Comparison of the Local Tissue Milieu in Normal Muscle a

初步数据显示，与无肌筋膜触发点或潜伏期(无症状)肌筋膜触发点的患者相比，肌筋膜触发点活跃的患者在肌筋膜触发点的局部环境中具有显著不同的生化特征。具体地说，与潜伏组和正常组的受试者相比，MTrP活跃的受试者在斜方肌上段标准化解剖位置的pH显著低于潜伏组和正常组，而SP、CGRP、缓激肽、5-羟色胺、去甲肾上腺素、肿瘤坏死因子-α和IL-1β的水平显著高于潜伏组和正常组。此外，局部生化环境似乎确实随着LTR的改变而改变。一个需要回答的重要问题是，远离活跃或潜伏的MTrP的解剖位置是否与MTrP本身具有相似的生化特征。应该对这些偏远的地点进行评估，以帮助区分MTrp是否具有当地的生化特征，或者与更广泛的现象有关。 我们根据以下特征选择了三组受试者[1，2，3]。然后，我们采集了斜方肌上段的GB-21和腓肠肌内侧上段胫骨内侧髁的后方和下方的LV-7，用于测定pH值、肌肉代谢物、炎症介质、花生四烯酸衍生物、神经肽等的标准部位。 本研究的目的是确定活性MTrP的局部生化环境是否与远离MTrP的解剖部位的生化环境相同。 针灸穴位GB-21和LV-7是在精心挑选的三组中专门选择的，以标准化采样点的位置： 1)健康受试者，无颈痛，在GB-21中双侧触诊无MTrP，在LV-7中无MTrP 2)无颈痛的健康受试者，在GB-21中通过触诊在上斜方肌中发现潜伏的MTP，在LV-7中没有通过触诊发现MTP， 3)健康受试者，颈部疼痛持续时间少于3个月，其中一块上斜方肌经GB-21的触诊确定为活动的MTrp，而在LV-7的双侧触诊未发现MTrp。 协议进度说明： 到目前为止，我们招募了10名受试者(5名女性和5名男性)，年龄从25岁到56岁不等。利用我们的微量分析采样技术，我们成功地在触发点1上斜方肌和小腿LV-7采集了每个受试者的样本，没有发生任何不良事件。分析结果还在等待中。

Preliminary data suggest that patients with active myofascial trigger points (MTrPs) have a significantly different biochemical profile within the local milieu of the MTrPs compared to those without MTrPs or those with a latent (non-symptomatic) MTrP. Specifically, subjects with an active MTrP have a significantly lower pH and significantly higher levels of SP, CGRP, bradykinin, serotonin, norepinephrine, TNF-alpha and IL-1beta at a standardized anatomical location in the upper trapezius muscle than subjects in the latent and normal groups. Furthermore, the local biochemical milieu does appear to change with a LTR. An important question to answer is whether anatomical loci, remote from active or latent MTrPs have similar biochemical profiles to the MTrP itself. These remote sites should be evaluated to help distinguish whether MTrPs have local biochemical profiles or are associated with a more widespread phenomenon. We selected three groups of subjects based on the following characteristics [1, 2, 3 below]. We then sampled GB-21 in the upper trapezius muscle and LV-7 (posterior and inferior to the medial condyle of the tibia in the upper portion of the medial gastrocnemius) standardized sites for pH, muscle metabolites, inflammatory mediators, arachidonic acid derivatives, neuropeptides, etc. The goal of this study is to determine whether the local biochemical milieu of an active MTrP is the same as the biochemical milieu at anatomical sites remote from the MTrP. The acupuncture points GB-21 and LV-7 were selected specifically to standardize the locations of a sampling point in three carefully selected groups: 1) healthy subjects without neck pain and who have no MTrPs identified by palpation bilaterally in GB-21, and who have no MTrPs identified by palpation bilaterally in LV-7 2) healthy subjects without neck pain in whom latent MTrPs are identified by palpation in GB-21 in one of the upper trapezius muscles, and who have no MTrPs identified by palpation bilaterally in LV-7, 3) healthy subjects complaining of neck pain of less than 3 months duration with active MTrPs identified by palpation in GB-21 in one of the upper trapezius muscles, and who have no MTrPs identified by palpation bilaterally in LV-7. Description of protocol progress: We have thus far recruited 10 subjects (5 women and 5 men), ranging in age from 25 to 56 years old. With our microanalytical sampling technique, we have successfully collected samples at trigger point 1 in the upper trapezius muscle and LV-7 in the calf from each subject without any untoward events. Analyte results are pending.