hypothesis, we established an SNL rat model and observed the thermal pain threshold and mechanical pain threshold of the rats after the massage to determine the analgesic effect of massage. By detecting the polarization status of microglia cells in CNP rats, and the polarization status of microglia cells in the spinal cord and IL-1β and IL-10 levels in rats after down-regulating HMGB1, in order to provide a new strategy for the prevention and treatment of CNP by antagonizing the polarization state of microglial cells.