He Rui, Zhao Bai-Xiao
School of Acupuncture-moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China.
School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China.
Zhen Ci Yan Jiu. 2019 Apr 25;44(4):307-11. doi: 10.13702/j.1000-0607.180043.
There are some records about the needling and moxibustion sensations in Chinese ancient medical literature, in which, the concept of ( arrival) and its relationship with the production of therapeutic effects were put forward. The generation of needling or moxibustion sensations is one of the symbol for qi reaching the affected site during the manipulation and is also related to the treatment outcomes. In the present paper, we reviewed current situations about the mechanisms of acupuncture and moxibustion stimulation induced sensations and their relation to the propagated sensation (PS) published in recent 10 years from the following four aspects: 1) the patterns of manifestation of needling sensations (including general sensations, and specific sensations, as well as the practitioner's hand felt heavy, tight, hard-going senses, etc.) and moxibustion sensations (local superficial and deep warmth); 2) modern anatomical and physiological basis (skin, loose and dense connective tissue, free nerve ending, various receptors); 3) neurohumoral mechanism of acupuncture stimulation induced PS phenomenon (mechanical receptors, afferent and efferent nerve fibers, neural center, various neurotransmitters/modulators, chemical substances, etc.); 4) neurohumoral mechanism of moxibustion stimulation induced channel transmission (transient receptor potential vanilloid receptors-heat sensitive receptors, heat-shock protein, immunocytes, etc.). Additionally, the authors also put forward some suggestions about future researches on acupuncture-moxibustion sensations.
中国古代医学文献中有一些关于针刺和艾灸感觉的记载,其中提出了“气至”的概念及其与治疗效应产生的关系。针刺或艾灸感觉的产生是操作过程中气血到达病所的标志之一,也与治疗效果相关。本文从以下四个方面综述了近10年来发表的关于针刺和艾灸刺激诱发感觉的机制及其与循经感传关系的研究现状:1)针刺感觉(包括一般感觉、特殊感觉以及医者手下的沉、紧、涩等感觉)和艾灸感觉(局部浅部和深部温热感)的表现形式;2)现代解剖生理学基础(皮肤、疏松和致密结缔组织、游离神经末梢、各种感受器);3)针刺刺激诱发循经感传现象的神经体液机制(机械感受器、传入和传出神经纤维、神经中枢、各种神经递质/调质、化学物质等);4)艾灸刺激诱发经络传导的神经体液机制(瞬时受体电位香草酸受体-热敏感受体、热休克蛋白、免疫细胞等)。此外,作者还对未来针灸感觉的研究提出了一些建议。