探讨揉拨法对肌筋膜疼痛综合征（MPS）大鼠的治疗作用及机制。【方法】 从60只大鼠中随机抽取12只作为正常 组，其余大鼠采用钝性打击结合离心运动法构建MPS模型。再将48只造模成功的大鼠随机分为模型组、揉拨法组、揉拨法+ 丹曲林[利若丁受体（RyR）抑制剂]组、揉拨法+生理盐水组，每组12只。采用von-Frey法测定机械性痛阈值；检测软组织张 力、肌电图；透射电镜观察激痛点组织超微结构；比色法检测激痛点组织内钙离子（Ca2+ ）含量；Western Blot法检测激痛点组 织二氢吡啶受体（DHPR）α1、RyR、乙酰胆碱酯酶（AChE）蛋白表达。【结果】 与正常组比较，模型组大鼠机械性痛阈值、激痛 点软组织张力以及激痛点组织DHPRα1、RyR、AChE蛋白表达降低，Ca2+ 含量增加（均P＜0.05），肌电图出现振幅较高的峰 电位、变化明显，激痛点组织超微结构受损；与模型组比较，揉拨法组、揉拨法+生理盐水组大鼠机械性痛阈值、激痛点软 组织张力以及激痛点组织DHPRα1、RyR、AChE蛋白表达升高，Ca2+ 含量减少（均P＜0.05），肌电图恢复平稳，激痛点组织 超微结构损伤减轻；与揉拨法组比较，揉拨法+丹曲林组大鼠机械性痛阈值、激痛点软组织张力以及激痛点组织 DHPRα1、 RyR、AChE蛋白表达降低，Ca2+ 含量增加（均P＜0.05），肌电图出现电活动变化，激痛点组织超微结构损伤加重。【结论】 揉 拨法可能通过激活DHPR/RyR信号通路改善大鼠MPS。

To explore the therapeutic effect and mechanism of pressing and rubbing method on myofascial pain syndrome （MPS） rats. Methods A total of 12 rats were randomly selected from 60 rats as the normal group， and the remaining rats were used to construct the MPS model by blunt strike combined with centrifugal exercise. Then 48 successfully modeled rats were randomly divided into model group， pressing and rubbing method group，pressing and rubbing method + Dantrolene [ryanodine receptor （RyR） inhibitor] group， pressing and rubbing method + normal saline group，with 12 rats in each group. The mechanical pain threshold was measured by von-Frey method. Detection of soft tissue tension，electromyography was performed；the ultrastructure of the pain point tissue was observed by transmission electron microscopy. The content of calcium ion （Ca2+ ） in the tissue of trigger point was detected by colorimetry. The protein expressions of dihydropyridine receptor （DHPR）α1， RyR and acetylcholinesterase （AChE） in the pain points of rats were detected by Western Blot. Results Compared with the normal group， the mechanical pain threshold， soft tissue tension in trigger point and the protein expressions of DHPRα1，RyR and AChE in the model group were decreased and the Ca2+ + content was increased （all P＜0.05）， and the peak potential with higher amplitude was observed in the electromyogram. The ultrastructure of the trigger point tissue was damaged. Compared with the model group， the mechanical pain threshold， soft tissue tension of trigger point and the protein expressions of DHPRα1， RyR and AChE in the trigger point tissue of the rats in the pressing and rubbing method group and the pressing and rubbing method + normal saline group were increased，and the Ca2+ content was decreased （all P＜0.05），the electromyography was restored to be stable， the ultrastructural damage of the trigger point tissue was alleviated. Compared with the pressing and rubbing method group，the mechanical pain threshold，soft tissue tension of trigger point and protein the expressions of DHPRα1，RyR and AChE in the trigger point tissue of the rats in the pressing and rubbing method + Dantrolene group were decreased， and the Ca2+ content was increased （all P＜0.05）， the electromyogram showed electrical activity changes， the ultrastructure of the trigger point tissue was damaged. Conclusion The pressing and rubbing method may improve MPS in rats by activating the DHPR/RyR signaling pathway.

R245.31

武汉市科学技术局2023年度知识创新专项项日（编号：2023020201020557）；湖北省中医药管理局中医药科研项目（编号：ZY2023M026）