从针刺镇痛原理看安慰针刺设置的问题  

Discussion on Existing Problems of Placebo Acupuncture Design Based on Acupuncture Analgesia

作　　者：毛文超[1] 刘保延[2] 何丽云[1] 刘志顺[3] 刘佳[1] 赵晔[1] 

机构地区：[1]中国中医科学院中医临床基础医学研究所,北京100700 [2]中国中医科学院,北京100700 [3]中国中医科学院广安门医院针灸科,北京100053

出　　处：《针刺研究》2013年第2期163-167,共5页Acupuncture Research

基　　金：国家"十二五"科技支撑计划项目(No.2012BAI 24B02)

摘　　要：本文回顾了针刺镇痛的神经机制及规律,即针刺镇痛的特异性与广泛性取决于刺激强度与刺激部位,当刺激部位与痛源处于同一神经节段时,不论弱刺激或强刺激均可产生镇痛效应;当刺激部位与痛源处于非同一神经节段的远端时,强刺激才能产生镇痛效应。在此基础上指出当前针对疼痛类疾病临床研究中安慰针刺对照设置存在的问题,提出在疼痛类疾病临床研究中,合理的安慰针刺的设置应当在与痛源部位处于非同一神经节段的远端部位进行弱刺激。In the present article, the authors made an overview about the existing problems of placebo acupuncture de- sign in accordance with the neurological basis of acupuncture analgesia. The neuron-segmental and systemic mechanisms initiated by local somesthetic stimuli at different intensities are involved in acupuncture analgesia. When the local pain locus and the stimu- lated point are in the same spinal segmental region, stimuli of either higher intensity or lower intensity may produce an obviotJs ana- lgesia effect. If the stimulation site is far from the pain locus （in remote spinal segment region）, only higher intensity stimulation works. From this viewpoint, the placebo acupuncture design in current clinical trials for pain treatment exists some unreasonable aspects. Both pain focus and intensity of acupuncture stimulation should be taken into consideration together. The optimal placebo acupuncture design for the treatment of pain conditions is that lower intensity acupuncture stimulation is given for longer distance between the pain origin locus and the stimulated acupoint.

关 键 词：安慰针刺设置 针刺镇痛 神经机制 针刺强刺激 针刺弱刺激 

分 类 号：R245.311[医药卫生—针灸推拿学]