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首页> 美国卫生研究院文献>The Korean Journal of Physiology Pharmacology : Official Journal of the Korean Physiological Society and the Korean Society of Pharmacology >The efficacy of combination treatment of gabapentin and electro-acupuncture on paclitaxel-induced neuropathic pain
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The efficacy of combination treatment of gabapentin and electro-acupuncture on paclitaxel-induced neuropathic pain

机译：加巴喷丁联合电针治疗紫杉醇性神经痛的疗效观察

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Paclitaxel, a chemotherapeutic drug, induces severe peripheral neuropathy. Gabapentin (GBT) is a first line agent used to treat neuropathic pain, and its effect is mediated by spinal noradrenergic and muscarinic cholinergic receptors. Electro-acupuncture (EA) is used for treating various types of pain via its action through spinal opioidergic and noradrenergic receptors. Here, we investigated whether combined treatment of these two agents could exert a synergistic effect on paclitaxel-induced cold and mechanical allodynia, which were assessed by the acetone drop test and von Frey filament assay, respectively. Significant signs of allodynia were observed after four paclitaxel injections (a cumulative dose of 8 mg/kg, i.p.). GBT (3, 30, and 100 mg/kg, i.p.) or EA (ST36, Zusanli) alone produced dose-dependent anti-allodynic effects. The medium and highest doses of GBT (30 and 100 mg/kg) provided a strong analgesic effect, but they induced motor dysfunction in Rota-rod tests. On the contrary, the lowest dose of GBT (3 mg/kg) did not induce motor weakness, but it provided a brief analgesic effect. The combination of the lowest dose of GBT and EA resulted in a greater and longer effect, without inducing motor dysfunction. This effect on mechanical allodynia was blocked by spinal opioidergic (naloxone, 20 μg), or noradrenergic (idazoxan, 10 μg) receptor antagonist, whereas on cold allodynia, only opioidergic receptor antagonist blocked the effect. In conclusion, the combination of the lowest dose of GBT and EA has a robust and enduring analgesic action against paclitaxel-induced neuropathic pain, and it should be considered as an alternative treatment method.
机译：紫杉醇是一种化学治疗药物，可引起严重的周围神经病变。加巴喷丁（GBT）是用于治疗神经性疼痛的一线药物，其作用由脊髓的去甲肾上腺素能和毒蕈碱型胆碱能受体介导。电针（EA）通过其通过脊椎阿片受体和去甲肾上腺素能受体的作用来治疗各种类型的疼痛。在这里，我们调查了这两种药物的联合治疗是否可以对紫杉醇诱发的感性和机械性异常性疼痛产生协同作用，分别通过丙酮滴落试验和冯·弗雷丝测定法评估了协同作用。在四次紫杉醇注射后观察到明显的异常性疼痛症状（累计剂量为8 mg / kg，腹腔注射）。单独使用GBT（3、30和100 mg / kg，腹腔注射）或EA（ST36，Zusanli）可以产生剂量依赖性的抗痛觉过敏作用。 GBT的中等剂量和最高剂量（30和100 mg / kg）具有很强的镇痛作用，但在Rota-rod试验中会诱发运动功能障碍。相反，最低剂量的GBT（3 mg / kg）不会引起运动无力，但提供了短暂的镇痛作用。最低剂量的GBT和EA的组合可产生更大和更长的效果，而不会引起运动功能障碍。对脊髓机械性异常性疼痛的这种作用被脊髓阿片类药物能（纳洛酮，20μg）或去甲肾上腺素能（伊达唑烷，10μg）受体拮抗剂阻断，而在冷性异常性疼痛中，仅阿片类药物受体拮抗剂阻止了该作用。总之，最低剂量的GBT和EA的组合对紫杉醇诱发的神经性疼痛具有强大而持久的镇痛作用，应被视为替代治疗方法。

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