| Summary: | 碩士 === 中國醫藥大學 === 物理治療學系復健科學碩士班 === 101 === Background and Purpose: The remote effectiveness of dry needling therapy for pain control of myofascial trigger points (MTrPs) has been demonstrated in many clinical studies. The alterations of serotonin (5-HT), β-endorphin (β-ep) enkephalin (Enk), and substance P (SP) are probably involved in analgesia and pain. However, little is known about the alterations of these biochemicals of nociception and antinociception affected by the dry needling at MTrPs on proximal skeletal muscles and spinal circuits after remote dry needling. The study aimed to elucidate the biochemical mechanism underlying remote effects by dry needling at rabbit skeletal muscle myofascial trigger spots (MTrSs, similar to human MTrPs) by immunoassays for β-ep, Enk, SP and 5-HT. Methods: New Zealand rabbits (2.5-3.0kg) received dry needling or sham-needling treatment at MTrSs of an unilateral gastrocnemius muscle (distal muscle) with 3 minutes for one session (1D) or five daily sessions (5D). Bilateral biceps femoris muscles (proximal muscle), dorsal root ganglion (DRG) of L2-L5 and spinal cords were sampled immediately and 5 days after dry needling. Immunoassays was performed to determine the levels of β-ep and SP in proximal muscles and DRG, Enk, SP and 5-HT in dorsal horns and serum β-ep level. Results: The β-ep levels in the bilateral muscles and DRGs were significant increased immediately after 5D. The serum β-ep levels significantly increased after 1D and 5D. The SP levels in ipsilateral muscles were significantly decreased except at 5 days after 1D. The expression of SP-like immunoreactivity in bilateral dorsal horns has similar findings with those in muscles and DRG. The increased Enk-like immunoreactivity was also found in bilateral dorsal horns immediately after 5D, but 5-HT immunoreactivity was decreased. Conclusion: Dry needling at distal MTrPs muscle might modulate β-ep and SP levels in proximal muscle and DRG, and Enk, 5-HT and SP levels in dorsal horns. Clinical Relevance: It can provide the evidence basis for developing therapeutic strategies in myofascial pain treatment.
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