急/慢性下腰痛：本体感觉传入异常及“温针”交感神经靶控疗法研究

随着现代生活工作方式的改变，颈、肩、腰腿痛正逐渐年轻化，并成为危害人类健康的常见、多发病。尽管椎骨增生，退变和椎间盘突出常被认为是上述病症的主因，但患者接受椎间盘切除等手术治疗后，临床效果往往不佳，且易复发。基于课题组肌肉痛研究成果，并结合临床软组织针热治疗取得良好疗效这一事实，申请者认为“肌梭/腱器官本体感觉传入异常-“感觉-交感”解剖/功能耦联-痛觉内源性调控紊乱”可能是颈、肩、腰腿痛的始动和维持因素，并进一步造成筋-骨稳态失衡，脊椎关节退变及椎间盘突出。采用电生理同步记录结合光遗传技术，联合行为学，免疫组化及分子生物学方法，本课题将聚焦急/慢性下腰痛，以肌梭/腱器官功能状态为研究切入点，以43°C温针靶向调节外周及中枢交感活性为治疗手段，探索肌肉本体感觉传入及丘脑-下丘脑介导的感觉-交感可塑性变化在下腰痛发生和发展中的作用及神经调控机制，为颈、肩、腰腿痛的预防和治疗提供新策略。

Following the changes of contemporary life and working style, as a common and prevalent disease neck, shoulder, and low back pain progressively occurs in patients with young ages and seriously influences human health. Despite the problems of vertebral hyperplasia, regression, and lumbar disk herniation, methods by means of surgical treatment in removing vertebral disk failed to fully relieve such diseases. Based on results from our series of studies associated with clinical trials related to the efficacy of heating-needle therapy in treatment of acute and chronic low back pain, the applicant hypothesizes here that the neck, shoulder, and low back pain might be initiated and maintained by abnormal proprioceptive afferents from muscle spindle/tendon organ-'Sensory-Sympathetic' anatomical and functional coupling-disorder of endogenous pain modulation, which in turn trigger imbalanced muscle-bone homeostasis, vertebral regression, and lumbar disk herniation. Utilizing multi-disciplinary approaches including behavioral, electrophysiological simultaneous recordings, immunohistochemical and molecular biology methods, and optogenetics, the current application will focus on the activities of muscle spindle/tendon organ, and the effects of 43°C warm-needle therapy in targeting peripheral and central sympathetic activities in order to explore the roles of muscular proprioceptive afferents and thalamus-hypothalamus induced sensory-sympathetic plastic manifestation, and its neural regulation mechanisms in generation and development of low back pain. The current application may also provide new strategy and policy in prevention and treatment of diseases from neck, shoulder, and low back pain.