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标准镇痛或不同针刺技术下最小免疫反应性血浆β-内啡肽及皮质醇降低

Minimal immunoreactive plasma beta-endorphin and decrease of cortisol at standard analgesia or different acupuncture techniques.

作者信息

Harbach H, Moll B, Boedeker R-H, Vigelius-Rauch U, Otto H, Muehling J, Hempelmann G, Markart P

机构信息

University of Giessen, Department of Anaesthesiology, Intensive Care, Pain Therapy, Palliative Medicine, Germany.

出版信息

Eur J Anaesthesiol. 2007 Apr;24(4):370-6. doi: 10.1017/S0265021506001906. Epub 2006 Dec 8.

Abstract

BACKGROUND AND OBJECTIVE

Acupuncture has been claimed to be associated with activation of the endogenous antinociceptive system. The analgesic effects of acupuncture have been ascribed to beta-endorphin interacting with opioid receptors. However, firstly, the release of beta-endorphin into the blood has been proven to be induced by stress, i.e. under dysphoric conditions, and, secondly, if released under stress, beta-endorphin has been shown not to be analgesic. Our aim was to test whether beta-endorphin immunoreactive material is released into the cardiovascular compartment during acupuncture comparing the most frequently used types of acupuncture with standard pain treatment under apparently low stress conditions.

METHODS

This prospective study included 15 male patients suffering from chronic low back pain. beta-Endorphin immunoreactive material and cortisol were measured in the plasma of patients who underwent, in random order, therapy according to a standard pain treatment, traditional Chinese acupuncture, sham acupuncture, electro acupuncture and electro acupuncture at non-acupuncture points before, at and after the treatment. Statistical analysis was performed using two-way ANOVA with repeated measures.

RESULTS

A decrease in plasma cortisol concentration measured over the five treatment protocols was highly significant (P < 0.001). The beta-endorphin immunoreactive material concentrations in plasma were minimal at all times and in all treatment conditions. The influence of treatments by various acupuncture procedures on cortisol and beta-endorphin immunoreactive material plasma concentrations over the three time points was not significantly different.

CONCLUSIONS

beta-endorphin immunoreactive material in blood is not released by any type of acupuncture as tested under low stress conditions.

摘要

背景与目的

据称针刺与内源性抗痛系统的激活有关。针刺的镇痛作用归因于β-内啡肽与阿片受体的相互作用。然而,首先,已证实β-内啡肽释放到血液中是由应激诱导的,即在烦躁不安的情况下,其次,如果在应激状态下释放,β-内啡肽已被证明没有镇痛作用。我们的目的是在明显低应激条件下,将最常用的针刺类型与标准疼痛治疗进行比较,测试针刺过程中β-内啡肽免疫反应性物质是否释放到心血管腔室中。

方法

这项前瞻性研究纳入了15名患有慢性下腰痛的男性患者。在接受标准疼痛治疗、传统中医针刺、假针刺、电针以及非穴位电针治疗的患者血浆中,在治疗前、治疗期间和治疗后测量β-内啡肽免疫反应性物质和皮质醇。采用重复测量的双向方差分析进行统计分析。

结果

在五种治疗方案中测得的血浆皮质醇浓度下降非常显著(P < 0.001)。在所有时间和所有治疗条件下,血浆中β-内啡肽免疫反应性物质浓度始终最低。在三个时间点上,各种针刺程序对皮质醇和β-内啡肽免疫反应性物质血浆浓度的影响没有显著差异。

结论

在低应激条件下测试时,任何类型的针刺均不会释放血液中的β-内啡肽免疫反应性物质。

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