Department of Neurology, DaeJeon Hankook Hospital, Neurology, 496-15 SungNam 2 Dong, DaeJeon, ChungCheong Nam-Do 300-709, South Korea.
Med Hypotheses. 2010 Apr;74(4):729-31. doi: 10.1016/j.mehy.2009.10.053. Epub 2009 Dec 14.
Visceral injury induces referred pain, autonomic concomitants, skeletal muscle spasm, and hyperalgesia of segmental pattern on the specific area of somatic tissue. Therefore, since visceral referred pain does not mean only a feeling which is considered as misperception of brain but accompanies accessory phenomena, referred phenomenon can be more reasonable expression. Visceral referred phenomenon has segmental pattern and is shown on the segmental constituents related to viscus and further spreads to multi-segments through central sensitization if visceral injury become severe and chronic. Segmental pattern observed in our body is not a feature developing only in human. Segmentation of animals is a general concept in body organization from Annelida to Vertebrata. The evolutionary advent of segmentation made possible development of much greater complexity in structure and function. Segmentation increased efficiency of movements, and further made fine neural control of movements possible. It is definite that segmentation of body bestows obvious advantages to an animal. If abnormality in a segment develops, to lessen energy expenditure of an organism consisting of multi-segments, the organism sacrifices the abnormal segment for the whole segments via defunctionalization. Defunctionalization of abnormal segment is just segmental phenomenon. Functional unit of grouped segments called as tagma in Arthropoda or its equivalent in Vertebrata could also show this phenomenon if abnormality develops in tagma or its equivalent. Visceral referred pain, referred pain originating from musculoskeletal structure, complex regional pain syndrome I and II are representatives of segmental or tagmatic phenomena.
内脏损伤会引起牵涉痛、自主伴随现象、骨骼肌痉挛和特定躯体组织区域的节段性痛觉过敏。因此，由于内脏牵涉痛不仅意味着大脑的感知错误，还伴随着附加现象，所以牵涉现象可以作为更合理的表述。内脏牵涉现象具有节段性模式，表现在与内脏相关的节段成分上，如果内脏损伤变得严重和慢性，还会通过中枢敏化进一步扩散到多个节段。我们身体中观察到的节段性模式并不是人类特有的特征。从环节动物到脊椎动物，动物的分段是身体组织的一般概念。分段的进化出现使得结构和功能的复杂性有了更大的发展可能。分段提高了运动效率，并进一步实现了运动的精细神经控制。毫无疑问，身体的分段赋予了动物明显的优势。如果一个节段发生异常，为了减少由多个节段组成的生物体的能量消耗，生物体通过去功能化来牺牲异常节段以换取整个节段。异常节段的去功能化就是节段性现象。节肢动物中的分组节段的功能单位称为体节，或其在脊椎动物中的等效物，如果体节或其等效物发生异常，也可能出现这种现象。内脏牵涉痛、起源于肌肉骨骼结构的牵涉痛、复杂性区域疼痛综合征 I 和 II 都是节段性或体节性现象的代表。
