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纳洛酮无法逆转针刺提高的痛阈:重新审视针刺镇痛作用

Naloxone fails to reverse pain thresholds elevated by acupuncture: acupuncture analgesia reconsidered.

作者信息

Chapman Richard C, Benedetti Costantino, Colpitts Yoko H, Gerlach Rebecca

机构信息

University of Washington Pain Center, Departments of Anesthesiology, Psychiatry and Behavioral Sciences and Psychology, University of Washington School of Medicine, Seattle, Wash. 98195, U.S.A. Department of Anesthesiology, University of Washington School of Medicine, Seattle, Wash. 98195 U.S.A.

出版信息

Pain. 1983 May;16(1):13-31. doi: 10.1016/0304-3959(83)90082-9.

Abstract

We were unable to demonstrate the reversal of dental acupunctural analgesia following the injection of 0.4 mg naloxone using evoked potential methodology. Since our findings differed from those of Mayer, Price and Rafii who used pain threshold methods, we attempted to replicate their study. Subjects who demonstrated acupunctural analgesia during electrical stimulation of the LI-4 point on the hands received either 1.2 mg naloxone or normal saline under double blind conditions. Pain thresholds elevated by acupuncture failed to reverse when naloxone was given. Review of experimental design issues, other related human subjects research, and animal studies on acupunctural analgesia provided little convincing evidence that endorphins play a significant role in acupunctural analgesia. Because endorphins can be released in response to a stressor, endorphin presence sometimes correlates with acupunctural treatment in animal studies and some human studies, especially those involving pain patients. The primary analgesia elicited by acupunctural stimulation seems to involve other mechanisms.

摘要

我们无法用诱发电位方法证明注射0.4毫克纳洛酮后牙针刺镇痛作用的逆转。由于我们的研究结果与使用疼痛阈值方法的梅耶、普赖斯和拉菲伊的研究结果不同,我们试图重复他们的研究。在手阳明大肠经4穴(LI-4)电刺激期间表现出针刺镇痛的受试者在双盲条件下接受1.2毫克纳洛酮或生理盐水。给予纳洛酮后,针刺提高的疼痛阈值未能逆转。对实验设计问题、其他相关人体研究以及针刺镇痛的动物研究进行回顾,几乎没有令人信服的证据表明内啡肽在针刺镇痛中起重要作用。由于内啡肽可因应激源而释放,在动物研究和一些人体研究中,尤其是涉及疼痛患者的研究中,内啡肽的存在有时与针刺治疗相关。针刺刺激引发的主要镇痛作用似乎涉及其他机制。

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