| Background Acupoints not only reflect the state of the body,but also were used as the site of treatment.The curative effect is often the final evaluation index to determine the effectiveness of acupoints,even giving acupoints "specificity".Compared with the non-acupoint area,in fact,the acupoint just present better effective,even sometimes there is no difference between them.This phenomenon in acupoint research indicates that it is not beneficial to explore the nature of acupoint if we set limit to acupoint location and treatment.The connection between surface and viscera,expressed by acupoints,as well as that between surface and deep soft tissue,is common to animals,not unique to humans.According to the previous study on the convergence-facilitation phenomenon of skin and viscera,we propose that compared with acupoint which is generally "silent" in healthy condition,acupoints are "living"and reflection of diseases.The sensitization acupoints could reveal the characteristics of acupoints and used to exert their therapeutic effect,and be of great significance to explore more biological characteristics of acupoints in depth.The phenomenon of acupoint sensitization includes neurogenic inflammation,which is characterized by enlarged body surface receptive field,pain sensitivity and local skin flush exudation.Previous studies have shown that in visceral diseases,afferent signal impulses from viscera are directly or indirectly reverse transmitted to the nerve endings that control the skin at the same segment through axonal reflex or dorsal root reflex,releasing bioactive substances such as Substance P(SP)Calcitonin gene related peptide(CGRP)to cause plasma exudation.Then,mast cells aggregate and degranulate to release 5-hydroxytryptamine(5-HT)and Histamine(HA)to intensify the release of inflammatory factors,and local "inflammatory soup" is formed in the skin and subcutaneous tissue.Therefore,the active substances in the "inflammatory soup" are the material basis of sensitization.So far,the related research has always focused on the referred pain and local skin change in physical and chemical properties caused by visceral diseases,but there is little research about acupoint sensitization and its mechanism caused by deep soft tissue lesions.In addition,skin microbes are widely inhabited in the stratum corneum and even the dermis.Under physiological circumstances,absolute asepsis does not exist,and it is easy to be ignored that recessive infection can cause inflammatory state without skin lesions.Unfortunately,compared with the extensive attention of researchers to intestinal microorganisms,the current research on skin microorganisms seems to limit to the field of dermatology.In recent years,correlational studies on "brain-gut-skin axis" have reported that intestinal microorganisms can affect the state of skin.On the contrary,skin damage,with changes in the distribution of skin microorganisms,also affect the distribution changes of intestinal microorganisms.Skin resident microorganisms participate in shaping and regulating the fetus skin immune system,both in innate immunity and adaptive immunity,to adapt to external stimuli from the beginning of gestation.At present,no researchers have contacted the skin microorganisms to explore the mechanism of acupoint sensitization.After all,there may be a relationship between the microorganisms,which exist all the time in the process of sensitization,and neuroactive substances.This study focused on the acupoint sensitization caused by deep soft tissue lesions.By comparing the microflora distribution between sensitized and non-sensitized sites,we preliminarily observed the effect of acupoint sensitization on skin microorganisms.Objective To compare the mechanical pain thresholds of the sensitization acupoints and control group points of the patients with soft issue lesions.To observe the distribution characteristics of bacteria at sensitization acupoints in different soft tissue diseases.Methods First of all,a hand-held esthesiometer was used to detect the bilateral mechanical pain threshold of patients with soft tissue lesions.Then,the skin sensitization acupoints and contralateral non-sensitization points of all 41 patients with soft tissue lesions were sampled with aseptic swabs.Comparison was conducted on two sides to observe the bacterial diversity,the distribution characteristics,and the abundance of individual bacterial species at sensitization acupoints,so as to preliminarily explore the different species that may be related to acupoint sensitization.Results 1:Mechanical pain threshold on sensitization acupoints and control group points.Compared with the control group points,the sensitization acupoints pain threshold of 11 patients with soft tissue lesions(8 patients with knee lesions and 3 patients with shoulder lesions)decreased significantly(P<0.05).Result 2:High-throughput sequencing of the bacterial 16SrDNA gene on skin sensitization acupoints and control group points.(1)The number of OTU.Compared with the control group points,the number of OTU at the sensitization acupoints of all 41 patients with soft tissue lesions decreased without statistically significant(P>0.05).(2)Alpha diversity.Compared with the control group points,the Observed_species index,Chao 1 index,Simpson index and Shannon index at the sensitization acupoints of all 41 patients with soft tissue lesions showed a downward trend without statistically significant(P>0.05).(3)Beta diversity.According to ANOSIM analysis between two groups,among all 41 patients with soft tissue lesions,those presents R>0 accounted for 80.49%,but the difference was not statistically significant(P>0.05).(4)Differential bacteria at phylum level.t phylum level,the abundance of Firmicutes increase significantly at the sensitization acupoints of all 41 patients with soft tissue lesions(P<0.05).The abundance of Proteobacteria and Actinobacteria of the sensitization acupoints tended to decrease compared with the control group points,but there was no significant difference between the two sides(P>0.05).There was no significant difference in abundance of Bacteroidetes either(P>0.05).(4)Differential bacteria at genus level.At genus level,the abundance of Staphylococcus at the sensitization acupoints in all 41 patients with soft tissue lesions was significantly higher than that at the control group points(P<0.05),while the abundance of Sphingomonas and Acinetobacter at the sensitization acupoints was significantly lower than that at the control group points(P<0.05).There was no significant difference among other bacteria,such as Enhydrobacter,Propionibacterium,Paracoccus and so on(P>0.05).At genus level,compared with control group points,the abundance of Staphylococcus at the sensitization acupoints of 20 patients with shoulder soft tissue lesions significantly increased,and there was no significant difference between these two sites among the other bacteria(P>0.05).In 8 patients with lumbar soft tissue lesions,the abundance of Acinetobacter,Ralstonia and Micrococcus at the sensitization acupoints was significantly lower than that of the control group points(P<0.05),and there was no significant difference between these two sites among the other bacteria(P>0.05).Conclusion(1)Compared with their own control group points,patients with soft tissue lesions had obvious pain sensitivity at sensitization acupoints;(2)Compared with their own control group points,the distribution uniformity of the number of bacterial species at the sensitization acupoints of patients with soft tissue lesions showed a decreasing trend;(3)Compared with their own control group points,the bacterial composition at the sensitization acupoints of patients with soft tissue lesions was different to some extent;(4)Compared with their own control group points,the abundance of Staphylococcus of Firmicutes increased significantly at the sensitization acupoints,while the abundance of Acinetobacter and Sphingomonas decreased significantly. |
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