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针刺和电针对持续性疼痛的作用机制。

Mechanisms of acupuncture-electroacupuncture on persistent pain.

机构信息

From the Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, Maryland (R.Z., L.L., and B.M.B.); and Department of Neural and Pain Sciences, Dental School, University of Maryland, Baltimore, Maryland (K.R.).

出版信息

Anesthesiology. 2014 Feb;120(2):482-503. doi: 10.1097/ALN.0000000000000101.

Abstract

In the last decade, preclinical investigations of electroacupuncture mechanisms on persistent tissue injury (inflammatory), nerve injury (neuropathic), cancer, and visceral pain have increased. These studies show that electroacupuncture activates the nervous system differently in health than in pain conditions, alleviates both sensory and affective inflammatory pain, and inhibits inflammatory and neuropathic pain more effectively at 2 to 10 Hz than at 100 Hz. Electroacupuncture blocks pain by activating a variety of bioactive chemicals through peripheral, spinal, and supraspinal mechanisms. These include opioids, which desensitize peripheral nociceptors and reduce proinflammatory cytokines peripherally and in the spinal cord, and serotonin and norepinephrine, which decrease spinal N-methyl-D-aspartate receptor subunit GluN1 phosphorylation. Additional studies suggest that electroacupuncture, when combined with low dosages of conventional analgesics, provides effective pain management which can forestall the side effects of often-debilitating pharmaceuticals.

摘要

在过去的十年中,电针对持续性组织损伤(炎症)、神经损伤(神经性)、癌症和内脏疼痛的临床前研究有所增加。这些研究表明,电针对健康状态和疼痛状态下的神经系统的激活方式不同,可缓解感觉和情感性炎症疼痛,并且在 2 至 10 Hz 时比 100 Hz 更有效地抑制炎症性和神经性疼痛。电针通过外周、脊髓和脊髓上机制激活多种生物活性化学物质来阻断疼痛。这些物质包括阿片类药物,它们使外周伤害感受器脱敏,并减少外周和脊髓中的促炎细胞因子,以及 5-羟色胺和去甲肾上腺素,它们减少脊髓 N-甲基-D-天冬氨酸受体亚基 GluN1 磷酸化。此外的研究表明,电针与低剂量的常规镇痛药联合使用,可以提供有效的疼痛管理,从而预防经常使人衰弱的药物的副作用。

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