神经末梢给药吸收途径及其效应特点  

Absorption pathway and effect characteristics of nerve ending administration

作　　者：周震球[1] 曾因明[2] 章云海[1] 李小民[1] 李爱民[1] 赵琳[1] 赵志斌[1] 周慎婷[3] 周洁[2] 徐韵 

机构地区：[1]徐州医学院附属连云港医院,江苏省连云港市222002 [2]徐州医学院江苏省麻醉学重点实验室,江苏省徐州市221004 [3]哈尔滨医科大学2000级临床医学系,黑龙江省哈尔滨市150086 [4]张家港市人民医院呼吸科,江苏省苏州市215600

出　　处：《中国临床康复》2006年第34期145-147,共3页Chinese Journal of Clinical Rehabilitation

基　　金：国家自然科学基金资助项目(30271260);江苏省科技厅指导计划课题(BS2002305);江苏省高校省级重点实验室第三批对外开放课题(K2093)~~

摘　　要：目的:临床上给药均依托血液、淋巴系统吸收、转运、分布到全身靶组织。本文探讨神经末梢吸收药物途径及其临床应用价值。资料来源:应用计算机检索万方数据库1990-01/2005-12期间的有关皮内、穴位注射、贴敷的文献,检索词“神经末梢、吸收、皮内、穴位、注射、贴敷”,限定文章语言种类为中文。并手工查阅相关书籍。资料选择:对资料进行初审,删除明显不随机临床试验,然后查找余下的文章全文,进一步判断是否为随机对照实验。纳入标准:①随机对照实验,无论是否为单盲、双盲、或非盲法。②平行对照组,为未采用经皮内、穴位注射或敷贴者。治疗组为经皮内、穴位注射或敷贴者。排除标准:明显不随机的临床实验。质量评价主要考察治疗的真实性,调查设计是否严密,实施过程是否严格,统计学处理是否合理。资料提炼:共检索20篇关于研究神经末梢吸收和皮内、穴位注射、贴敷的随机对照试验,11篇符合纳入标准。排除的9篇均是重复的同一研究。资料综合:无论是传入神经还是传出神经,在其末梢部位都存在着一定选择性的吸收功能。当药物被分布到神经末梢部位后,特别是皮内、穴位、黏膜和某些部位的肌肉等神经末梢密集区,可被神经末梢吸收到神经细胞内,并随轴浆远程转运到脊神经节、交感神经节、脊髓前角的胞体及其轴突、树突,进而到达相应的中枢神经部位及所联系的组织、器官,在局部形成较高药物浓度发挥药物作用。对一些小分子亲水性药物,还有可能通过神经细胞的缝隙连接实现跨细胞转运,从而发挥更广泛的作用。结论:在特定区域的皮内及穴位等神经末梢丰富的部位给药,可通过“神经末梢吸收一轴浆转运一缝隙连接传递一靶组织、靶器官效应”发挥作用。由于该途径给药可在对应的靶组织、靶器官局部形成较高浓度,故�OBJECTIVE： The clinical practice is mainly by means of blood and lymphatic system to absorb, transport and distribute the administration to the target tissues of the whole body. This paper aims to explore the absorption pathway and clinical application value of administration via nerve ending. DATA SOURCES： An online search of Wanfang database from January 1990 to December 2005 was conducted to identify the literatures about intradermal and acupoints injections as well as paste by inputting Chinese key words of ＂nerve ending, absorption, intradermal acupoints, injection, paste＂. Meanwhile the related books were retrieved manually. STUDY SELECTION： After the primary check, the obviously nonrandom clinical trials were excluded, and the residual articles were searched for full-texts to judge whether in accordance with random controlled experiment. Inclusive criteria：①random controlled experiment, no matter singleblind, double-blind or non-blind method; ②Treatment group adopted the cases by means of intradermal and acupoint injections or paste, while parallel control group adopted those without approaches of intradermal and acupoint injections or paste. Exclusive criteria： obvious nonrandom clinical trials. Quality evaluation consisted of the validity of the treatment, exactness of investigation＇s design, severity of practice progress and reasonability of statistical management. DATA EXTRACTION： A total of 20 researches on the random controlled experiments of nerve ending absorption, intradermal and aeupoint injections as well as paste were screened out, and 11 of them we.re selected in accordance with the inclusive criteria while other 9 ones were deleted due to the duplication of the same content. DATA SYNTHESIS： No matter afferent nerve or efferent nerve, all the nerve endings can absorb selectively. When the drugs are distributed into the nerve ending, especially ending intensive areas such as intradermally,acupoints, mucous membrane and partly muscles, nerve ending can absorb the drugs in

关 键 词：神经末梢 吸收 皮内 穴位 注射 贴敷 

分 类 号：R74[医药卫生—神经病学与精神病学]