这项研究得到了台湾彰化市Chang Bing Show Chwan纪念医院动物中心的资助。作者要感谢台湾IRCAD展春纪念医院在整个研究项目中的宝贵支持和帮助。

2022 年 10 月，台湾彰化市 Chang Bing Show Chwan 纪念医院 （111031） 的机构动物护理和使用委员会 （IACUC） 批准了所有涉及动物受试者的程序（图 1）。
1.动物的准备
<ol><li>购买48只雄性Sprague-Dawley（SD）大鼠（年龄：8-10周，体重：250-300g）。</li>
	<li>在24±2°C和12小时的黑暗和光照循环的通风笼中单独饲养大鼠。</li>
	<li>用无菌饮用水喂养大鼠标?...

改进大鼠模型中的 FSN 治疗：最大限度地减少不适并最大限度地提高效率

本研究观察了FSN治疗对大鼠CCI模型神经性疼痛的影响。本研究提出了一种 SFI 和电生理测试方案，以评估 FSN 或 TENS 治疗后的治疗效果。此外，它还说明了如何使用非侵入性行为测试和生理测量来评估受伤神经的功能恢复。结果显示，CCI诱导的坐骨神经疼痛后FSN治疗在所有预后指标上均明显优于TENS治疗。这项研究在未来以FSN疗法为重点的动物研究中具有巨大的应用潜力，以弥合基础研究和临床应?...

神经性疼痛，定义为由神经损伤引起的疼痛，估计影响世界人口的 6.9%-10%，报告的终生患病率为 49%-70%1,2。它也被认为是最难控制的疼痛综合征之一。使用药物治疗神经性疼痛的成功有限，因为常用的止痛药（如非甾体抗炎药和阿片类药物）在缓解此类疼痛方面几乎没有疗效 3,4。因此，非常需要探索新的治疗方案，尤其是非药物治疗。针灸作为一种非药物干预，通过对体感系统施加镇痛作用，可能减轻神经性疼痛。临床和临床前研究表明，针灸可有效缓解神经性疼痛症状，无明显副作用5,6,7。然而，针灸治疗缓解神经性疼痛的核心机制仍有待进一步研究。
近年来，傅氏皮下针（FSN）在治疗疼痛相关神经系统疾病方面越来越受欢迎8。FSN起源于中国传统针灸，由中医师傅忠华于1996年首次描述9,10。FSN虽然起源于传统针灸，但其技术和理论与经络针灸、阴阳原理和穴位概念有很大不同。FSN 更加重视神经生理学和解剖学方法，以有效解决肌筋膜疼痛11.FSN 疗法在临床实践中用于治疗各种疼痛性肌肉疾病，针对与肌肉密切相关的结缔组织，特别专注于肌肉紧绷 （TM） 的治疗12。作为缓解疼痛的补充疗法，还有临床证据表明，FSN 除了提供快速疼痛管理和显着改善软组织痉挛外，还可有效治疗软组织损伤13,14。FSN 治疗涉及为解决与该病症相关的潜在肌筋膜触发点 （MTrP） 而量身定制的特定技术。FSN针头的插入位置是根据这些触发点的位置精心选择的，可以精确定位受影响的区域。在手术过程中，将FSN针插入皮下层，在那里它被故意停止以优化治疗效果。然后采用一种称为摇摆运动的独特技术，包括针头的轻柔摆动运动以刺激组织并促进治疗反应10。MTrPs的发展与能量危机理论有关，该理论解释说，慢性肌肉超负荷、过度运动、不适当的劳累姿势、肌肉萎缩和退化等因素都会导致肌肉组织缺血和缺氧的发生。肌肉组织内的这种氧气和能量缺乏被认为在 MTrPs 的形成中起着关键作用15,16。先前的动物研究发现，FSN治疗大鼠慢性疼痛在一定程度上改善了TM中线粒体的形态结构和功能，验证了FSN疗法促进受损神经和肌肉恢复的潜力17。
坐骨神经痛被归类为神经性疼痛18。神经性疼痛的起源被认为位于运动终板和肌肉外纤维层之间的任何地方，涉及细胞水平的微血管系统和神经递质。当神经损伤发生时，肌肉神经支配丧失和神经支配神经细胞凋亡发生19，导致患肢出现与疼痛相关的步态。此外，神经的慢性压迫或刺激会导致神经功能方式的各种变化，从而进一步加剧坐骨神经痛的症状20。然而，神经系统的复杂性使其难以在体外复制，因此需要使用动物模型进行此类研究。在神经性疼痛障碍的研究中，通常采用模式生物，涉及各种直接周围神经损伤的方法，例如坐骨神经结扎、横断或压迫21,22。Sprague-Dawley大鼠的慢性收缩损伤（CCI）模型已被用于诱导神经性疼痛。该模型通过手术收缩周围神经来复制人类观察到的神经损伤引起的疼痛，模仿神经压迫综合征和周围神经病变等情况下的压迫或卡压。
在这项研究中，我们评估了FSN疗法和低频电疗法（经皮神经电刺激器，TENS）对慢性收缩损伤和神经性疼痛大鼠的镇痛效果。由于麻醉会减慢或阻断神经冲动并影响突触传递和神经元功能23，因此动物不能在所有针刺程序和摇摆运动下被麻醉。因此，需要适当的针头技术来减少大鼠的不适。详细描述了建立大鼠CCI模型的步骤，用FSN联合无麻醉摇摆运动治疗大鼠的方式，可行的动物行为模式测试和电生理学检查。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Forceps</td>
			<td>World Precision Instruments</td>
			<td>14098</td>
			<td></td>
		</tr>
		<tr>
			<td>Fu&#8217;s subcutaneous needling</td>
			<td>Nanjing Paifu Medical Science and Technology Co.&#160;</td>
			<td></td>
			<td>FSN needles are designed for single use. The FSN needle is made up of three parts: a solid steel needle core (bottom), a soft casing pipe (middle), and a protecting sheath (top).</td>
		</tr>
		<tr>
			<td>Medelec Synergy electromyography</td>
			<td>Oxford Instrument Medical Ltd.</td>
			<td>034W003&#160;</td>
			<td>Electromyogram (EMG) are used to help in the diagnosis and management of disorders such as neuropathies. Contains a portable two-channel electromyography/nerve conduction velocity system.</td>
		</tr>
		<tr>
			<td>Normal saline (0.9%) 20 mL</td>
			<td>Taiwan Biotech Co.,Ltd.</td>
			<td>4711916010323</td>
			<td>Lot: 1TKB2022</td>
		</tr>
		<tr>
			<td>POLYSORB 4-0 VIOLET 30&#34; CV-25</td>
			<td>UNITED STATES SURGICAL, A DIVISION OF TYCO HEALTHC</td>
			<td>GL-181</td>
			<td></td>
		</tr>
		<tr>
			<td>Retractor</td>
			<td>COOPERSURGICAL, INC.(USA)</td>
			<td>3311-8G</td>
			<td></td>
		</tr>
		<tr>
			<td>Rompun</td>
			<td>Elanco Animal Health Korea Co. Ltd.</td>
			<td>27668</td>
			<td></td>
		</tr>
		<tr>
			<td>SCISSORS CVD 90MM</td>
			<td>BBRUAN</td>
			<td>XG-LBB-BC101R</td>
			<td></td>
		</tr>
		<tr>
			<td>Transcutaneous Electrical Nerve Stimulation</td>
			<td>Well-Life Healthcare Co.</td>
			<td>Model Number 2205A</td>
			<td>Digital unit which offers TENS. Supplied complete with patient leads, self-adhesive electrodes, 3 AAA batteries and instructions in a soft carry bag. Interval ON time 1&#8211;30 s. Interval OFF time 1&#8211;30 s.</td>
		</tr>
		<tr>
			<td>Zoletil&#160;</td>
			<td>VIRRBAC</td>
			<td>8V8HA</td>
			<td></td>
		</tr>
	</tbody>
</table>

efficacy of fu's subcutaneous needling on sciatic nerve pain: behavioral and electrophysiological changes in a chronic constriction injury rat model

傅氏皮下针灸（FSN）是一种从中医发明的针灸技术，在世界范围内用于缓解疼痛。然而，作用机制仍未完全了解。在FSN治疗期间，FSN针头入并长时间保留在皮下组织中，并具有摇摆的运动。然而，对于研究人员来说，在动物模型（例如大鼠）中操作 FSN 时保持姿势会带来挑战。不舒服的治疗会导致对FSN针头的恐惧和抵抗，增加受伤的风险，甚至可能影响研究数据。麻醉也可能影响研究结果。因此，需要对动物进行FSN治疗的策略，以尽量减少干预期间的伤害。本研究在 Sprague-Dawley 大鼠中采用慢性收缩损伤模型来诱发神经性疼痛。该模型通过手术收缩周围神经来复制人类观察到的神经损伤引起的疼痛，模仿神经压迫综合征和周围神经病变等情况下的压迫或卡压。我们介绍了一种适当的操作，以便轻松地将FSN针头插入动物身体的皮下层，包括针头的插入和方向，针头的保持和摇摆运动。尽量减少大鼠的不适感，防止大鼠紧张，导致肌肉收缩，阻碍针头进入，提高研究效率。

Neuropathic pain, defined as pain caused by nerve damage, is estimated to affect 6.9%-10% of the world&#39;s population, and the reported lifetime prevalence is 49%-70%1,2. It is also considered to be one of the most difficult pain syndromes to manage. The use of pharmacological agents to manage neuropathic pain has yielded limited success as commonly prescribed pain medications like non-steroidal anti-inflammatory drugs and opioids have shown little efficacy in relieving this type of pain3,4. There is therefore a great need to explore new treatment options, especially non-pharmacological treatments. Acupuncture, as a non-pharmacological intervention, potentially alleviate neuropathic pain by exerting analgesic effects on the somatosensory system. Both clinical and preclinical studies have indicated that acupuncture is effective in relieving neuropathic pain symptoms without significant side effects5,6,7. However, the central mechanism of acupuncture treatment for pain relief in neuropathic pain remains to be further investigated.
In recent years, Fu&#39;s subcutaneous needling (FSN) has gained popularity for treating pain-related neurological disorders8. FSN originated from traditional Chinese acupuncture and was first described by traditional Chinese physician Zhonghua Fu in 19969,10. While originating from traditional acupuncture, FSN differs significantly in its techniques and theories from meridian-based acupuncture, yin and yang principles, and acupuncture point concepts. FSN places greater emphasis on neurophysiological and anatomical approaches to effectively address myofascial pain11. FSN therapy is applied in clinical practice to address various painful muscular disorders, targeting the connective tissues closely associated with the muscles, particularly focusing on the treatment of tightened muscles (TMs)12. As a complementary therapy for pain relief, there is also clinical evidence that FSN is effective in treating soft tissue injuries in addition to providing rapid pain management and significant improvement in soft tissue spasms13,14. FSN therapy involves specific techniques tailored to address the underlying myofascial trigger points (MTrPs) associated with the condition. The FSN needle insertion position is carefully chosen based on the location of these trigger points, allowing precise targeting of affected areas. During the procedure, the FSN needle is inserted into the subcutaneous layer, where it is intentionally stopped to optimize therapeutic effects. A distinctive technique known as the swaying movement is then employed, involving a gentle oscillating motion of the needle to stimulate the tissues and promote the therapeutic responses10. The development of MTrPs is associated with the energy crisis theory, which explains that factors such as chronic muscle overload, excessive exercise, improper exertional postures, muscle atrophy, and degeneration can contribute to the onset of muscle tissue ischemia and hypoxia. This oxygen and energy deficiency within the muscle tissue is believed to play a key role in the formation of MTrPs15,16. Previous animal studies have found that FSN treatment for chronic pain in rats improves the morphological structure and function of mitochondria in TMs to some extent, validating the potential of FSN therapy to promote the recovery of damaged nerves and muscles17.
Sciatica has been classified as neuropathic pain18. The origin of neuropathic pain is thought to lie anywhere between the motor endplate and the outer fibrous layer of the muscle, involving the microvascular system and neurotransmitters at the cellular level. Loss of muscle innervation and apoptosis of innervated nerve cells occurs when nerve damage occurs19, leading to pain-related gait in the affected limb. Additionally, chronic compression or irritation of the nerve can lead to a variety of changes in the way of nerve functions, which can further exacerbate the symptoms of sciatica20. However, the complexity of the nervous system makes it difficult to replicate it in vitro, thus necessitating the use of animal models for such studies. In the investigation of neuropathic pain disorders, model organisms are commonly employed, involving various methods of direct peripheral nerve injury, such as sciatic nerve ligature, transection, or compression21,22. The chronic constriction injury (CCI) model in Sprague-Dawley rats has been used to induce neuropathic pain. This model replicates the pain induced by nerve injury observed in humans through surgical constriction of a peripheral nerve, mimicking the compression or entrapment seen in conditions such as nerve compression syndromes and peripheral neuropathies.
In this study, we evaluated the analgesic effects of FSN therapy and low-frequency electrotherapy (transcutaneous electrical nerve stimulator, TENS) in rats with chronic constriction injury and neuropathic pain. As anesthesia slows or blocks nerve impulses and affects synaptic transmission and neuronal function23, animals cannot be anesthetized under all needling procedures and swaying movements. Therefore, an appropriate needle technique is required to reduce discomfort in rats. The steps for establishing a rat CCI model, the way the rats were treated with FSN combined swaying movement without anesthesia, feasible animal behavioral pattern tests, and electrophysiological investigations are described in detail.

作者聚焦：揭示 FSN 治疗的治疗效果 – 桥接神经性疼痛的研究和临床应用

傅氏皮下针刺治疗坐骨神经疼痛的疗效：慢性缩窄损伤大鼠模型中的行为和电生理变化

SFI的足迹和确定 我们研究了 CCI、CCI+FSN 和 CCI+TENS 组中 SFI 的发展（图 7）。在第 7 天进行 4 次 FSN 和 TENS 治疗后，CCI+FSN 组 （-15.85 ± 3.46） 和 CCI+TENS （-29.58 ± 9.19） 组的 SFI 与单独 CCI 组 （-87.40 ± 14.22） 相比显着改善。与CCI+TENS组相比，CCI+FSN组的改善是显着的（图7A）。
我们还研究了假（0.02 ± 0.52）、单独 FSN（0.06 ?...

Watch this Scientific Journal Video about Efficacy of Fu's Subcutaneous Needling on Sciatic Nerve Pain: Behavioral and Electrophysiological Changes in a Chronic Constriction Injury Rat Model at JoVE.c

我们提出了一种在慢性收缩损伤模型中使用 Fu 皮下针刺诱导大鼠坐骨神经疼痛的方案。

Fu&#39;s subcutaneous needling (FSN), an invented acupuncture technique from traditional Chinese medicine, is used worldwide for pain relief. However, the ...

傅氏皮下针刺治疗坐骨神经疼痛的疗效：慢性缩窄损伤大鼠模型中的行为和电生理变化

Abstract