Liao S J
Yale J Biol Med. 1978 Jan-Feb;51(1):55-65.
The controversy about acupuncture is familiar to us since its recent reintroduction into this country. Much of its philosophical concepts were taken at their face values as the bases for condemnation. Since I last reviewed these antiquated concepts in the light of modern medicine, much has developed. It seems that if the effects of acupuncture were transmitted along the peripheral nerves to the central nervous system, it would be more effective if applied segmentally to the site of noxious stimulation. Disruption of extralamniscal pathways would abolish its analgesic effect. The distant and nonsegmentally located acupuncture points exert their influences through the integrative efforts of the reticular formation and the thalamus. The demonstration of transmissibility of acupuncture analgesia through blood and cerebrospinal fluid in animals implicates the involvement of humoral factors. Since such an effect can be suppressed by naloxone or by hypophysectomy, endorphins are thought to be involved. Such laboratory evidences indeed begin to shed some light on a possible neurohumoral mechanism of acupuncture. The differences between acupuncture and hypnosis are discussed. Acupuncture points were compared with referred pain, trigger points and motor points of the skeletal muscles. Its possible uses for other than pain, such as drug addiction, alcoholism, etc. are also reviewed.
自针灸最近重新引入我国以来，我们对其争议已耳熟能详。其许多哲学概念被照单全收，作为遭到谴责的依据。自从我上次根据现代医学审视这些陈旧观念以来，已有许多新进展。似乎如果针灸的效应是沿外周神经传导至中枢神经系统，那么将其分段应用于有害刺激部位会更有效。外侧丘系通路的中断会消除其镇痛效果。远处且非分段定位的穴位是通过网状结构和丘脑的整合作用发挥其影响的。动物实验证明针灸镇痛可通过血液和脑脊液传导，这表明体液因素参与其中。由于这种效应可被纳洛酮或垂体切除所抑制，所以认为内啡肽与之有关。这些实验室证据确实开始为针灸可能的神经体液机制提供了一些线索。文中还讨论了针灸与催眠的区别。将穴位与牵涉痛、触发点和骨骼肌运动点进行了比较。还综述了针灸除用于止痛之外的其他可能用途，如药物成瘾、酗酒等。
