不同针灸刺激的镇痛作用与神经传入特征  

Analgesic effect and somatosensory afferent fibers of different acupuncture stimulations

作　　者：陈李圳 王晓宇[1] 何伟[1] 谢益宽[2] 景向红[1] CHEN Li-zhen;WANG Xiao-yu;HE Wei;XIE Yi-kuan;JING Xiang-hong(Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences,Beijing 100700,China;Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences,Beijing 100005,China)

机构地区：[1]中国中医科学院针灸研究所,北京100700 [2]中国医学科学院基础医学研究所,北京100005

出　　处：《中华中医药杂志》2022年第5期2622-2626,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.81973964);中国中医科学院博士研究生创新人才培养基金项目。

摘　　要：目的:观察不同强度不同层次针灸刺激承山穴对腓肠肌炎性痛的镇痛作用,分析热灸样刺激(Mox)、电针(EA)和经皮穴位电刺激(TEAS)的镇痛特征及其和感觉传入的关系。方法:以双足承重差值为疼痛行为指标,在肌肉炎性痛模型上,分别观察Mox、不同强度不同层次EA、不同强度TEAS的镇痛效果;免疫荧光染色观察皮下SP/CGRP+C-纤维的表达;透射电镜观察胫神经中髓鞘的结构;切断皮神经或用蛇毒破坏A-纤维髓鞘,分析参与镇痛的外周传入类型。结果:Mox、1 mA EA深刺肌肉和5 mA TEAS能显著改善大鼠痛行为(P<0.01)。Mox和TEAS均可激活皮下肽能C-纤维;去皮神经后这种效应消失。切断皮神经后Mox的镇痛作用消失,TEAS的镇痛效应减弱,但EA的镇痛不受影响。阻断肌肉A-纤维传入后,EA和TEAS的镇痛作用消失。结论:Mox与EA镇痛作用分别通过激活皮肤C-纤维、肌肉A-纤维来实现,介导TEAS镇痛的感觉传入主要是肌肉A-纤维。这可能是3种针灸刺激镇痛作用的神经传入特征。Objective:To observe analgesic effects on muscular inflammatory pain via three acupuncture stimulations with different intensities and layers on local acupoint of Chengshan(BL 57),and to analyze characteristics of moxibustionlike stimulation(Mox),electro-acupuncture(EA)and transcutaneous electrical acupoint stimulation(TEAS)analgesia with the relationship of primary afferents.Methods:Analgesic effects of Mox,EA with different layers and intensities,and TEAS with different intensities were studied respectively by different score of weight-bearing in the rat chronic inflammatory gastrocnemius pain model.The expression of SP/CGRP+C-fibers was observed by immunofluorescence staining,while the myelin sheath structure of tibial nerve was observed by transmission electron microscope.The analgesia driven by different kinds of afferent fibers was verified via skin transection or cobra venom-induced demyelination of A-fiber.Results:Mox,1 mA deep EA and 5 mA TEAS significantly improved the pain behavior(P<0.01).Both Mox and TEAS could activate subcutaneous C-fibers,which disappeared following cutaneous denervation.After skin transection,the analgesic effect of Mox disappeared,and TEAS analgesia was weakened,but it had no effect on deep EA.Furthermore,venom selectively destroyed muscular A-fiber myelin and abolished the analgesic effect of EA and TEAS.Conclusion:Mox and EA analgesia are achieved by muscular A-fibers and cutaneous C-fibers,respectively,while TEAS analgesia is mainly mediated by muscle A-fibers,which maybe the characteristic of acupuncture stimulations analgesia driven by somatosensory afferents.

关 键 词：热灸样刺激 电针 经皮穴位电刺激 层次 A-纤维 C-纤维 镇痛 神经纤维 

分 类 号：R246.2[医药卫生—针灸推拿学]