针灸的神经生物学机理  

Neurobiological mechanisms of acupuncture

作　　者：潘卫星 PAN Wei-xing(Janelia Research Campus,Howard Hughes Medical Institute,Ashbum,VA 20147,USA)

机构地区：[1]Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA 20147, USA

出　　处：《中华中医药杂志》2018年第10期4281-4297,共17页China Journal of Traditional Chinese Medicine and Pharmacy

摘　　要："针刺感受处,疾病反应所,治疗作用点"是腧穴的三大功能,也是理解针灸作用原理的基本点。现代研究表明:(1)穴位感针现象的实质是神经感受。针刺激动不同类型的神经成分而产生针感。不同针法(刺激形式和刺激量)可激动不同类型和数量的外周神经,从而引起性质、范围、时间上各异的调节效应。阻断支配穴区的神经可取消针感和针效,而刺激外周神经可模拟针效,表明神经系统是介导针效的充分必要条件。因而穴位是相对的,体表可以施针的位点与数量不限于经典穴。(2)穴位应病现象的机制是脊髓同节段和脊神经节同神经元支配的内脏-躯体相关的神经元性炎症敏化过程。对于内脏病症,体表敏化点是可资选择的靶向精准的活化穴。(3)针疗作用的三个基本特点是:针灸的作用性质属机能调节,通过激励自愈力而获效;穴位作用范围具有选择性调节和泛调节双重效应,分别通过局部微创、轴突反射、脊髓节段支配、脑内整合及脑输出等五级效应途径实现;针灸的调节方式呈双向性调衡效应,以机体稳态自动控制和适应性调节为基础。大量生物学实验已为揭开这些针灸作用之谜提供了多层次多角度的考察与阐释,并为提高临床疗效提供了新的途径和启示。总结既往丰富的研究结果,不难看到,针灸机理的系统性构架已经呈现,正逐步走向成熟。Abstract： A large number of modem research has shown that acupuncture procedures have significant physiological effects and that the mechanisms of acupuncture may now become clearer. The main findings are： ①acupuncture is a physiological curative approach that may unblock/reinforce self-healing potentials and regulate/optimize the healing process to restore overall balance;②the acupuncture effects are obtained by peripheral nerve stimulation, and different effects may be evoked by stimulating different types of peripheral nerve fibbers; ③acupuncture possesses dual roles of selective regulation （through spinal reflexes） and pan-regulation （through brain integration and the outputs of the brain, the neuroendocrine and Neuroimmunomodulation）; and in particular, acupuncture produces bi-directional regulation or homeostatic regulation, which may give new insight into biological cybernetics. This article is to provide a comprehensive overview of the data from both human examinations and animal laboratory experiments, with a conceptual framework for organizing the empirical observation.

关 键 词：针灸 穴位 针灸机理 针刺双向调节 外周神经刺激 

分 类 号：R245[医药卫生—针灸推拿学]