近五年针刺治疗慢性疼痛机制研究进展  

Research progress on mechanism of acupuncture for chronic pain in recent five years

作　　者：张柏雯 戴晓红[3] 刘婷[4] 匡炳霖 邹伟[3] ZHANG Baiwen;DAI Xiaohong;LIU Ting;KUANG Binglin;ZOU Wei(Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学第一临床医学院,哈尔滨150040 [2]黑龙江中医药大学第二临床医学院 [3]黑龙江中医药大学附属第一医院针灸三科 [4]彭州市中医医院康复科

出　　处：《环球中医药》2022年第5期888-894,共7页Global Traditional Chinese Medicine

基　　金：黑龙江省中医药管理局省级名中医专家传承工作室(20190529)。

摘　　要：针刺镇痛在临床上被广泛应用。针刺的神经传导通路与机体痛觉传导通路基本相似,对周围神经和中枢神经均有一定的影响,因此推断这可能是针刺缓解疼痛的一种调节机制。本文总结了近五年针刺治疗各种疼痛疾病的机制研究,从传导通路上分析得知针刺能激发神经元活性,改善周围神经的病理变化,增加神经元之间突触传递,修复受损的周围神经以缓解疼痛。此外,应用针刺或加用电针治疗痛症,能改善大脑内与疼痛相关各功能区之间的联系,对镇痛起到一定的中枢调控作用。在研究中还发现针刺能减少病变区炎性反应和细胞凋亡,增加细胞自噬和血管调节因子的表达。这些反应之间常存在一定的相互作用,共同缓解机体疼痛症状。然而,临床中针刺手法及辅助方法众多,治疗选取的相关穴位各异,根据疾病定位定性后选择最优组合方式是今后总结经验的重要目标。Acupuncture analgesia is widely used in clinical practice.The nerve conduction pathway of acupuncture is basically similar to the body's pain conduction pathway,which has a certain impact on the peripheral and the central nervous system.Therefore,it is speculated that this may be a regulatory mechanism for acupuncture to alleviate pain.This paper summarizes the researches of acupuncture mechanism in the treatment of various pain diseases in the past five years.From the analysis of the conduction pathway,it was found that acupuncture can stimulate the activity of neurons,improve the pathological status of peripheral nerves,increase the synaptic transmission between neurons,therefore it could repair the damaged peripheral nerves to relieve pain.In addition,the application of acupuncture or electroacupuncture in the treatment of pain could improve the relationship between the cerebral lobes and pain-related functional areas,which played a central regulatory role in analgesia.In this study,it was also found that acupuncture could reduce the inflammatory response and apoptosis in the lesion area,and increase the expression of autophagy and vascular regulatory factors.There were often certain interactions between these reactions,which jointly alleviate the pain symptoms of the body.However,there are many acupuncture techniques and auxiliary methods in clinical practice,and the relevant acupoints selected for treatment are different.It is an important goal to select the optimal combination method to treat diseases after the precision diagnosis.

关 键 词：慢性疼痛 针刺 镇痛 炎症因子 血管调节因子 自噬 凋亡 

分 类 号：R285[医药卫生—中药学]