摘要
针刺尤其是电针有很好的镇痛作用,但针刺介导的外周和中枢镇痛机制仍处于不断研究中。对相关研究及时进行综述,有利于更好地阐述针刺对炎性疼痛的作用机制,并为今后的研究指出方向。本文从外周、脊髓和脊髓上水平阐述针刺对炎性疼痛的镇痛机制,主要包括外周炎性介导的免疫反应和伤害性感受器上的受体之间的神经免疫交互作用,脊髓神经递质、神经调质、胶质细胞、信号通路及其他相关活性分子等相互作用机制,和针刺对脊髓上水平痛感觉和痛情绪的作用机制。
Although acupuncture,especially electroacupuncture（EA）is widely used to treat pain,its mechanisms have not been completely understood.In the present paper,we review the development of researches on the underlying mechanisms of EA in relieving inflammatory pain in recent years from a）peripheral inflammation-mediated immune response and neuro-immune interaction of receptors on primary nociceptors,b）crosstalk of neurotransmitters or neuromodulators,cellular signaling pathways,other related bioactive molecules,as well as glial activation in the dorsal horns of spinal cord,and c）supraspinal modulation of both sensory and affective components of pain.Inflammatory pain involves complex neuro-immune networks of neurons and nonneurons,various inflammatory mediators,neurotransmitters,neuromodulators and cellular signaling molecules in the peripheral and central nervous systems.Therefore,the analgesic mechanism of acupuncture still needs to be studied in depth at multi-levels and multi-targets,for instance,the reciprocal actions of peripheral opioid peptide,adenosine and TRPV 1（which have been demonstrated to be involved in EA analgesia individually）,the roles of spinal cord adenosine A 1 receptor（A 1 R）and A 2 R（for which fewer studies have been conducted）,the interactions of classical neurotransmitters/neuromodulators/neuropeptides and their receptors,changes of intracellular molecules at transcriptional and translation levels,etc.during acupuncture analgesia.Furthermore,the mechanisms underlying reciprocal actions of neurotransmitters,neuromodulators and their receptors complicated in acupuncture-induced relief of pain affection in the higher brain regions also need to be explored further.
作者
李媛
吴凡
程珂
沈雪勇
劳力行
LI Yuan;WU Fan;CHENG Ke;SHEN Xue yong;LAO Li-xing(Acupuncture and Tuina Academy Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shanghai Research Center of Acupuncture and Meridian,Shanghai 201203;The University of Hong Kong School of Chinese Medicine,Hongkong,China)
出处
《针刺研究》
CAS
CSCD
北大核心
2018年第8期467-475,共9页
Acupuncture Research
基金
国家自然科学基金重大国际合作项目(No.81320108028)
关键词
针刺镇痛
炎性疼痛
机制研究
综述
Acupuncture analgesia
Inflammatory pain
Mechanism research
Review
