Study of Neuropathways of Acupuncture Effect on Functional Regulation and Disease Treatment

目的：探讨针刺信息调整自主神经功能和治疗疾病的神经通路机制，揭示针刺穴位和靶组织、器官效应的相互关系。方法：以大鼠和小鼠为对象，对躯体性针刺或电刺激下的传入神经反应特征、自主神经功能调控的重要机制之一的躯体-交感反射（一种躯体-自主神经反射）、谷氨酸神经递质的中枢性调控作用以及相应靶组织和靶器官反应的研究进行了回顾和分析。结果与结论：手针或电针刺激动物后三里穴位可以诱发支配后三里穴区的传入神经放电，而直接电刺激传入神经可模拟此过程。在外周躯体传入神经如胫神经直接给予电刺激，可在支配内脏的自主神经传出神经如交感神经上反射性诱发一个电位，该过程定义为躯体-交感反射。研究显示中枢神经系统的兴奋性谷氨酸类神经递质参与了该反射的调控。另一方面，研究显示动物后三里等穴位的躯体刺激如电针刺激可抑制小鼠后肢炎症痛的躯体感觉传入和肠易激综合症大鼠的结直肠痛的内脏感觉传入，其中脊髓GABA和NMDA受体被证明分别参与了前后过程。

Study of neuropathways of acupuncture effect on functional regulation and disease treatment

Objective  To reveal the neuropathways of acupuncture effect on regulation of autonomic functions, treatment of diseases and the relationship between treating acupoint and certain target tissue or organ. Methods: it is reviewed for the authors’ studies of characteristics of afferent nerve response, somato-sympathetic reflex (one of the somato-autonomic reflexes) and glutamate derived central modulation, target tissue and organ responses to somatic stimulation of acupuncture or electrical shock in rats and mice. Results and Conclusion  An electrical discharge from the nerve afferent serving Zusanli (ST 36) was recorded by applying manual acupuncture or electroacupuncture to Zusanli (ST 36). Such process could be replaced by applying electric shock directly to the afferent nerve assumingly. Somatic electrical stimulation of the afferent nerve e.g. tibia nerve can reflexively elicit an electrical discharge from autonomic efferent nerve e.g. sympathetic nerve that is defined as somato-sympathetic reflex. The reflex can be modulated by an excitatory neurotransmitter of glutamate in the central pathways. On the other hand, somatic stimulation of Zusanli (ST 36), etc. by electroacupuncture showed that there were inhibitory modulation of somatic sensory input from target tissue of the inflammatory pain in the hind paw of the mouse and visceral sensory input from target organ of the colorectum hyperagesia in the irritable bowel syndrome (IBS) rat. Spinal GABA and NMDA receptors were proved to be involved in the former and latter processes, respectively. Author: LI Wei-min (1959- ), male, professor of Fudan University, assistant director of Shanghai Research Center of Acupuncture and Meridian, mainly engage in the study on autonomic nervous system, neural network and acupuncture analgesia