尾核在针刺镇痛中的作用

<正> 在传统概念中,尾核属于锥体外系,参与机体运动的调节。然而近三十余年来对尾核的研究逐渐深入,从形态、生理、生化和药理等方面提供了不少资料,表明它与行为植物性机能以及感觉机能有关。针刺镇痛原理研究的开展,进一步积累了尾核参与痛觉调制的资料,提出了它在针刺镇痛中的主要作用。本文将作一概述。     

大鼠扣带皮质一氧化氮合酶(NOS)阳性神经元的分布和脑缺血后的变化

采用NADPH－d组织化学方法，观察了NOS阳性神经元在大鼠脑扣带皮质前部24区、32区、25区和后部23区、29区的分布，并夹闭双侧颈总动脉，造成脑缺血2h后，再观察各区NOS阳性神经元的变化。结果为扣带皮质前、后部的5个区均有NOS阳性神经元。其前部的24区NOS阳性神经元较多，后部的23区和29区次之，前部的32区和25区较少。夹闭双侧颈总动脉2h后，再观察的结果为扣带皮质前、后部NOS阳性神经元数量均明显增加（P＜0．01）。     

GABA改变大脑皮层体感Ⅱ区机能状态对丘脑束旁核神经元电针效应的影响

<正> 关于大脑皮层参与疼痛及针刺镇痛过程的研究,近年来国内已有报导。我们也观察到电刺激大脑皮层体感Ⅱ区(SⅡ),可减弱丘脑中央中核(CM)神经元的伤害性反应,电针穴位同样获得CM神经元伤害性反应的抑制效应。我们设想大脑皮层参与疼痛及镇痛过程的机制可能是通过各种信息在皮层内的整合,也可能是通过某些信息影响皮层后产生了下行性作用。虽然,起源于皮层的下行冲动可影响皮层下许多神经元的活动,但对于伤害性传入信息的下行性影响较少研究,尤其是来自大脑皮层体感Ⅱ区     

隔核参与针刺镇痛的传入途径

<正> 隔核包括内侧隔核(sin)、外侧隔核(sl)、斜角带核(td),三角隔核及伞隔核等。sm、sl 及 td 是其主要部分。隔核是边缘前脑的重要结构,含有大量的胆碱能细胞、密集的脑啡肽能神经未梢和细胞体以及丰富的阿片受体,与痛觉机能有密切的关系。电刺激隔区能使动物的痛阈升高以及能提高电刺激牙髓的阈值;刺激隔区对外侧核、束旁核、中缝背核及中脑导水管周围灰质的痛诱发电位有明显的抑制作用。说明隔区参与痛觉的调节。对隔区已有许多形态学研究,但对隔区亚细胞群与脑内某些与疼痛有关区域的联系尚未见专门报道。我们采用 HRP、WGA-HRP 和 CB-HRP 法较详细地观察了与疼痛有关脑区至隔区主要亚细胞群 sm、sl、td 的传入联系。材料和方法实验用成年大鼠133只,选其中定位较准确,较局限的45只作为分析材料。用戊巴     

隔核参与针刺镇痛的传出途径—WGA—HRP和HRP法研究

<正> 随着针刺镇痛原理研究的开展和对隔区研究的不断深入,提示隔核在疼痛调节方面有重要作用。隔核对疼痛的调节与其内部所含递质有关,也可能与脑内某些与疼痛有关脑区的纤维联系有较密切的关系。大鼠隔     

Disinhibitory involvement of the anterior cingulate cortex in the descending antinociceptive effect induced by electroacupuncture stimulation in rats

The present study was conducted to clarify the role of the anterior cingulate cortex (ACCX) in acupuncture analgesia. Experiments were performed on 35 female Wistar albino rats weighing about 300 g. Single unit recordings were made from ACCX neurons with a tungsten microelectrode. Descending ACCX neurons were identified by antidromic activation from electrical shocks applied to the ventral part of the ipsilateral PAG through a concentric needle electrode. Cathodal electroacupuncture stimulation of Ho-Ku (0.1 ms in duration, 45 Hz) for 15 min was done by inserting stainless steel needles bilaterally. An anodal silver-plate electrode (30 mm x 30 mm) was placed on the center of the abdomen. Naloxone (1.0 mg/kg, i.v.) was used to test whether changes of ACCX activities were induced by the endogenous opioid system. Data were collected from a total of 73 ACCX neurons. Forty-seven neurons had descending projection to the PAG, and the other 26 had no projections to the PAG. A majority of descending ACCX neurons were inhibited by electroacupuncture stimulation. By contrast, non-projection ACCX neurons were mainly unaffected by electroacupuncture. Naloxone did not reverse acupuncture effects on the changes of ACCX neuronal activities. Acupuncture stimulation had predominantly inhibitory effects on the activities of descending ACCX neurons. Since the functional connection between ACCX and PAG is inhibitory, electroacupuncture caused disinhibition of PAG neurons, whose activity is closely related to descending antinociception to the spinal cord. This disinhibitory effect elicited by acupuncture stimulation is thought to play a significant role in acupuncture analgesia.     

经皮穴位电刺激诱发的大脑fMRI信号与镇痛的关系

针刺主要是通过激发内源性阿片达到镇痛的目的。不同个体针刺镇痛效果的差异 ,与胆囊收缩素 (ＣＣＫ)等抗阿片物质的个体水平有关 ,那么 ,ＣＣＫ是通过何种通路来影响针刺镇痛的呢 ?我们应用功能性磁共振成像 (ｆＭＲＩ)针对这个问题进行了研究。实验采用两种频率 (2Ｈｚ,1 0 0Ｈｚ)的经皮穴位电刺激 (ＴＥＡＳ)模拟针灸的不同手法 ,其优点是镇痛效果肯定 ,刺激参数可以量化。以前的研究表明 ,不同的脑内神经通路分别介导低频和高频ＴＥＡＳ镇痛 ,中脑、丘脑和下丘脑的某些核团起着关键性的作用。 2 5名健康被试者随机分成两组 ,分别接受高…     

The effect of the septal area in acupuncture analgesia]

This review summarized some articles on the effect of the septal area in acupuncture analgesia. The data showed that the pain threshold of animal was increased when septal area was stimulated by electro-acupuncture, and that electrical stimulation of septal area had a marked inhibitory effect on the pain discharges of cells in parafascicular nucleus of thalamus, lateral habenular nucleus, periaqueductal gray and dorsal raphe nucleus. The septal area play an important role in acupuncture analgesia. The majority of the cholinergic neurons in septal area are located in nucleus of the vertical limb of the diagonal band (VDB); gamma-aminobutyric acid of septal area is mainly found in the diagonal band nucleus(td); Dopamine is present in high levels in td and lateral septal nucleus(S1) of septal area; The S1 contain high densities enkephalin-containing neuronal cell bodies and terminals; In addition, substance P and norepinephrine are also high levels in the septal area. These substance above-mentioned have a relations with acupuncture analgesia of septal area. A large number of serotonin-containing neurons are found in the raphe nuclei. The serotonin play an important role in acupuncture analgesia. The serotonin-containing neurons in dorsal raphe nucleus project to S1. The fiber connections of the raphe nuclei with the td are reciprocation. The periaqueductal gray is a important structure on pain modulation. It projects to septal area and receives the fibers from S1. A number of adrenergic neurons are located within the locus coeruleus. The locus coeruleus participate pain modulation and acupuncture analgesia. The neuro-anatomy study demonstrated that locus coeruleus projects to septal area.(ABSTRACT TRUNCATED AT 250 WORDS)     

GABA改变额叶皮层机能状态对PAG神经元电针效应的影响

<正> 大脑皮层体感Ⅰ区、Ⅱ区、额叶皮层等参与疼痛及针刺镇痛的研究已有不少报导。也有研究表明PAG是电刺激脑、和吗啡、内啡肽、脑内微量注射产生镇痛作用的最有效部位。PAG内阿片受体分布密集,内啡肽含量很高。电刺激大鼠PAG能进一步增强针刺镇痛的效果。损毁大鼠的PAG后,针刺镇痛效应明显降低,因而认为PAG参与针刺镇痛。     

大鼠隔区向缰核的一氧化氮合酶(NOS)阳性神经元的投射

刺激隔区产生的镇痛作用是经缰核而实现的。为了提供依据以解释其机制，采用辣根过氧化物酶（HRP）法与还原型辅酶Ⅱ黄递酶（NADPH-d）相结合方法，对大鼠隔区向缰核的NOS阳性神经元的投射进行了研究。结果表明，缰外侧核接受来自斜角带核垂直支（VDB）腹侧部、斜角带核水平支（HDB）及VDB背侧部的NOS阳性神经元的投射；缰内侧核接受少量来自VDB腹侧部NOS阳性神经元的投射。这种隔区与缰核之间的NOS阳性神经元联系可能是其具有针刺镇痛作用的重要形态学基础之一。     

Positron emission tomography analysis of the analgesic effects of acupuncture in rhesus monkeys

The purpose of this study was to examine whether pain-induced brain activation was suppressed by acupuncture analgesia. We investigated the suppression of the pain-induced neuronal activation in specific brain areas of three male rhesus monkeys (aged four years old) using positron emission tomography (PET), in which changes in the regional cerebral blood flow (rCBF) were examined as an index of the neuronal activation. The brain areas such as the thalamus, insula and anterior cingulate cortex were activated by heating the tail of monkeys in 47 degrees C water compared to the heating at 37 degrees C. Those activations were suppressed by electroacupuncture (EA) with a 2 sec alteration of the frequency of 4 Hz/60 Hz at the right ST36 (the upper anterior tibial muscle) and the right LI4 (the back palm between the first and second metacarpal) acupoints. Meanwhile, this EA analgesic effect was confirmed by prolonging the tail withdrawal latencies from hot water in the temperature range from 45 to 50 degrees C.These brain areas were corresponded to the pain-related areas as reported in previous studies. In conclusion, we were able to visualize the acupuncture analgesia in the CNS. We also detected the brain areas activated or inactivated by acupuncture. The areas that responded to acupuncture stimulation at 47 degrees C water were different from the regions at 37 degrees C. We consider that this difference in the response to acupuncture may support the variation of the clinical efficacy of acupuncture in patients bearing pain or other disorders.     

家兔脑不同部位胆碱能神经介质在电针镇痛时的变化

<正> 在针麻原理研究中,我国工作者分别论述了中枢神经系统不同部位及神经介质在针刺镇痛机制中的作用。部分文献报导了针刺诱导和针刺镇痛对脑分区乙酰胆碱(ACh)含量和胆碱酯酶(ChE)活力的影响。但这方面工作较少,结果也不一致。为了增加对胆碱能神经介质在针刺镇痛机制中作用的了解,我们观察了电针镇痛时家兔尾核、下丘脑、大脑皮层 ACh 含量和乙酰胆碱酯酶(AChE)活力的变化。     

关节炎大鼠腹腔注射阿托品减弱脑刺激及电针的效应

<正> 我们在佐剂诱发的急性关节炎大鼠上研究的结果已经表明,电针穴位和电刺激皮层体感运动Ⅰ区(SmⅠ区)均可明显抑制关节炎鼠丘脑束旁核(Pf)神经元的伤害性反应,用利多卡因局部阻滞SmⅠ区时,电针对Pf神经元伤害性反应的抑制作用削弱,说明皮层SmⅠ区对Pf神经元的伤害性反应     

针刺镇痛过程中大脑皮层作用研究

本文就国内近年来研究大脑皮层在针刺镇痛中作用原理的文献作简要综述。针刺麻醉是在中医经络脏腑理论及针刺疗法的丰富实践,尤其是镇痛实践基础上发展起来的。众所周知针麻手术是在病人清醒状态下完成的。因此,这一课题在理论上和实践上都具有一定的意义。本文从临床和实验室,生理和生物化学等方面总结了针刺对大脑皮层功能活动影响的一些研究成果。结果表明大脑皮层参与针刺镇痛过程,在针刺镇痛过程中起一定的作用。当然,近年来做了一些研究工作,取得一定的成绩,但总的来说是不够的。进一步的研究将会对阐明针刺镇痛原理作出应有的贡献。参考文献约70篇。     

针刺对糖尿病小鼠脑内NOS表达的影响

目的 :本研究探讨一氧化氮 (NO)在糖尿病神经病变发病机制中的作用及针刺的效应。方法 :用腹腔注射链脲佐菌素 (Streptozotocin ,STZ)建立糖尿病动物模型 ,采用免疫组织化学方法观察糖尿病小鼠脑内神经原性一氧化氮合酶 (nNOS)免疫阳性神经元在脑内的分布。结果 :糖尿病可引起小鼠脑内各区 (包括大脑皮层、海马、下丘脑和杏仁核 )nNOS免疫阳性神经元表达增多 ,大脑皮层和杏仁核内的nNOS表达增加有显著性意义 ,在杏仁核和梨状皮质过度区也有大量nNOS阳性神经元分布 ,而针刺能抑制糖尿病引起的nNOS免疫阳性神经元表达的增加 ,这种抑制作用在大脑皮层和杏仁核具有显著性意义。另外在糖尿病小鼠的海马、下丘脑中可见到nNOS阳性神经元 ,也较正常组多 ,针刺右侧“太溪”对nNOS阳性神经元的增加也有一定的抑制作用 ,但均未达显著性意义。结论 :糖尿病可增加脑内nNOS免疫阳性神经元表达 ,针刺可抑制这种nNOS阳性神经元的增加 ,有类似NOS抑制剂的作用 ,可拮抗nNOS的神经毒性     

LONG-TIME REPEATED ACUPUNCTURE STIMULATIONS INDUCE HABITUATION IN SOMATOSENSORY CORTEX

Objective: Many fMRI studies on acupuncture have been reported in recent years, but the mechanism underlying acupuncture therapeutic effects is still under debate since heterogeneous results were reported.Most of the previous studies about brain responses to acupuncture were designed to investigate the instant effects of acupuncture stimulation while the cumulative effect, which is more important, has seldom been investigated.In this study, cumulative effect of acupuncture was analyzed in order to find the possible acupuncture mechanism.Methods: Forty healthy volunteers were recruited to take part in the study in which more than 40 min of repeated acupuncture stimulation was implemented.Three runs of acupuncture fMRI data were acquired and each run consisted of two blocks of acupuncture stimulation.Besides GLM analysis to each block, acupuncture cumulative effects were analyzed with ANCOVA tofind the correlation between the degree of brain response in each stimulation block and the cumulative duration of acupuncture stimulation.Results: The brain response in the first block was the strongest although the brain response to acupuncture was time-variant.The habituated areas and the activated areas in the first block were overlapped in somatosensory areas, including bilateral middle cingulate cortex, bilateral paracentral lobule, right secondary somatosensory cortex and right thalamus.The brain response changes in the course of habituation were bimodal, i.e., positive response was presented at the beginning, and became negative at last.Conclusion: Habituation in somatosensory areas was found to be the features of acupuncture cumulative effect and its characteristic was the bimodal brain response.Considering the important role of somatosensory cortex in pain perception and the other characteristics of habituation, such as the generalization and long-term characteristics, it was suggested that the habituation might play an important role in acupuncture analgesia mechanism.     

针刺三阴交对痛经患者脑葡萄糖代谢的影响

目的：探讨针刺三阴交治疗痛经的中枢作用机制。方法：对6例痛经患者行经疼痛时行右侧三阴交假针刺和针刺，用数字疼痛强度分级法比较刺激前后疼痛情况，并在假针刺和针刺时利用正电子发射断层摄影技术（positron emission tomograph，PET）对痛经患者行埔F—FDG脑功能成像，用SPM软件分析，获得针刺激活的脑解剖功能区。结果：假针刺前后疼痛值差异无显著性意义（P〉0．05），针刺三阴交后疼痛值比针刺前明显降低（P〈0．01）。针刺右侧三阴交引起痛经患者多个与疼痛相关脑区被激活，针刺使同侧豆状核（苍白球、壳）、同侧小脑、同侧岛叶、双侧背侧丘脑、同侧中央旁小叶、双侧杏仁体、对侧中脑黑质、双侧第Ⅱ躯体感觉区、同侧海马回、同侧扣带回前部、对侧下丘脑乳头体葡萄糖代谢增强，大脑皮质小区域葡萄糖代谢降低。结论：针刺三阴交能明显缓解痛经患者疼痛，其机理为针刺三阴交可激活皮质、皮质下边缘系统和小脑与疼痛相关脑区，可能通过平衡与疼痛有关的中枢网络而减轻疼痛，神经内分泌也可能在治疗中起作用。     

大鼠下丘脑室旁核在针刺镇痛中的作用

<正> 多年来,人们对痛觉调制的研究主要集中于阿片类物质,大量的实验资料表明,各级中枢的阿片肽均参与痛觉调制。近来,人们对非阿片类神经肽在痛觉调制方面是否起作用开始感兴趣。精氨酸加压素(AVP)是下丘脑室旁核(PVN)分泌的一种非阿片类的9肽。已有实验表明,中枢或外周给予AVP可     

电针对大鼠皮层SmI区神经元自发放电的影响

为了探讨针刺镇痛中皮层ＳｍＩ区对Ｐｆ神经元的下行调节是否与针刺激活ＳｍＩ区神经元有关,本文观察了电针对大鼠皮层 ＳｍＩ区神经元自发放电的影响。结果发现,电针可引起大鼠皮层ＳｍＩ区神经元的自发放电明显增加（Ｐ＜０．０５）。由此表明,在针刺镇痛中皮层ＳｍＩ区对丘脑Ｐｆ神经元伤害性反应的抑制作用是通过针刺激活皮层神经元而实现的。