Fang Jian-Qiao, Shao Xiao-Mei
Zhejiang University of Traditional Chinese Medicine, Hangzhou 310053, China.
Zhen Ci Yan Jiu. 2017 Feb 25;42(1):85-9.
With the development of pain study, researchers gradually recognized that pain is composed of three main dimensions, namely "sensory-discriminative" "affective-motivational" and "cognitive-evaluative" which influence each other and are also independent from each other. Pain study has shifted away from focusing on the single mode of nociception to the multi-dimensional mode of sensory-affection-cognition. It is held early in traditional Chinese medicine that "when there is a stoppage, there is a pain" and a worsening disease Feb induce depression, which has already shown a multi-dimensional recognition about pain. Acupuncture therapy has been considered to be an effective adjuvant approach for relieving pain. In the present paper, the authors introduced applicability of acupuncture analgesia by modulating the abovementioned multi-dimensions of pain from the following 4 aspects:1) multi-dimensions of pain and related brain regions; 2) recognitions of traditional Chinese medicine about pain; 3) development of researches on acupuncture analgesia, including a) balancing activities of endogenous analgesic and algogenic substances, and triggering intracellular mitogen-activated protein kinase (MAPK) signaling to reduce algesia, b) improving psychological symptoms of patients with depression, anxiety, insomnia, etc., c) modulating functional activities of some common brain regions (as hippocampus, anterior cingutate, frontal lobe of cerebral cortex, etc.) sharing both pain information and learning-memory processing. Hence, the authors hold that if the clinical study and application and experimental researches conducted on the underlying mechanisms of acupuncture analgesia extend towards the multi-dimensions of pain, a series of new concepts or thoughts will be brought out, thereby possibly opening a bright applicable prospect for acupuncture analgesia.
随着疼痛研究的发展,研究人员逐渐认识到疼痛由三个主要维度组成,即“感觉辨别性”“情感动机性”和“认知评价性”,它们相互影响又相互独立。疼痛研究已从专注于单一的伤害感受模式转向感觉-情感-认知的多维度模式。中医早有“不通则痛”的说法,疾病加重会导致抑郁,这已体现出对疼痛的多维度认识。针刺疗法被认为是缓解疼痛的一种有效辅助方法。在本文中,作者从以下4个方面介绍了针刺镇痛通过调节上述疼痛多维度的适用性:1)疼痛的多维度及相关脑区;2)中医对疼痛的认识;3)针刺镇痛研究的进展,包括a)平衡内源性镇痛物质和致痛物质的活性,触发细胞内丝裂原活化蛋白激酶(MAPK)信号传导以减轻疼痛,b)改善抑郁症、焦虑症、失眠症等患者的心理症状,c)调节一些共同脑区(如海马体、前扣带回、大脑皮层额叶等)的功能活动,这些脑区既共享疼痛信息又参与学习记忆处理。因此,作者认为,如果对针刺镇痛的临床研究与应用以及对其潜在机制的实验研究朝着疼痛的多维度方向拓展,将会引出一系列新的概念或思路,并可能为针刺镇痛开辟广阔的应用前景。