目的：观察正清风痛宁注射液穴位注射对大鼠骨质疏松性椎体骨折的影响。方法：用随机数字表将40只雌性SD大鼠编号后随机分为假手术组、模型组、0.5 mg组和2 mg组，采用手术摘除双侧卵巢以建立大鼠骨质疏模型，术后2个月再剪断L3椎体前缘建立大鼠骨质疏松性椎体骨折模型。成模后0.5 mg组和2 mg组分别于L3夹脊穴注射正清风痛宁注射液治疗4周，模型组和假手术组给予等体积生理盐。采用机械触诱发痛和自发痛观察疼痛行为学改变。采用酶联免疫吸附（ELISA）法检测脑脊液八肽胆囊收缩素（CCK-8）、6-酮-前列腺素E1α（6-keto-PGE1α）、一氧化氮（NO）及神经元型一氧化氮合酶(nNOS)含量。采用骨定量超声诊断技术检测骨折腰椎骨定量振幅衰减（BUA）及骨密度（BMD）。结果：与模型组比，2 mg组抬腿次数和抬腿持续时间降低，大鼠4周后足缩足阈值均值明显提高，1、2、3、4周机械缩足阈值（MWT）逐步提高，且脑脊液中nNos、NO、CCK-8 和6-keto-PGE1α明显低于模型组（P＜0.05）；骨定量超声显示BUA 及BMD 均明显高于模型组（P＜0.05）。结论：正清风痛宁穴位注射可增加骨质疏松性椎体骨折大鼠下丘脑nNOS分泌、抑制6-keto-PGE1α和NO合成、降低CCK-8和6-keto-PGE1α而产生中枢镇痛作用，并可促进大鼠骨质疏松性椎体骨折愈合。

This study was aimed to observe the effect of acupoint injection of Zheng-Qing Feng-Tong-Ning (ZQFTN) injection on osteoporotic vertebral fracture rats. A random number table was used to divide 40 female SD rats into the sham operation group, model group, 0.5 mg group and 2 mg group. Osteoporotic vertebral fracture rat model was established by the surgical removal of bilateral ovaries. Two-month after the operation, the anterior edge of L3 vertebral body was cut to establish the osteoporotic vertebral fracture rat model. After molding, the 0.5 mg group and the 2 mg group were injected with ZQFTN injection at the L3 Jiaji acupoint for 4 weeks. The same volume of physiological salt was given to rats in both the model group and the sham operation group. Changes on pain behavior were observed using mechanical allodynia and spontaneous pain. Enzyme- linked immunosorbent assay (ELISA) was used to detect cholecystokinin octapeptide (CCK- 8) in cerebrospinal fluid (CSF), 6- keto- prostaglandin E1 alpha (6- keto- PGE1 alpha), nitric oxide (NO) and neuronal nitric oxide synthase (nNOS) content. Lumbar bone quantitative attenuation (BUA) and bone mineral density (BMD) were detected with quantitative ultrasound bone fracture diagnosis technique. The results showed that compared with the model group, the number of leg lift and the leg lift duration were decreased in the 2 mg group. After 4- week intervention, the mean foot withdrawal threshold significantly increased, the mechanical withdrawal threshold (MWT) of 1, 2, 3, 4 weeks gradually increased, nNos, NO, CCK-8 in CSF and 6-keto-PGE1 alpha was significantly lower than that of the model group (P < 0.05); the bone quantitative ultrasound showed that BUA and BMD were significantly higher than those of the model group (P < 0.05). It was concluded that ZQFTN injection can increase the nNOS secretion of hypothalamus, inhibit the synthesis of 6-keto-PGE1 alpha and NO, reduce CCK-8 and 6-keto-PGE1 alpha, promote the central analgesic effect in osteoporotic vertebral fracture rats, and promote the healing of osteoporotic vertebral fractures in rats.

湖北省卫生厅自然科学基金指导性项目（2016CFC602）：基金线粒体凋亡信号转导通路探讨内热针治疗膝关节炎的机制研究，负责人：万超。