<p style="text-align: center;">郑桂芝，李&nbsp; 晗，方臻臻，马&nbsp; 喆，周次利，吴焕淦</p><p style="text-align: center;">（1.上海中医药大学，上海，201203；2.上海中医药大学上海市针灸经络研究所&nbsp; 上海，200030；3.济宁医学院，山东济宁，272067）</p><p style="text-align: justify;"><strong>摘要</strong>：<strong>背景</strong>：围绕体表神经性瞬时电位感受器香草酸亚型 1（Neuronal&nbsp; Transient&nbsp; receptor&nbsp; potential vanilloid 1，nTRPV1）研究温和灸皮肤启动机制和对内脏痛模型的镇痛效果。方法：野生型 C57BL\6小鼠作为主要研究对象。于 8 周龄时予 130ug/ml 硝基苯磺酸灌肠（Three nitrobenzene sulfonic acid，TNBS）诱导慢性内脏痛模型小鼠。12 周龄时，温和灸（Moxibustion，Mox）和假温和灸组（Sham Mox）的小鼠足三里穴区接受温和灸刺激，Mox 的穴区皮肤温度控制在 45±1°C，而 Sham&nbsp; Mox 控制在 37±1°C。借用腹部撤回反射评分（Abdominal withdrawal reflex，AWR）作为疼痛主要观察指标。使用神经纤维素蛋白（Protein&nbsp; gene&nbsp; product&nbsp; 9.5，PGP9.5）和 TRPV1 免疫荧光双标，观察艾灸对于nTRPV1 的影响。同时使用 TRPV1 阻断剂——辣椒平（Capsazepine，CAP）， 分别以高、低剂量阻断体表 TRPV1，观察 Mox 的镇痛和体表 nTRPV1 的表达。另外，又分别使用坐骨神经结扎和树脂毒素（Resiniferatoxin， RTX）阻断皮下 nTRPV1，研究 Mox 的镇痛和体表 nTRPV1 表达。<strong> 结果</strong>：相对于 Sham Mox，Mox 显著改善了内脏痛模型小鼠的 AWR 评分（P&lt;0.05）和促进 nTRPV1 的表达量增加。使用CPZ 阻断后，Mox 未能引起 AWR 的改善，但低剂量的 CPZ 无法抑制 Mox 引起的 nTRPV1 的增多。而使用 nTRPV1 阻断方式后，发现体表的 nTRPV1 显著减少。 Mox 不能有效的发挥镇痛效果，而且不能促进 nTRPV1 的增多。<strong>结论</strong>：温和灸可能通过影响体表 nTRPV1 的方式，对内脏痛模型发挥相应的镇痛效果，阻断 nTRPV1 之后，温和灸镇痛效果消失。</p><p style="text-align: justify;"><strong>关键词</strong>：针灸；温和灸；内脏痛；体表神经性 TRPV1；镇痛；皮肤启动机制</p><p style="text-align: justify;"><strong>Abstract</strong>：<strong>Background</strong>:&nbsp; Depending&nbsp; on&nbsp; the&nbsp; cutaneous&nbsp; neuronal&nbsp; transient&nbsp; receptor&nbsp; potential&nbsp; vanilloid&nbsp; 1(nTRPV1),&nbsp; the&nbsp; aim&nbsp; was&nbsp; to&nbsp; study&nbsp; the&nbsp; relationship&nbsp; between&nbsp; the&nbsp; cutaneous&nbsp; starting&nbsp; mechanism&nbsp; and&nbsp; the<span style="text-align: justify;">analgesia&nbsp; effect&nbsp; of&nbsp; warm&nbsp; moxibustion&nbsp; on&nbsp; visceral&nbsp; pain.&nbsp; Methods:&nbsp; SPF&nbsp; wild&nbsp; type&nbsp; C57BL\6&nbsp; mouse&nbsp; were involved in this study.&nbsp; At the Week 8, the Visceral pain was modeled by 130ug/ml TNBS that was injected into the colon in SPF C57BL/6 wild type mouse. During the Week 12, ST -36 of Mouse in the Mox group and Sham Mox group were received warm moxibustion. The cutaneous temperature&nbsp; was controlled around 45±1°C in the Mox group while 37±1°C in the Sham Mox group. The analgesia effect of moxibustion was assessed&nbsp; by&nbsp; Abdominal&nbsp; withdrawal&nbsp; reflex&nbsp; (AWR).&nbsp; nTRPV1&nbsp; in&nbsp; the&nbsp; cutaneous&nbsp; were&nbsp; observed&nbsp; by immunofluorescence which was marked with protein gene product 9.5 (PGP9.5) and TRPV1. Low and high volume capsazepine (CAP) inhibiting cutaneous TRPV1 activity were involved to observe the changes of analgesia effect and the nTRPV1 expression. Furthermore, sciatic nerve ligation (SNL) and resiniferatoxin (RTX) inhibiting nTRPV1 activity respectively were used to study the differences of analgesia and nTRPV1 expression.&nbsp; </span><strong style="text-align: justify;">Results</strong><span style="text-align: justify;">:&nbsp; Comparing with Sham Mox, Mox significantly reduced the AWR score in the visceral pain mouse (P&lt;0.05), and increased the expressions of nTRPV1. After CPZ involved, the analgesia effect of Mox was inhibited, but low volume CPZ was not able to inhibit the promotion of nTRPV1 by moxibustion. Furthermore both SNI and RTX involved was able to inhibit the analgesia and the nTRPV1 of moxibustion.</span><strong style="text-align: justify;">Conclusion</strong><span style="text-align: justify;">: Warm moxibustion is able to improve the pain level of visceral pain which may be mediated by the&nbsp; cutaneous&nbsp; nTRPV1.&nbsp; After&nbsp; blocked&nbsp; the&nbsp; TRPV1&nbsp; in&nbsp; the&nbsp; skin,&nbsp; the&nbsp; analgesia&nbsp; of&nbsp; warm&nbsp; moxibustion&nbsp; was disappeared.&nbsp;</span></p><p style="text-align: justify;"><strong>Key words</strong>:&nbsp; Acupuncture and Moxibustion,&nbsp; Warm moxibustion;Visceral pain;Cutaneous neuronal TRPV1, Analgesia, The starting mechanism of the skin</p><p style="text-align: justify;"><br/></p>