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下行痛觉抑制系统在电针镇痛中的作用

The Involvement of Descending Pain Inhibitory System in Electroacupuncture-Induced Analgesia.

作者信息

Lv Qiuyi, Wu Fengzhi, Gan Xiulun, Yang Xueqin, Zhou Ling, Chen Jie, He Yinjia, Zhang Rong, Zhu Bixiu, Liu Lanying

机构信息

School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.

Journal Center of Beijing University of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.

出版信息

Front Integr Neurosci. 2019 Aug 21;13:38. doi: 10.3389/fnint.2019.00038. eCollection 2019.

Abstract

Chronic pain is a major health problem, which can impair quality of life and reduce productivity. Electroacupuncture (EA), a modality of medicine based on the theories of Traditional Chinese Medicine (TCM), presents great therapeutic effects on chronic pain. Its clinical application has gained increasing popularity, and in parallel, more research has been performed on the mechanisms of EA-induced analgesia. The past decades have seen enormous advances both in neuronal circuitry of needle-insertion and in its molecular mechanism. EA may block pain by activating the descending pain inhibitory system, which originates in the brainstem and terminates at the spinal cord. This review article synthesizes corresponding studies to elucidate how EA alleviate pain the mediation of this descending system. Much emphasis has been put on the implication of descending serotonergic and noradrenergic pathways in the process of pain modulation. Also, other important transmitters and supraspinal regions related to analgesic effects of EA have been demonstrated. Finally, it should be noticed that there exist some shortcomings involved in the animal experimental designed for EA, which account for conflicting results obtained by different studies.

摘要

慢性疼痛是一个主要的健康问题,它会损害生活质量并降低生产力。电针是一种基于中医理论的医学疗法,对慢性疼痛具有显著的治疗效果。其临床应用越来越受欢迎,与此同时,对电针镇痛机制的研究也越来越多。在过去几十年中,针刺的神经回路及其分子机制都取得了巨大进展。电针可能通过激活起源于脑干并终止于脊髓的下行疼痛抑制系统来阻断疼痛。这篇综述文章综合了相关研究,以阐明电针如何通过该下行系统的介导来减轻疼痛。人们非常重视下行5-羟色胺能和去甲肾上腺素能通路在疼痛调节过程中的作用。此外,还证实了与电针镇痛作用相关的其他重要递质和脊髓上区域。最后,应该注意的是,针对电针的动物实验存在一些缺陷,这导致了不同研究得出相互矛盾的结果。

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