三叉神经系统在颜面部针刺镇痛过程中的作用及其实验形态学的研究

<正> 祖国的医学实践表明,针刺头面部穴位有明显的镇痛效应,且可用于治疗某些疾思。近年来大量的临床资料证明,针刺颜面部穴位既能产生明显的镇痛效应又能抑制内脏牵拉反应;头面部针刺麻醉还能作远隔部位的手术。神经解剖学记载:颜面部痛觉是由三叉神经传入到三叉神经脊束核的。脊束核的尾段内可记录出“痛”细胞放电,这就更加说明三叉神经及其尾侧脊束核与颜面部痛觉有关。

THE EFFECT OF THE TRIGEMINAL SYSTEM IN FACIAL ACUPUNCTURE ANALGESIA AND ITS EXPERIMENTAL MORPHOLOGICAL STUDY

Adult healthy cats, rabbits and mice were used as experimental animals in this study. The effect of the trigeminal system in facial acupuncture analgesia and its morphological basis were studied. It has been worked out on the following aspects: 1. Subcutaneous ionotophoretic potassium was used for inducing pain. The motor reaction of the fore leg of the rabbit was considered to be an index for pain reaction. Following the section of the trigeminal infra- orbital branch, or after the destruction of the trigeminal spinal caudal nu- cleus, it was shown that the analgesia response was obviously decreased or disappeared in facial acupuncture (i.g."SiBai" and "Jiache").It was suggested that the facial acupuncture impulse was transmitted into the trigeminal spinal caudal nucleus by the trigeminal nerve. 2. Following a complete or partial section of the trigeminal roots, stereotactic coagulation of its spinal caudal nucleus of the rabbit, or fo- llowing a lesion of the trigeminal ganglion of the cat, the trigeminal primary afferent fibers and the fiber projections of the trigeminal spinal caudal nucleus were traced by means of Nauta and Fink-Heimer techniques. The results were as follows. The trigemlnal primary afferent fibers projected into the trigeminal sensory nuclei, posterior horn of cervical spinal cord,the reticular forma- tion of the brain stem, solitary nucleus, nucleus raphe magnus, cuneatus nucleus, vestibular nucleus, etc. The trigeminal spinal caudal nucleus gave rising fibers to the thala- mic ventral posteromedial nucleus, intralaminar nucleus (parafasciculo-cen- tromedian nuclear complex), medial geniculate nucleus, the reticular for- mation of the brain stem, some nuclei of the cranial nerves(such as so- litary nucleus, dorsal motor nucleus of the vagus, facial nucleus), the other nuclei unrelated with the cranial nerve(nucleus raphe magnus, cunea- tus and lateral cuneatus nucleus)and the upper cervical spinal segment In addition, after complete transection or partial transection of the spin- al cord ad cervical, thoracic and lumbar levels in young rabbits the secti- ons of the brain stem were stained with the retrograde degeneration meth- od. It was found that the reticulospinal tract took origin from the ventral medullary reticular nucleus, gigantocellular reticular nucleus and nucleus raphe magnus. The trigeminal primary fibers and the trigeminal spinal caudal nucle- us connected with the central nuclei into which the impulses conveying from the somatic and visceral origin were converged. It is preliminarily assumed that the convergence of impulses coming from the facial acupuncture and other sources mentioned above is the neu- rological basis for their interaction. The significant function of the fiber projection connexions of the tri- geminal nerve and of its caudal nucleus is discussed in facial acupuncture analgesia. 3. In the serial sections of the rabbit brain stem stained with thionin and silver impregnation the trigeminal caudal nucleus consists of the ro- stral and caudal part. The latter is divided into the subnucleus marginalis, subnuleus gelatinosus and snbnucleus magnocellularis corresponding to lamina Ⅰ, Ⅱ-Ⅲ and Ⅳ of Rexed, respectively. 4. A piece of tissue of the trigeminal spinal caudal nucleus in the rabbit or mouse was removed under binocular. The thin sections were pre- pared in routine as usual and stained with uranyl acetate and lead citrate. The ultrastrucuures of the synapses in the nucleus were examined. It was found that several types of synapses were present within the nucleus, including axo-dendritic, axo-somatic axo-axonic and dendro-dendritic syna- pses. The translucent vesicles were mostly found in the presynaptic bou- ton, but granular in a few number. It is probable that axo-axonic syapses are the morphological basis for presynaptic inhibition.