摘要
目的 探究马桑狗帮油介导的苗医刮治法治疗寒湿型腰肌劳损（CDT-LMS）的作用机制。方法 将50只SPF级雄性SD大鼠随机分为正常组、模型组、茶油刮痧组、马桑狗帮油刮痧组及马桑狗帮油涂擦组，通过低温联合打击法建立CDT-LMS大鼠模型后实施对应干预。采用ELISA法检测血清IL-1β、IL-6、TNF-α（炎性因子）、β-EP（镇痛物质），结合HE染色观察腰部肌肉组织形态学变化，透射电镜评估超微结构变化。结果 与模型组相比，马桑狗帮油刮痧组能显著降低血清IL-1β、IL-6、TNF-α炎性因子水平，升高内源性镇痛物质β-EP含量，且肌肉组织形态修复效果最优，各项指标接近正常组。与模型组相比，马桑狗帮油刮痧组血清中IL-1β、IL-6、TNF-α水平显著降低（P<0.0001），β-EP水平显著升高（P<0.0001），肌肉组织炎性浸润明显减少。HE染色显示该组肌纤维排列整齐、炎细胞浸润减少；透射电镜可见细胞结构完整，线粒体、内质网无明显病变，无自噬或焦亡现象。其疗效优于茶油刮痧组和单纯涂擦组。结论 马桑狗帮油介导的苗医刮治法通过抗炎、镇痛及组织修复协同作用治疗CDT-LMS，其优效性可能源于药物介质与力学刺激的协同效应，为该疗法的临床应用提供了实验依据。
关键词： 炎症；镇痛；寒湿型腰肌劳损；苗医刮治法；组织形态学；马桑狗帮油
Abstract
Objective To investigate the mechanism of Coriaria nepalensis oil-mediated Miao medicine scraping therapy in treating cold-dampness type lumbar muscle strain (CDT-LMS). Methods Fifty SPF-grade male Sprague-Dawley rats were randomly divided into a normal group, a model group, a camellia oil scraping group, a Coriaria nepalensis oil scraping group, and a Coriaria nepalensis oil application group. A CDT-LMS rat model was established using a low-temperature combined impact method, followed by the corresponding interventions. Serum levels of IL-1β, IL-6, TNF-α (inflammatory factors), and β-EP (an analgesic substance) were measured using ELISA. Morphological changes in lumbar muscle tissue were observed via HE staining, and ultrastructural changes were assessed using transmission electron microscopy. Results Compared to the model group, the Coriaria nepalensis oil scraping group significantly reduced serum levels of the inflammatory factors IL-1β, IL-6, and TNF-α, increased the content of the endogenous analgesic substance β-EP, and exhibited the most optimal muscle tissue morphological repair, with all indicators approaching those of the normal group. Specifically, compared to the model group, the Coriaria nepalensisoil scraping group showed significantly lower levels of IL-1β, IL-6, and TNF-α in serum (P<0.0001), and a significantly higher level of β-EP (P<0.0001), and significantly reduced inflammatory infiltration in muscle tissue. HE staining revealed neatly arranged muscle fibers and reduced inflammatory cell infiltration in this group. Transmission electron microscopy showed intact cellular structures, mitochondria and endoplasmic reticulum without significant lesions, and an absence of autophagy or pyroptosis. The therapeutic efficacy of this group was superior to that of the camellia oil scraping group and the simple application group. Conclusion Coriaria nepalensis oil-mediated Miao medicine scraping therapy treats CDT-LMS through the synergistic effects of anti-inflammation, analgesia, and tissue repair. Its superior efficacy may stem from the synergistic interaction between the medicinal medium and mechanical stimulation, providing an experimental basis for the clinical application of this therapy.
Key words： Inflammation; Analgesia; Cold-dampness type lumbar muscle strain; Miao medicine scraping therapy; Histomorphology; Coriaria nepalensis oil
参考文献 References
[1] Ghafouri M, Ghasemi E, Rostami M, et al. The quality of care index for low back pain: a systematic analysis of the global burden of disease study 1990–2017[J]. Archives of Public Health, 2023, 81(1): 167.
[2] 张琪,马信龙,赵娜,等.循经点穴疗法结合易筋经治疗寒湿型腰肌劳损临床疗效观察[J].中国中西医结合外科杂志,2025,31(02):176-181+186.
[3] Chen S, Chen M, Wu X, et al. Global, regional and national burden of low back pain 1990–2019: A systematic analysis of the Global Burden of Disease study 2019[J]. Journal of orthopaedic translation, 2022, 32: 49-58.
[4] 陈婷婷,付本升,丁宇,等.腰肌劳损的中医药治疗研究进展[J].中国疗养医学,2024,33(05):59-62.
[5] 唐东昕, 夏景富. 苗医外治法[M]. 北京: 中国中医药出版社, 2022.
[6] 蒙自己. 马桑狗帮油刮治法治疗寒湿型慢性腰肌劳损临床疗效观察[D]. 贵阳: 贵州中医药大学, 2023.
[7] 张逊. 马桑狗帮及其油剂有效性与安全性实验研究[D]. 贵阳: 贵州中医药大学, 2013.
[8] Zhang Y, Huang Z, Zhou W, et al. Inflammatory cytokines in muscle injury and repair[J]. Front Physiol, 2020, 11:592647.
[9] Miller RE, Miller RJ, Malfait AM. Osteoarthritis joint pain: the cytokine connection[J]. Cytokine, 2020, 130:155047.
[10] 鲁义,刘存志,耿武军,等.DSA引导下鞘内镇痛泵植入结合子午流注开穴法用于肿瘤患者癌痛治疗的专家共识[J].南方医科大学学报,2025,45(08):1800-1808.
[11] Wang Y, Zhuang Y, DiBerto J F, et al. Structures of the entire human opioid receptor family[J]. Cell, 2023, 186(2): 413-427. e17.
[12] 孙秀玲,张靖涵.肾着汤对寒湿性腰腿痛小鼠模型的治疗作用机制研究[J].大医生, 2022,(011):007.
[13] Zhao Z, Li J, Wen J, et al. Effect of Moxibustion on Inflammatory Cytokines for Low Back Pain: A Systematic Review, Meta-Analysis and Meta-Regression[J]. Ther Clin Risk Manag, 2023, 19:811-827.
[14] Lu R, He Z, Zhang W, et al. Oroxin B alleviates osteoarthritis through anti-inflammation and inhibition of PI3K/AKT/mTOR signaling pathway and enhancement of autophagy[J]. Front Endocrinol (Lausanne), 2022, 13:1060721.
[15] 卢春霞, 赵冬, 崔瑾. 马桑狗帮的研究进展[J]. 中国民族民间医药, 2016, 25(16):42-43.
[16] 李章春,宁燕,李珀,等.苗药五香血藤提取物对慢性非细菌性前列腺炎大鼠NF-κB P65、iNOS表达的影响[J].中国老年学杂志,2023,43(05):1193-1196.
[17] Wang X Q , Duan P B ,Zheng M Y, et al. Effect of Scraping Therapy on Chronic Low Back Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials[J]. Journal of manipulative and physiological therapeutics: JMPT, 2021, 44(3):255-270.
[18] 高玉洁.基于改善DRG缺氧微环境研究刮痧治疗神经根炎性痛的效应机制[D]. 南京: 南京中医药大学, 2024.
[19] Westphal M, Li C H. β-Endorphin: demonstration of binding sites in three human neuroblastoma cell lines specific for the COOH-terminal segment of the human hormone[J]. Biochemical and Biophysical Research Communications, 1984, 120(3): 873-878.
[20] 李敏,黎喜平,薛林林.苗医弩药液抹搽联合温针灸治疗寒湿痹阻型慢性腰肌劳损31例疗效观察[J].中国民族民间医药,2025,34(20):111-114.
[21] 雪梅.蒙药增味那如-3罨敷疗法结合针刺疗法治疗慢性腰肌劳损的临床研究[D]. 内蒙古: 内蒙古民族大学, 2025.
[22] Wang S, Zhang J, Yang H, et al. Acupoint specificity on acupuncture regulation of hypothalamic-pituitary-adrenal cortex axis function[J]. BMC Complementary and Alternative Medicine, 2015, 15(1): 87.
[23] 陈玉佩.电针“委中”对大鼠腰多裂肌细胞外基质重塑和卫星细胞增殖的影响[D]. 北京: 北京中医药大学, 2019.
[24] Chinvattanachot G, Rivas D, Duque G. Mechanisms of muscle cells alterations and regeneration decline during aging[J]. Ageing Research Reviews, 2024, 102: 102589.
[25] Dumont N A, Bentzinger C F, Sincennes M C, et al. Satellite cells and skeletal muscle regeneration[J]. Comprehensive Physiology, 2015, 5(3): 1027-1059.
[26] Guilhot C, Catenacci M, Lofaro S, et al. The satellite cell in skeletal muscle: A story of heterogeneity[J]. Current Topics in Developmental Biology, 2024, 158: 15-51.
[27] LANGEN R C J, SCHOLS A M W J, KELDERS M C J M, et al. Inflammatory cytokines inhibit myogenic differentiation through activation of nuclear factor‐κΒ[J]. The FASEB Journal, 2001, 15(7): 1169-1180.
[28] Zheng J, Li B, Yan Y, et al. β-Hydroxy-β-Methylbutyric Acid Promotes Repair of Sheep Myoblast Injury by Inhibiting IL-17/NF-κB Signaling[J]. International Journal of Molecular Sciences, 2022, 24(1): 444.
[29] 陆科闵,王福荣.苗族医学[M]. 贵阳: 贵州科技出版社, 2006.
[30] 韦宏,曾凡健,陆敏仪,等.马桑根的化学成分研究[J].药学学报,1998,(09):49-53.