【摘要】：目的:觀察不同強(qiáng)度電針對(duì)傷害性刺激的鎮(zhèn)痛效應(yīng)差異,探討彌漫性傷害抑制性控制(DNIC)系統(tǒng)是否參與了電針的鎮(zhèn)痛效應(yīng)。方法:以人體和動(dòng)物作為實(shí)驗(yàn)對(duì)象,進(jìn)行四部分實(shí)驗(yàn)。動(dòng)物行為學(xué)實(shí)驗(yàn),用1mA、3mA電針強(qiáng)度電針針刺正常清醒大鼠兩側(cè)足三里,觀察針刺前后的機(jī)械刺激誘導(dǎo)的縮足反射。動(dòng)物C-纖維反射實(shí)驗(yàn),電刺激左側(cè)腓神經(jīng)皮膚感受野測(cè)得能誘發(fā)出股二頭肌肌電(E MG)的Aδ,C-纖維反射閾值。以1.2倍C-纖維反射的閾值強(qiáng)度作為檢驗(yàn)刺激,分別以不同強(qiáng)度,電針記錄電極同側(cè)、對(duì)側(cè)足三里,記錄電針前后0-5min檢驗(yàn)刺激誘發(fā)的EMG變化。人體dQST試驗(yàn)挑選符合條件的10名知情健康志愿者入組為受試者,應(yīng)用溫度感覺(jué)分析儀給予左側(cè)大魚(yú)際一個(gè)4s47℃熱灸的檢驗(yàn)刺激,記錄1min電針的條件刺激對(duì)檢驗(yàn)刺激的影響。受試者分別在電針前及電針開(kāi)始后30s,1min,1min30s和2min給出疼痛評(píng)分VAS值,分析不同強(qiáng)度電針前后VAS值的變化。人體RⅢ反射試驗(yàn),給予左側(cè)腓腸神經(jīng)刺激,得出誘發(fā)股二頭肌肌電的RⅢ反射閾值,并且以1.2倍的RⅢ反射閾值作檢驗(yàn)刺激,分別以不同強(qiáng)度電針兩側(cè)足三里,并記錄電針前及電針結(jié)束后0-5min誘發(fā)EMG的變化。結(jié)果:(1)動(dòng)物行為學(xué)實(shí)驗(yàn)結(jié)果與人體dQST試驗(yàn)結(jié)果基本一致。動(dòng)物行為學(xué)實(shí)驗(yàn),大鼠機(jī)械性縮足反射潛伏期是13.04±3.09(s)。閾值是13.28±3.02(g)。兩種強(qiáng)度針刺后,大鼠機(jī)械性縮足反射潛伏期和閾值均升高(p0.05,n=10)。人體dQST試驗(yàn),受試者疼痛評(píng)分VAS平均值是61.5±8.1。電針結(jié)束后,受試者疼痛評(píng)分VAS值降低,耐痛值增高(p0.05,n=10)。且電針強(qiáng)度越大,大鼠和人體痛閾越高。(2)動(dòng)物c-纖維反射實(shí)驗(yàn)和人體RⅢ反射試驗(yàn)結(jié)果基本一致。C-纖維反射實(shí)驗(yàn)測(cè)得10只正常SD大鼠發(fā)生Aδ反射的閾值刺激(TAδ)為0.54±0.23mA,C-纖維反射的閾值刺激(Tc)為2.92±0.39mA。Tc、2Tc強(qiáng)度電針對(duì)側(cè)足三里,在針刺結(jié)束后1min內(nèi),1.2Tc引起C反射反應(yīng)的EMG減少,而0.8Ta強(qiáng)度電針對(duì)C反射反應(yīng)的抑制效果不明顯。人體RⅢ反射試驗(yàn)測(cè)得10名受試者誘發(fā)出RⅢ反射的閾值刺激(TrⅢ)是7.95±1.8mA,電針強(qiáng)度增加,對(duì)EMG的抑制效果增強(qiáng)。結(jié)論:條件刺激對(duì)檢驗(yàn)刺激的抑制效應(yīng)隨著電針強(qiáng)度的增大而增強(qiáng),抑制時(shí)間隨著電針強(qiáng)度的增大而延長(zhǎng)。因此條件刺激作為可控參數(shù),是決定針刺鎮(zhèn)痛的關(guān)鍵因素之一。引起C-纖維反射的電針強(qiáng)度,抑制對(duì)側(cè)C-纖維反射的EMG反應(yīng),起到鎮(zhèn)痛的效果。針刺異神經(jīng)節(jié)段支配部位所誘導(dǎo)的全身性鎮(zhèn)痛效果,彌漫性傷害性抑制控制(DNIC)參與了針刺異神經(jīng)節(jié)段部位的全身性鎮(zhèn)痛作用,也可能有其他的鎮(zhèn)痛機(jī)制參與。
[Abstract]:Aim: to observe the analgesic effects of electroacupuncture on nociceptive stimuli with different intensities, and to explore whether the diffuse nociceptive inhibitory control (DNIC) system is involved in the analgesic effect of electroacupuncture. Methods: four parts of the experiment were carried out with human and animal as experimental objects. The animal behavior experiment was conducted to observe the reflex induced by mechanical stimulation before and after acupuncture in normal conscious rats. In animal C-fiber reflex experiment, the electrical stimulation of the left peroneal nerve skin sensing field could induce the A 未 and C-fiber reflex threshold of the biceps femoris electromyography (E MG). The threshold intensity of 1.2-fold C-fiber reflex was used as the test stimulus. The changes of EMG induced by 0-5min test before and after electroacupuncture were recorded with different intensities and electroacupuncture recording electrode ipsilateral and contralateral Zusanli respectively. Human dQST test selected 10 informed and healthy volunteers as subjects. They were given a test stimulation of 4s47 鈩，

本文編號(hào)：2292160