中脑腹侧被盖区参与低频或高频电针对甩尾实验的镇痛效应

中脑腹侧被盖区 (ｖｅｎｔｒａｌｔｅｇｍｅｎｔａｌａｒｅａ,ＶＴＡ)的ＤＡ能通路在成瘾药物中的奖赏作用已被广泛研究。近年来有报道此通路参与吗啡的镇痛作用。而电针镇痛的机制与吗啡镇痛有相似之处 ,但在电针的镇痛效应中是否有此通路的参与尚无研究。本研究利用电针及核团损毁技术研究了中脑ＶＴＡ的ＤＡ能通路是否参与不同频率 (2Ｈｚ,1 0 0Ｈｚ)电针对甩尾实验的镇痛效应。不同频率电针的ＳＤ大鼠分别随机分为两组 :假损毁组及损毁组。随后通过脑立体定位技术分别进行大鼠双侧ＶＴＡ的假损毁 (注入溶 6 ＯＨＤＡ的溶剂——— 0 .3%…     

针刺镇痛频率特异性的进一步证明

我们以往的工作证明 ,不同频率的电针会引起中枢不同种类的神经肽释放 ,产生不同的生理作用和治疗效果 ,近年来又有一些新的资料进一步证明并扩展了这一假说。1 .2Ｈｚ电针引起中枢内吗啡肽 (ＥＭ)释放 ,1 0 0Ｈｚ无效ＥＭ是近年新发现的一种阿片肽 ,还不清楚何种频率的电针可促进其释放。①将ＥＭ抗体注入大鼠脊髓蛛网膜下腔可阻断 2Ｈｚ电针镇痛 ,而不影响 1 0 0Ｈｚ电针镇痛 (Ｈａｎ ,ｅｔａｌ.ＮｅｕｒｏｓｃＬｅｔｔ,1 999,2 74:75) ;②将ＥＭ抗体或μ受体拮抗剂ＣＴＯＰ注入小鼠脑室 ,阻断 2Ｈｚ电针镇痛而不影响 1 0 0Ｈｚ电针镇痛 (…     

八肽胆囊收缩素对抗电针对大鼠尾核痛反应神经元电活动和甩尾痛阈的同时影响

许多资料表明 ,八肽胆囊收缩素 (ＣＣＫ 8)能对抗阿片物质的镇痛作用。实验用雄性Ｗｉｓｔａｒ大鼠 30只 ,用 2 0 %氨基甲酸乙酯 (1 .0 ｇ/ｋｇ体重 )麻醉下实施常规手术。以辐射热照射大鼠尾部作为伤害性刺激 ,用玻璃微电极引导尾核中痛反应神经元放电。本实验以大鼠尾核中痛兴奋神经元(ＰＥＮ)和痛抑制神经元 (ＰＩＮ)的电变化及甩尾反射潜伏期 (ＴＦＬ)三者为指标 ,研究了脑室注射1 5ｎｇＣＣＫ 8对抗电针对尾核痛反应神经元放电和甩尾痛阈的同时作用。结果 :①辐射热照尾可使大鼠尾核中ＰＥＮ痛诱发放电频率增加、诱发放电潜伏期缩短或…     

针刺对乳腺增生病患者T细胞亚群与性激素关系的影响

应用抗人淋巴细胞单抗ＯＫＴ系列，以ＡＰＡＡＰ法和放射免疫法分别测定了１６例乳腺增生病患者针刺前后的外周血Ｔ细胞亚群和血清性激素（Ｅ２、Ｐ、ＰＲＬ、Ｔ、ＬＨ、ＦＳＨ）。结果显示针刺后的ＣＤ＋８百分率较针刺前明显升高（Ｐ＜０．０５），ＣＤ＋４／ＣＤ＋８较针刺前明显下降（Ｐ＜０．０５）。针刺后血清Ｅ２、ＰＲＬ水平较针刺前下降明显（Ｐ＜０．０５），ＦＳＨ较针刺前明显升高（Ｐ＜０．０５）。Ｅ２对ＣＤ＋８呈负相关，对ＣＤ＋４／ＣＤ＋８呈正相关。提示乳腺增生病患者存在细胞免疫功能的紊乱和性激素的紊乱，针刺后可使这种紊乱得以调节。     

三七总皂甙抗炎和镇痛作用及其机理探讨

本研究通过建立炎症动物模型，应用三七总皂甙（ＴＳＰＮ）、电针（ＥＡ）进行治疗，并用纳洛酮（Ｎｘ）阻断两者作用，用组织化学的方法对ＴＳＰＮ和ＥＡ的效应进行比较。结果可见痛阈（ＰＴ）在ＴＳＰＮ组、ＥＡ组和ＥＡ加ＴＳＰＮ组均显著提高，且硝基蓝四氮唑试验（ＮＢＴ）阳性的多形核白细胞（ＰＭＮ）和醋酸萘酚酯酶（ＡＮＡＥ）的点型亚群计数均明显增加，以上的全部效应均被纳洛酮部分阻断；ＴＳＰＮ组与Ｎｘ组腹腔肥大细胞脱颗粒率无明显差异。由此可见，ＴＳＰＮ与ＥＡ效应相似，具有明显的抗炎镇痛及免疫调整作用。这提示三七总皂甙可能是阿片样肽受体的激动剂而不具有成瘾副作用。     

电针不同经穴对不同性周期雌鼠黑质神经元放电的影响

探讨不同经穴的镇痛作用及针刺镇痛中多巴胺（ＤＡ）与性激素的关系。方法在去卵巢（ＯＶＸ）大鼠和ＯＶＸ加注雌二醇（ＯＶＸ＋Ｅ２）大鼠黑质（ＳＮ）神经元的自发放电和几种刺激的诱发反应之后,分别电针“肾俞”或“三阴交”两穴,以观察电针不同经、穴对上述反应的影响。结果电针“三阴交”后,两组自发放电均趋抑制;而电针“肾俞”后,两组放电均有不同程度激活。结论经、穴对同一ＳＮ单位的不同作用表明经、穴是相对独立存在的,各经、穴分别产生不同的调节机制;针刺在镇痛过程中可能对体内的激素水平、镇痛系统和递质系统产生了复杂的综合调节作用。     

中国药学杂志第九届编辑委员会

名誉主编 (ＣＨＩＥＦＥＤＩＴＯＲＥＭＥＲＩＴＵＳ)　郑筱萸 (ＺＨＥＮＧＸｉａｏ ｙｕ)主编 (ＥＤＩＴＯＲ ＩＮ ＣＨＩＥＦ)　周海钧 (ＺＨＯＵＨａｉ ｊｕｎ)副主编 (ＡＳＳＯＣＩＡＴＥＥＤＩＴＯＲＳ ＩＮ ＣＨＩＥＦ)肖培根 (ＸＩＡＯＰｅｉ ｇｅｎ)陈凯先 (ＣＨＥＮＫａｉ ｘｉａｎ)王晓良 (ＷＡＮＧＸｉａｏ ｌｉａｎｇ)田颂九 (ＴＩＡＮＳｏｎｇ ｊｉｕ)庄林根 (ＺＨＵＡＮＧＬｉｎ ｇｅｎ)李大魁 (ＬＩＤａ ｋｕｉ)张万年 (ＺＨＡＮＧＷａｎ ｎｉａｎ)陈文选 (ＣＨＥＮＷｅｎ ｘｕａｎ)章捷 (ＺＨＡＮＧＪｉｅ) ,(常务副主编 )…     

不同频率电针对大鼠可卡因条件性位置偏爱效应的影响

本文利用条件性位置偏爱方法 (ｃｏｎｄｉｔｉｏｎｅｄｐｌａｃｅｐｒｅｆｅｒｅｎｃｅ,ＣＰＰ )评价电针对可卡因渴求的抑制作用。药物引起的ＣＰＰ是目前公认的药物渴求的动物模型。在本实验中 ,采用“倾向性”程序训练不同剂量可卡因的大鼠ＣＰＰ模型 ,以偏爱分值作为判别大鼠产生ＣＰＰ的指标。ＣＰＰ形成后 ,分别对两组大鼠给予 2Ｈｚ和 1 0 0Ｈｚ电针刺激 ,观察其对ＣＰＰ的影响 ,并对另外四组大鼠分别给予足底电击、插针不给电刺激、单纯放入固定架以及不给任何处理作为不同的对照组。本实验还观察了单次电针刺激对ＣＰＰ抑制作用的…     

丘脑中央下核和腹外侧眶皮层在针刺镇痛和痛觉调制中的整合作用

近年来 ,我们根据以往解剖学和电生理学的研究 ,提出并证明了一个假设 ,即 :丘脑中央下核(Ｓｍ)和腹外侧眶皮层 (ＶＬＯ)在整合伤害性信息的过程中 ,不仅参与痛觉感受 ,也参与痛觉调制。Ｓｍ ＶＬＯ ＰＡＧ构成一个痛觉调制通路 ,通过激活脑干下行抑制系统在脊髓和三叉水平抑制伤害感受性传递。该通路在针刺兴奋细纤维产生的镇痛中起重要作用。研究结果如下 :①电解损毁双侧Ｓｍ易化辐射热诱发的大鼠甩尾 (ＴＦ)反射 ,ＴＦ反射潜伏期 (ＴＦＬ)明显缩短。如果Ｓｍ是一个单纯的痛觉感受中枢 ,损毁它应当得到相反的结果。提示Ｓｍ参与痛觉调制 …     

持续硬膜外镇痛在前列腺摘除术后的应用

前列腺摘除术后常见并发症之一是膀胱痉挛疼痛。我院将持续硬膜外镇痛用于该手术术后患者 ,起到了镇痛和抑制膀胱收缩的双重作用 ,效果满意 ,现报道如下。1　临床资料1 1　一般资料　经膀胱前列腺摘除患者 48例 ,年龄 65～ 84岁 ,ＡＳＡⅠ～Ⅲ级 ,根据患者自愿的原则 ,将使用硬膜外镇痛的 2 8例患者列为Ａ组 ;未使用硬膜外镇痛的 2 0例患者列为Ｂ组。术中采取连续硬膜外麻醉 ,于Ｌ2— 3间隙穿刺 ,头向置管 ;局麻药用 1.6%利多卡因 + 0 .5 %布比卡因混合液。术中常规监测ＥＣＧ ,ＢＰ ,ＨＲ ,Ｓｐ(Ｏ2 )。1 2　方法　Ａ组在手术结束前给予 0 …     

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。     

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.     

THE PROJECTIONS OF NITRIC OXIDE SYNTHASE (NOS) POSITIVE NEURONS TO CINGULATE CORTEX FROM SOME BRAIN AREAS RELATING PAIN IN THE RAT

Somebrainareashaverelationtothepainmodulation,andplayasignificantroleinana1ge-siawhenthesebrainareaswerestimulatedbyelectricity.Theanalgesiceffectproducedbyelectro-stimu1atingbrainareasiscalledthestim-ulation-producedanalgesia(SPA).TheSPAcanrelievechronic…     

杏仁核在针刺镇痛中作用——动物实验报告

<正> 文献记载,杏仁核不仅同下丘脑,中脑网状结构,中央灰质,尾核头部有密切的纤维联系,也与内侧丘脑,后丘脑有一定的纤维联系.关于杏仁核同疼痛的关系,国内外已有一些报导.如:杏仁核含有丰富的内啡胀和吗啡受体,向杏仁核内微量注射吗啡和5-羟色胺可以提高动物的痛阈,抑制动物的攻击性行为,电刺激杏仁核可以提高动物的痛阈.可见,杏仁核同痛反应有一定的关系.为了探讨杏仁核及     

Analgesic effects of different acupoint stimulation frequencies in humans

Transcutaneous electrical acupoint stimulation (TEAS) provides a convenient and standardized technique for pain treatment. The cold-pressor test is a simple and reliable model in humans for the induction of tonic pain. In this controlled study, the effects of TEAS on cold pressor-induced pain were evaluated in 22 healthy human subjects. Electrical stimulation at 4 Hz and 32 Hz was applied to He-Gu (LI 4) and Nui-Guan (P 6) acupoints for 15 minutes. Pain score ratings were evaluated at four time points from 30-170 seconds during the cold-pressor test. We observed an analgesic effect at both 4 Hz and 32 Hz of stimulation, and pain score rating reductions were statistically significant compared to control (p < 0.01). Our data support the efficacy of TEAS analgesia. However, there was no significant difference between pain scores at 4 Hz and 32 Hz stimulation.     

电针镇痛和吗啡镇痛的个体差异性

<正> 针刺镇痛具有较大的个体差异性。不论在针麻临床实践中,在正常人体测痛中,或实验动物中均观察到类似的现象。这种差异的原因是什么?能否用简便的方法加以预测?一直是针刺镇痛原理研究和针麻临床实践中的一个引人注目的课题。近年来镇痛原理研究的大量工作证明,中枢神经系统中存在着内源性的镇痛系统,各种镇痛措施如针刺、吗啡等虽然作用方式和途径     

刺激大脑皮层体感区观察对中缝大核放电的影晌

<正> 近年来,国内外在医学和兽医学临床上,广泛地应用了针刺镇痛.并对针刺镇痛原理也进行了比较广泛地研究,提出针刺镇痛是痛觉传入信息和针刺传入信息在中枢神经系统的不同水平上相互整合作用的     

DISSOCIATION OF THE ACUPUNCTURE EFFECT OF SOMATOSENSORY NEEDLING AND NEEDLING CREDIBILITY ON LOW BACK PAIN PATIENTS USING fMRI

Background: Sham acupuncture as well as real acupuncture, a specific form of needling, is known to reduce low back pain(LBP), but the brain mechanism of placebo effect in sham acupuncture has not been clearly understood.We devised a novel form of sham acupuncture, so called phantom acupuncture which induces needling credibility without somatosensory needling.And we aimed to dissociate the brain correlates with somatosensory needling and needling credibility effect.Methods: Thirty LBP patients were randomized into the real(REAL, n=15) and phantom acupuncture(PHNT, n=15) groups.Sensory threshold and LBP intensity(VAS) were measured before and after the fMRI scanning.During the scanning, two steady state pain sessions were scanned before and after acupuncture stimulation(using low-back extension pain-model) and pain intensity(PAIN) induced by the pain model was collected.In acupuncture session, the REAL group got real acupuncture, while the PHNT group got only the visual stimulation(recorded needling manipulation video) to create needling credibility.Autonomic response of heart rate(HR) and skin conductance(SC), and acupuncture sensation were measured.Results: There was greater SC response, acupuncture sensation, signal increase in sensorimotor network(SMN), periaqueductal grey(PAG) and nucleus accumbense(NAC), and greater signal decrease in default mode network(DMN) in the REAL group.Also increase in vibration detection threshold and decrease in PAIN were observed.The HR decrease and signal increase in salience network(SLN), as well as the decrease in pressure pain threshold and unpleasantness of PAIN were observed both in the REAL and PHNT group.In the PHNT group, decrease in VAS was found.Different correlation between the change in outcome measure and the change in resting state network connectivity was found.Conclusion: Physical information processing and placebo/analgesic brain area were involved in somatosensory needling effect, while cognitive processing was related to the needling credibility effect.     

急性疼痛及电针镇痛评估系统的临床研究

目的研究急性疼痛和电针镇痛时各项生理指标和血清生化指标之间的关系，从而探讨采用生理指标代替生化指标实现即时监测疼痛，调整针刺强度达到最佳针刺镇痛效果的可行性。方法100例患者随机分为疼痛刺激组和针刺镇痛组，疼痛刺激组和针刺镇痛组均分别以10Hz、20Hz、30Hz电刺激模拟不同强度的疼痛，刺激前及每次刺激后即刻记录生理指标并采集外周血检测血清生化指标，针刺镇痛组在模拟疼痛刺激前先采用电针刺足三里穴15min。结果两组在电疼痛刺激前后生理和生化指标都有显著差异，生理指标的变化和生化指标的变化之间存在显著的相关性，并且针刺镇痛组模拟疼痛刺激后的生理和生化指标变化幅度均小于疼痛刺激组。结论生理指标可以代替生化指标即时监测疼痛的程度，据此调节针刺强度，以优化针刺镇痛的效果。