Further study of the neurohumoral factor, endorphin, in the mechanism of acupuncture analgesia.

Cross circulation was performed between the femoral arteries and veins of paired rabbits that were entirely conscious. Jaw opening reflex by dental pulp stimulation was used as pain index. When acupuncture was applied to the donor rabbit the pain thresholds of both the donor and recipient were elevated from 30 minutes to one hour after acupuncture stimulation and lasted for another 30 minutes after withdrawal of acupuncture. The analgesic effect in both the donor and recipient was abolished by the pretreatment of naloxone. The increase in the pain threshold of the non-acupunctured recipient was due to an opiate-like, humoral substance generated from the acupuncture donor. The possible role of endorphins in the mechanism of acupuncture analgesia is discussed.     

激活GABA_B受体在针刺镇痛中的作用

目的 :脑室注射γ 氨基丁酸 (GABA)A受体的拮抗剂荷包牡丹碱 (Bic)未能阻断针刺镇痛效应 ,微电泳导入Bic部分阻断电针抑制脊髓背角伤害性反应 ,说明GABA可通过激活A受体参与针刺镇痛中脊髓节段性抑制。本文进一步探讨了激活GABAB 受体在针刺镇痛中的作用。方法 :以辐射热照射大鼠尾部引起甩尾反射潜伏期作为痛阈的指标 ,以针刺“次”穴后痛阈最大变化百分率判断镇痛效应 ,观察脑室注射 (icv) 5μL或蛛网膜下腔 (ith)注射 1 0 μLGABAB 受体的拮抗剂CGP 55845对针刺镇痛效应的影响。每组 6～ 8例。结果 :icvGABA( 1 2 5μg、2 50 μg、50 0 μg)或GABAB 受体激动剂苯氯丁氨酸 (Baclofen ,2 5ng、2 50ng、2 50 0ng)可产生剂量依赖的镇痛效应。icvCGP 55845( 5ng、50ng)可大部分阻断GABA和Baclofen的镇痛效应。针刺双侧“次”穴( 50Hz,1～ 2mA) 1 0min ,痛阈提高到针前值的 ( 1 42 .5± 2 .1 ) % ,镇痛效应显著。针前icvCGP55845针后痛阈分别提高到 ( 1 1 1 .2± 1 .2 ) %和 ( 1 1 2 .1± 1 .1 ) % ,阻断率分别为 73 .7%和 71 .6% ,和事先icv生理盐水 ( 1 43 .7± 2 .0 ) %相比 ,阻断效应明显。若针刺前ithCGP 55845( 50ng、50 0ng) ,也能明显阻断针刺镇痛效应。结论 :脑内注射GABA或Baclofen可通过激?     

针刺麻醉在直肠癌手术中的作用

目的:观察针刺麻醉的镇痛效能.方法:69例直肠癌手术患者随机分为Ⅰ组、Ⅱ组和Ⅲ组各23例.针刺麻醉取穴均为足三里、三阴交.Ⅰ组针刺诱导后全麻,Ⅱ组全麻后针刺,Ⅲ组单纯全麻.记录术中最低肺泡内有效浓度(MAC).结果:Ⅰ组MAC平均为(1.35±0.19)Vol%,Ⅱ组为(1.49±0.22)Vol%,Ⅲ组为(1.64±0.27)Vol%,全麻诱导前或全麻诱导后针刺均有降低全麻下行直肠癌手术患者所需MAC约0.29%、0.15%.3组相比较差异有非常显著性或显著性意义(P＜0.01或P＜0.05).结论:针刺麻醉具有一定的麻醉镇痛辅助作用,且以全麻前加强针刺诱导效能较佳.     

纳洛酮对不同强度电针所致镇痛效应的作用

<正> 脑内阿片受体及内啡肽系统的发现,对针刺镇痛原理研究提供了新的线索,关于针刺所致各种效应,特别是镇痛效应和阿片受体及其递质系统有何关系的问题,引起人们广泛的兴趣。Mayer 和上海市人体针刺镇痛实验协作组分别在人体用吗啡拮抗剂—纳洛酮阻断了针刺镇痛效应。然而动物实验的结果却存在分歧,Pomerang 报导纳洛酮能明显拮抗小鼠的电针镇痛作用;上     

电针对大白鼠杏仁核青霉素痫样放电的抑制作用

<正> 癫痫是危害人民健康的常见病,其发病机理复杂。针灸治疗癲痫历史悠久,至今仍在临床广泛应用,表明针灸治疗癫痫有一定疗效。近年虽有一些用针灸治疗癫痫机制研     

针刺复合麻醉在经阴道取卵术中的应用

目的:观察针刺复合麻醉在经阴道超声引导下取卵术中的镇痛效果和安全性.方法:将316例接受体外受精和胚胎移植的不孕症患者随机分为针刺复合麻醉组(n=146)和单纯度冷丁组(n=170),术前30 min 2组分别接受电针复合肌肉注射度冷丁和单纯肌肉注射度冷丁镇痛.结果:针刺复合麻醉组在疼痛等级和疼痛积分方面明显优于单纯度冷丁组(P<0.01);术后1 h和术后2-5 h腹痛发生率低于单纯度冷丁组(P<0.01).结论:在经阴道超声引导下的取卵术中,针刺复合麻醉具有安全、高效、术后恢复快、不良反应小的优点,是一种可供选择的麻醉镇痛方法.     

阿片系统在针刺镇痛外周机制中的作用

以往工作已证明内阿片系统参与关节炎大鼠针刺镇痛的中枢机制,本文拟进一步探讨其在外周镇痛中的作用。在右侧外踝注射弗氏佐剂形成急性关节炎的大鼠,电针双侧环跳穴10分钟,患侧痛阈提高明显优于健侧。全身注射纳络酮(250μg)可完全阻断针刺镇痛效应并出现更明显的痛觉过敏,局部注射20μg 纳络酮就可阻断针刺镇痛效应。全身注射吗啡可引起剂效相关的镇痛效应,且患侧镇痛效应明显优于健侧。以上结果说明内源性阿片系统也参与针刺镇痛的外周机制。针刺可能促使炎症区释放内阿片肽,作用在被炎症致敏的阿片受体,导致炎症区产生更强的针刺镇痛效应。     

针刺麻醉在鼻部手术中的运用及探讨

从鼻腔手术的不同麻醉方式的运用特点、针刺麻醉选穴原则、电针频率及术中评价等方面论述。针刺复合局部麻醉既可以防止局麻的镇痛不全,又可以避免全麻的不良反应,同时可减少麻醉药用量,体现了针刺麻醉自身的独特优势。目前初步认为取迎香及印堂,频率为30Hz,波型为连续波,用于鼻部手术可取得较满意效果。但目前针刺麻醉运用于鼻内镜手术的临床报道不多,且缺乏操作规范,希望优化针刺麻醉鼻腔手术的操作流程,促进针刺麻醉鼻腔手术的临床推广与应用。     

红核的镇痛作用和加强电针镇痛的作用

<正> 红核属锥体外系,其主要机能是调节躯体运动和肌紧张。但近年来的工作指出它与感觉的调制也有关。如电刺激红核可抑制大鼠的伤害性行为反应。刺激红核可兴奋中缝大核(NRM)神经元的电活动,而刺激NRM可加强电针在三叉神经脊束核尾侧     

Changes in adrenocorticotropic hormone (ACTH) and cortisol levels in drug addicts treated by a new and rapid detoxification procedure using acupuncture and naloxone.

Plasma ACTH, cortisol, and cyclic-AMP levels of eleven heroin addicts were dertermined before and after treatment with a fast detoxification procedure using acupuncture and electrical stimulation (AES) together with the administration of limited doses of naloxone. At the end of the treatment period, the average plasma ACTH, cortisol, and cyclic-AMP level rose 130,83, and 24 percent, respectively. In view of the appearance of mild withdrawal signs during this method of treatment, the observed increases in ACTH and cortisol levels probably reflect the inability of AES to suppress withdrawal symptoms induced by naloxone completely. The mechanism underlying this new method of treatment is discussed in relation to AES's ability to stimulate the secretion of endorphins.     

脑内GABA参与针刺镇痛吗?

我们曾观察到微电泳导入γ 氨基丁酸 (ＧＡＢＡ)抑制脊髓背角神经元伤害性反应 ,导入荷包牡丹碱 (Ｂｉｃｕｃｕｌｌｉｎｅ,Ｂｉｃ)明显阻断导入ＧＡＢＡ和电针穴位抑制脊髓背角的伤害性反应 ,说明ＧＡＢＡ参与针刺镇痛中的脊髓节段性抑制 ,后又证明ＧＡＢＡ参与针刺镇痛中的突触前、突触后抑制。但也有不少报道说明脑内ＧＡＢＡ含量增加拮抗针刺镇痛效应。本文进一步在大鼠比较观察了脑室注射 (ｉｃｖ)和蛛网膜下腔注射 (ｉｔｈ)Ｂｉｃ对针刺镇痛效应的影响。以辐射热照射尾部引起甩尾反射潜伏期作为痛阈的指标 ,以脑室注射 5μＬ、蛛网膜下…     

针刺复合麻醉下胃大部切除术的临床观察

<正> 大量的临床及实验室研究已充分证明,针刺麻醉虽然具有一定的镇痛效应,但仍镇痛不全,为提高针麻的镇痛效果,克服镇痛不全的缺点,我们除术前用综合予测的方法选择适宜针麻的个体外,还应用一些药物麻醉方法来配合针刺麻醉.针麻的镇痛不全可由少量的麻醉药物补足,同时针麻本身的镇痛效应又可减少麻醉药物的用量,因而相应地减少了麻醉药物所引起的生理机能紊乱.我们自1978年起选择针麻效果尚不稳够定的胃大部初除应用针刺复合麻醉方法(下称针麻复合方法)进行临床观察,初步报告如下.     

针刺内麻点超前镇痛在四肢骨科手术中的应用

超前镇痛就是在病人没感觉疼痛之前所使用的镇痛方法。我们将针刺内麻点用于骨科手术后疼痛的超前镇痛 ,效果良好。6 0例择期四肢骨科手术患者 ,随机分为两组 ,针刺镇痛组和对照组。两组年龄、手术时间基本相同 ,均在常规药物麻醉下施行手术。针刺镇痛组在麻醉前取双侧内麻点针刺 ,通电刺激 30ｍｉｎ后拔针行常规药物麻醉 ,两组麻醉方法、使用药物基本相同。术后用盲法观察疼痛情况 ,参考ＷＨＯ术后疼痛评级标准 ,将术后疼痛分为四级。认真观察记录术后 2 4ｈｒ疼痛性质、生命指征、表情变化、镇痛药用量、用法等情况 ,结合病人术后 2 4ｈｒ…     

Randomised double-blind trial on the immediate effects of naloxone on classical Chinese acupuncture therapy for chronic pain

The present study was designed to test the hypothesis that acupuncture therapy and acupuncture analgesia are both endorphin mediated. Thirty consecutive patients, all with pain at the time of treatment, were chosen. Classical acupuncture was used on seventeen patients; ear acupuncture was combined with classical Chinese acupuncture on eight patients, and ear acupuncture alone was used in five cases. No electrical stimulation of any sort was used. Pain was assessed by the patients on a visual scale of 0 to 100 before and after acupuncture therapy. Immediately following the post-acupuncture pain assessment, the patient was injected intravenously with a 1 ml. injection of 400 micrograms of Naloxone or a 1 ml. injection of 0.9% Sodium Chloride on a randomised double-blind basis. The effect on pain relief was noted immediately and after thirty minutes. No significant change in pain relief already obtained was noted after Naloxone in any patient. This does not support the hypothesis that acupuncture therapy is mediated by endorphin.     

腹部针麻手术穴位选择和药物配伍研究进展

针刺麻醉创始于上世纪50年代末，在头颈部外科有较好的镇痛效果。目前针麻下颅窝手术、颈椎前路手术、甲状腺手术、拔牙术等已通过部级科研成果鉴定，进入常规麻醉手术行列。但在腹部外科仍存在镇痛不全、肌紧张、脏器牵拉反应等缺陷。制约了针刺麻醉的应用与推广。本文综述了近年针麻穴位选择与药物配伍方面的研究进展，以期为提高麻醉效果提供参考。     

针刺对心脏手术病人功能调节的观察

目的　为观察针刺对体外循环心脏手术病人的机体调节作用。方法　４０ 例房间隔缺损修补术病人随机分为针麻组（ｎ＝ １２），针刺加全麻组（ｎ＝ １２），和全麻组（ｎ＝ １６）。观察术中平均动脉压（ Ｍ Ａ Ｐ）、脉率氧饱和度（ Ｓｐ Ｏ２ ），术中、术后血管活性药物用量及术后并发症发生率。结果　术毕全麻组 Ｍ Ａ Ｐ明显低于针麻组和针刺加全麻组（ Ｐ＜ ０．０５）， Ｓｐ Ｏ２ 、 Ｈ Ｒ 各组间无统计学差异。针麻组、针刺加全麻组术中心脏自动复跳率明显高于全麻组，全麻组血管活性药物用量、术后循环、神经系统并发症明显高于针麻组和针刺加全麻组。结论　针刺有增强心脏手术病人机体功能的调节作用     

Effects of promethazine on acupuncture analgesia

Promethazine, one of histaminergic H1-receptor antagonist, was often used as an adjuvant drug prior to and during acupuncture anesthesia in clinics, However, its effects was not known clearly. By using potassium iontophoretic dolorimetry and stimulating unilateral "Hegu" and "Waiguan" points with electroacupuncture (EA) in 42 rabbits, we found that Promethazine could drop the pain threshold in small dosages (0.5 mg/kg, 1 mg/kg) and raise the pain threshold in relatively large dosages (2 mg/kg, 4 mg/kg). In different dosages (1 mg/kg, 2 mg/kg), promethazine could attenuate the analgesic effect of EA. It was suggested that promethazine should be used carefully in acupuncture anaesthesia.     

Analgesic effects of acupuncture on pain after mandibular wisdom tooth extraction

We evaluated the analgesic effects of acupuncture on postoperative pain by comparing patients who underwent routine tooth extraction alone (control group) and those who underwent tooth extraction in combination with acupuncture (experimental group) by the random allocation method. As teeth easy to extract. requiring no gingival incision (grade A) or those difficult to extract, requiring gingival incision or bone cutting (grade B). As local anesthesia, 1.8 ml or 3.6 ml of 2% xylocaine was used. The LI.4, Hegu on both sides and ST.7, Xiaguan and ST.6, Jiache on the affected side were selected. Low frequency electrical acupuncture was performed. When acupuncture was used in combination with tooth extraction, 3 of 22 patients did not develop postoperative pain. In patients with wisdom teeth difficult to extract (grade B), acupuncture used in combination with local anesthesia decreased postoperative pain.     

A controlled trial on acupuncture for chronic neck pain

To evaluate the efficacy of Chinese medicine (CM) acupuncture for chronic neck pain (CNP), a single blind, controlled, crossover, clinical trial was undertaken. Twenty-nine volunteers with CNP were randomly recruited into two groups. Both groups received two phases of treatment with a washout period between the two phases. Group A (14 volunteers) received CM acupuncture in the first phase and sham acupuncture in the second, while Group B (15 volunteers) received sham in the first and real in the second. CM acupuncture was individualized and consisted of nine sessions on both local and distal points. Manual twisting of the needle was applied on all points plus strong electrical stimulation of distal points in CM acupuncture. Sham acupoints (lateral to the real) and sham (weak) electrical stimulation was used in the control group. Comparison of subjective and objective measures between the two groups was made at different periods, including baseline, after each phase of treatment, after washout, and after the 16th week follow-up. The subjective measures included pain intensity, duration per day, analgesic medication count, visual analogue scales (VAS) and neck disability index (NDI). The objective measures consisted of neck range of motion (ROM) and pain threshold (PT). Both the real and sham treatments significantly reduced subjective pain, without significant differences between groups for most subjective measures. Objective measures showed no significant change for either group before and after each period or by inter-groups analysis. A minimum 16-week effect of both real and sham acupuncture was found for subjective measures in the follow-up periods. Further study is recommended with an increased sample size, a longer washout period, and a longer baseline period.     

针刺镇痛中大鼠经穴皮肤与血浆P物质含量的变化

<正> 业已证明:P物质(SP)系初级伤害性传入纤维末梢所释放,与皮肤痛觉的传导有关,参与痛觉调制。曾有报导指出:人穴位区皮肤的肥大细胞明显多于非六区,并见人、小鼠穴区皮肤内肥大细胞与神经轴突形成联接,且肥大细胞中含SP颗粒,针刺后肥大细胞脱颗粒。那么,经六皮