催产素在脊髓水平对电针镇痛的影响

采用玻璃微电极胞外记录和脊髓表面给药的方法观察了催产素（ＯＴ）、抗催产素血清（ＡＯＴＳ）以及电针穴位对背角神经元伤害性诱发放电的影响。结果表明：电针穴位或脊髓表面施加ＯＴ可部分抑制脊髓背角神经元的伤害性诱发放电;在电针的基础上施加ＯＴ则明显加强电针的抑制效应;相反,用ＡＯＴＳ预处理后,电针的抑制作用放取消。提示ＯＴ在脊髓水平参与了对痛觉信息的调制,并与一定频率的针刺镇痛有关。     

刺激蓝斑及电针对大鼠脊髓背角神经元伤害性反应的影响

以往的工作表明,蓝斑（LC）-去甲肾上腺素能神经元系统在痛觉调制和针刺镇痛中起着重要作用,本文用电生理学方法研究刺激LC和电针对大鼠脊髓背角神经元伤害性反应的影响,其主要结果如下：1、刺激LC或电针有明显抑制脊髓背角神经元伤害性反应的作用。2、损毁中缝大核和腹腔注射纳洛酮并不明显影响刺激LC的抑制效应。3、α2受体激动剂氯压啶能加强刺激LC或电针的抑制效应,而α受体阻断剂酚妥拉明在一定程度上能削弱这种抑制效应,这些实验结果提示,刺激LC和电针可激活LC神经元,通过其下行纤维,在脊髓水平释放NE,通过α2受体,阻断伤害性信息的传递。     

电针刺激可在大鼠脊髓诱发Fos样蛋白的生成

本研究利用Fos蛋白的免疫组织化学方法首次报道电针“三阴交”穴位可在大鼠脊髓诱发原癌基因c-fos的表达。电针后大量Fos免疫反应(FLI)细胞出现在脊髓腰膨大的背、腹角,但标记最密集区为背角Ⅲ,Ⅳ层。在动物足部注射福尔马林产生的伤害性刺激亦可在脊髓腰膨大背、腹角诱发大量FLI细胞,但以背角Ⅰ,Ⅱ层标记最为密集。因此电针和伤害性刺激引起的脊髓c-fos表达在分布上是不同的。电针诱发的Foc蛋白可能参与针刺镇痛。     

家兔尾核内微量注入东莨菪碱对电针镇痛作用的影响

近年来的研究表明,尾核具有镇痛机能,并与针刺镇痛有关。动物实验中曾观察到,刺激尾核时痛阈升高,并可加强电针镇痛效应;而损毁尾核后电针的镇痛效应明显减弱。电针刺激“合谷”时,尾核出现诱发电位。记录尾核的单位放电也可看到多数神经元对电针有反应。某些神经元在电针数分钟后逐渐出现反应,停止电针后反应仍可持续数分钟,与临床实践中所见针刺效应的出现需要诱导期及停针后有后效应颇为相似。临床观察表明,电针人的合谷等穴位时,尾核也有诱发电反应,刺激尾核可以缓     

传入 C 纤维的兴奋在电针“足三里” 激活中缝大核中的作用

为了分析电针“足三里”是否以其伤害性刺激性质引起镇痛作用,我们试探了电刺激“足三里”穴区所引起的传人(顺行)冲动是否可以减小刺激腓总神经引起的逆行 C 波。碰撞实验表明刺激“足三里”确可兴奋了腓神经的一些 C 纤维。此外我们还观察到刺激“足三里”的强度达到或超过 C 纤维阈值时。可明显激活中缝大核神经元,当刺激强度达到可引起最大 c 波时,激活 NRM 的效应也达到最大。上述结果提示电针“足三里”除可以其非伤害性刺激性质引起镇痛作用外,可能主要是以其伤害性刺激,经 C 类纤维激活 NRM,再经过痛负反馈调制引起镇痛。     

电针对佐剂性关节炎大鼠病灶局部CRH阳性细胞免疫反应性的影响

目的研究电针对佐剂性关节炎大鼠的镇痛作用机制是否与其对病灶局部CRH阳性细胞免疫反应性的影响有关。方法本课题采用佐剂性关节炎模型大鼠,研究电针同侧环跳穴、阳陵泉穴对运动障碍的改善作用,采用免疫组化技术,观察电针对致炎后模型大鼠外踝关节周围皮肤及皮下组织CRH阳性细胞免疫反应性的影响,同时针刺非穴位和对侧穴位进行对照,探讨针刺作用的穴位特异性。结果造模后,除空白组外其他各组大鼠运动障碍明显,分别电针同侧及对侧穴位可显著改善炎症大鼠的运动障碍。炎症组病灶局部CRH阳性细胞的面积百分比、平均光密度均显著高于空白对照组,电针同侧穴位、对侧穴位显著降低炎症组CRH阳性细胞的平均光密度,而非经穴电针对照组没有显著疗效。结论电针同侧穴位、对侧穴位可通过促使定向迁移至炎性痛病灶的免疫细胞合成并释放CRH,从而发挥镇痛作用,与中医“巨刺法”的说法相呼应。     

下丘脑室旁核参与脑刺激镇痛的实验研究

目的 :探讨下丘脑室旁核 (PVN )的镇痛与脑刺激镇痛间的关系及作用途径。方法 :用 4%水合氯醛麻醉大鼠 ,在PVN埋藏双极刺激电极或不锈钢管 ,在中缝大核 (NRM )埋藏损毁电极 ,并暴露脊髓用玻璃微电极记录脊髓背角神经元对伤害刺激坐骨神经的反应 ,信号由计算机采集处理。结果 :电解中缝大核 (NRM )后 ,刺激PVN可抑制脊髓背角神经元伤害反应 ,其作用时间持续 15～18min ,其中 3～ 6min抑制作用最强 ;向PVN微量注射吗啡 10 μg ,脊髓背角神经元伤害单位放电明显减少 ,纳洛酮可反转吗啡的抑制作用。结论 :PVN除通过已知的内源性镇痛系统中的NRM中继外 ,也可能通过PVN 脊髓背角间的直接神经投射等途径参与脑刺激镇痛 ,此作用过程中在PVN可能有吗啡参与。本工作对痛觉生理及镇痛的研究具有重要意义。     

电针对氯胺酮成瘾大鼠内侧前额叶皮质酪氨酸羟化酶表达的影响

目的观察不同时辰电针“足三里”和“三阴交”穴对氯胺酮成瘾大鼠内侧前额叶皮质（mPFC）酪氨酸羟化酶（TH）表达的影响,探讨电针治疗氯胺酮滥用成瘾的作用机制。方法将56只SD大鼠随机分为正常对照组、生理盐水对照组、模型组、电针治疗组,电针治疗组再分为子时（23：00）、卯时（05：00）、午时（11：00）、酉时（17：00）4个电针组,每组8只。每天1次经腹腔注射氯胺酮复制氯胺酮成瘾模型,不同时辰电针组在给药7d后分别选取一侧“足三里”和“三阴交”穴给予低频（2Hz）电针治疗,每次30min,连续治疗7d。采用免疫组织化学染色方法检测mPFC内TH的表达。结果与正常对照组和生理盐水对照组相比较,模型组mPFC内TH免疫反应阳性神经元的数量明显增多（P〈0．01）,细胞平均灰度值降低（P〈0．01）,与模型组相比较,午时、酉时电针组TH免疫反应阳性神经元的数量明显减少（P〈0．01）,细胞平均灰度值升高（P〈0．01）;子时、卯时电针组则无明显变化（P〉0．05）。结论氯胺酮成瘾使mPFC内TH的表达明显增加;午时、酉时电针“足三里”和“三阴交”穴可明显下调mPFC内TH的表达,改善氯胺酮成瘾症状。     

血管紧张素Ⅱ在脊髓水平对吗啡作用的影响

本工作以玻璃微电极记录脊髓腰段（Ｌ２－３）背角神经元电活动,观察血管紧张素Ⅱ（ＡⅡ）对其伤害性诱发放电的影响,并探讨ＡⅡ与吗啡抑制效应的相互关系。结果表明,ＡⅡ５０－５００ｎｇ脊髓表面微量滴注对背角神经元伤害性诱发放电主要为抑制效应,而ＡⅡ２μｇ为易化效应;注射吗啡（５ｍｇ／ｋｇ,ｉｐ）后１０ｍｈ;ＡⅡ２５０ｎｇ脊髓表面微量滴注不能对抗吗啡的抑制作用,而ＡⅡ２一４μｇ则能部分或完全抵消吗啡对背角神经元伤害性诱发放电的抑制作用。本工作提示,ＡⅡ可调制脊髓背角神经元对外周传入的伤害性反应;较大剂量ＡⅡ可对抗吗啡对伤害性诱发放电的抑制作用。     

猫皮层体感Ⅱ区下行活动在中央中核水平针刺镇痛效应中的作用

本文分析了大脑皮层体感Ⅰ区(SⅠ)的下行活动是否参与针刺对疼痛的调节过程。在清醒麻痹家猫观察到,电针穴区对丘脑中央中核(CM)多数神经元的伤害性反应有抑制作用。当用2%利多卡因局部阻滞 SⅠ后,多数神经元的伤害性反应不为电针所抑制。而盐水对照组的电针效应仍与单纯电针组相同,是以抑制为主。在一组神经元同体比较两次电针效应可见,SⅠ局部阻滞的结果是使得电针对伤害性反应的抑制明显减弱甚至消失、抑制时程可被缩短。这表明,针刺镇痛效应与 SⅠ机能状态有关;SⅠ的下行活动参与了针刺效应的产生与维持。     

Are bulbo-spinal serotonergic systems involved in the detection of nociceptive messages? (author's transl)

Intensely noxious peripheral stimuli of the anaesthetized rat produce two changes in the activity of convergent dorsal horn units: the segmental neuronal pool is activated, while all other convergent neurones are inhibited. These Diffuse Noxious Inhibitory Controls (DNIC) are highly potent (60-80% inhibition) and suppress all convergent neuronal activity, whether spontaneous or evoked by noxious or nonnoxious stimuli. On the other hand, they have no effect on other dorsal horn cell types, including noxious-only and proprioceptive units. The "DNIC" circuits include at least one supraspinal relay since DNIC is not seen in spinal animals. Furthermore, they are greatly reduced by lesions of the Nucleus Raphé Magnus (NRM). It has been shown that this nucleus massively projects onto the spinal cord, in particular onto the dorsal horn, and that stimulation of the NRM results in convergent unit inhibition of the same degree of magnitude as with DNIC. The role of serotonergic mechanisms in DNIC can be demonstrated pharmacologically: pCPA pre-treatment (3 daily I.P. injections, 300 mg/kg) or cinanserin (4 mg/kg I.V.) both result in a potent decrease (50-80%). We have proposed that the nociceptive message from the convergent units could result in a contrast between activity of the activated segmental pool and silence of the remaining convergent units. If this hypothesis can be verified, then some raphé nuclei and brain stem serotonergic pathways may function as filters in the detection of nociceptive messages, allowing extraction of information from somatic background activity including the firing from peripheral mechanoreceptors. While superficially paradoxical in fact our hypothesis fits well with the observation of profound analgesia following NRM stimulation: indeed, this hypothetical contrast would be completely eliminated by NRM stimulation since both neuronal pools would then be inhibited.     

传入C纤维的兴奋在中电针“足三里”激活中缝大核中的作用

The purpose of the present work is to study whether the analgesia of "Zusanli" EA was mainly produced by its noxious effect. The antidromic C waves on N. peroneus communis innervating the area of "Zusanli" point were recorded. When "Zusanli" point was stimulated by trains of stimuli, the amplitude of the antidromic C wave was obviously decreased due to collision with the orthodromic stimulation. It was suggested that EA of "Zusanli" could excite some C fibers. It was observed that when the stimulation intensity reached the threshold of C fiber, the NRM neurons were obviously activated, and when it reached or exceeded the intensity for producing the maximal C wave, the NRM neurons were highly activated. Therefore, EA analgesia is probably produced mainly by its noxious stimulus component, especially carried by C fibers, via a negative feedback mechanism in modulating pain.     

刺激大鼠“涌泉”穴诱发的脊髓背表面电位

刺激大鼠“涌泉”穴诱发的节段性背表面电位(Y-sCDP),在远节段(L3-T7)逐渐消失,而在更远节段(C6)又记录到一个背表面电位(Y-dCDP),该电位为一慢电位正波(P波),高位横断脊髓后Y-dCDP完全消失,说明它来源于脊髓上结构,当电解损毁中脑导水管周围灰质(PAG)后,P波幅值显著降低(P<0.05),说明刺激“涌泉”穴产生的Y-dCDP为激活PAG等痛觉调制核团下行诱发的脊髓背表面电位。     

Involvement of Spinal Serotonin Receptors in Electroacupuncture Anti-Hyperalgesia in an Inflammatory Pain Rat Model

We previously showed that electroacupuncture (EA) activates medulla-spinal serotonin-containing neurons. The present study investigated the effects of intrathecal 5,7-dihydroxytryptamine creatinine sulfate, a selective neurotoxin for serotonergic terminals, the 5-hydroxytryptamine 1A receptor (5-HT1AR) antagonist NAN-190 hydrobromide and the 5-HT2C receptor (5-HT2CR) antagonist SB-242,084 on EA anti-hyperalgesia. EA was given twice at acupoint GB30 after complete Freund’s adjuvant (CFA) injection into hind paw. CFA-induced hyperalgesia was measured by assessing hind paw withdrawal latency (PWL) to a noxious thermal stimulus 30 min post-EA. Serotonin depletion and the 5-HT1AR antagonist blocked EA anti-hyperalgesia; the 5-HT2CR antagonist did not. Immunohistochemical staining showed that spinal 5-HT1AR was expressed and that 5-HT2CR was absent in naive and CFA-injected animals 2.5 h post-CFA. These results show a correlation between EA anti-hyperalgesia and receptor expression. Collectively, the data show that EA activates supraspinal serotonin neurons to release 5-HT, which acts on spinal 5-HT1AR to inhibit hyperalgesia.     

Muscarinic-mediated analgesia

Systemic administration of cholinesterase inhibitors which cross the blood brain barrier have long been known to produce analgesia and enhance analgesia from opiates. A major site of analgesic action of cholinergic agents is the spinal cord. Muscarinic receptors are concentrated in the superficial layers of the dorsal horn of the spinal cord, an area of noxious sensory processing, and these reflect innervation primarily from cholinergic neurons with cell bodies deep in the neck of the dorsal horn. Spinal injection of cholinergic agonists results in analgesia which primarily reflects muscarinic receptor activation. Analgesia occurs in animal models of acute noxious stimulation and of chronic hypersensitivity pain. Although no cholinergic agonists have been tested for safety in humans, the cholinesterase inhibitor, neostigmine, has undergone such testing, and produces analgesia to experimental, acute postoperative, and chronic pain. Thus, muscarinic cholinergic agonists and cholinesterase inhibitors hold promise as non-opiate agents for the treatment of moderate to severe acute and chronic pain.     

L-364,718 Potentiates Electroacupuncture Analgesia Through Cck-A Receptor of Pain-Related Neurons in the Nucleus Parafascicularis

Electroacupuncture (EA) has been successfully used to alleviate pain produced by various noxious stimulus. Cholecystokinin-8 (CCK-8) is a neuropeptide involved in the mediation of pain. We have previously shown that CCK-8 could antagonize the analgesic effects of EA on pain-excited neurons (PENs) and pain-inhibited neurons (PINs) in the nucleus parafascicularis (nPf). However, its mechanism of action is not clear. In the present study, we applied behavioral and neuroelectrophysiological methods to determine whether the mechanisms of CCK-8 antagonism to EA analgesia are mediated through the CCK-A receptors of PENs and PINs in the nPf of rats. We found that focusing radiant heat on the tail of rats caused a simultaneous increase in the evoked discharge of PENs or a decrease in the evoked discharge of PINs in the nPf and the tail-flick reflex. This showed that radiant heat could induce pain. EA stimulation at the bilateral ST 36 acupoints in rats for 15 min resulted in an inhibition of the electrical activity of PEN, potentiation of the electrical activity of PIN, and prolongation in tail-flick latency (TFL), i.e. EA stimulation produced an analgesic effect. The analgesic effect of EA was antagonized when CCK-8 was injected into the intracerebral ventricle of rats. The antagonistic effect of CCK-8 on EA analgesia was reversed by an injection of CCK-A receptor antagonist L-364,718 (100 ng/μl) into the nPf of rats. Our results suggest that the pain-related neurons in the nPf have an important role in mediating EA analgesia. L-364,718 potentiates EA analgesia through the CCK-A receptor of PENs and PINs in the nPf.     

Alternative Forms of Interaction of Substance P and Opioids in Nociceptive Transmission

Many years preclinical and clinical anatomic, pharmacologic, and physiologic studies suggest that SP- and opioid-expressing neurons produce opposite biological effects at the spinal level, i.e., nociception and antinociception, respectively. However, in certain circumstances intrathecally administered SP is capable of reinforcing of spinal morphine analgesia and may therefore function as an opioid adjuvant in vivo. The SP dose-response curve of spinally administered SP follows a bell-shaped or inverted-U configuration, permitting pharmacological dissociation of opioid-potentiating and analgesic properties of SP from traditional hyperalgesic effects seen at significantly higher concentrations. This analgesic effect is blocked by naloxone but unaffected by transection of the spinal cord, thus demonstrating the lack of supraspinal modulation. The present report briefly describes both reinforcing and opposing interactions between multiple opioid systems and substance P at the spinal level. We propose that a likely mechanism underlying SP-mediated enhancement of opioid analgesia is the ability of SP to release endogenous opioid peptides within the local spinal cord environment.     

Alternative Forms of Interaction of Substance P and Opioids in Nociceptive Transmission

Summary Many years preclinical and clinical anatomic, pharmacologic, and physiologic studies suggest that SP- and opioid-expressing neurons produce opposite biological effects at the spinal level, i.e., nociception and antinociception, respectively. However, in certain circumstances intrathecally administered SP is capable of reinforcing of spinal morphine analgesia and may therefore function as an opioid adjuvantin vivo. The SP dose-response curve of spinally administered SP follows a bell-shaped or inverted-U configuration, permitting pharmacological dissociation of opioid-potentiating and analgesic properties of SP from traditional hyperalgesic effects seen at significantly higher concentrations. This analgesic effect is blocked by naloxone but unaffected by transection of the spinal cord, thus demonstrating the lack of supraspinal modulation. The present report briefly describes both reinforcing and opposing interactions between multiple opioid systems and substance P at the spinal level. We propose that a likely mechanism underlying SP-mediated enhancement of opioid analgesia is the ability of SP to release endogenous opioid peptides within the local spinal cord environment.     

High and low frequency electroacupuncture analgesia are mediated by different types of opioid receptors at spinal level: a cross tolerance study

Previous studies have shown that rats subjected to low or high frequency electroacupuncture (EA) stimulation release enkephalins or dynorphins respectively to produce analgesia. This conclusion was tested in the present study by using cross tolerance technique for further analysing their receptor mechanisms. The main results were as follows: (1) In rats subjected to 2 Hz EA for 6 h, there was a gradual decrease in the analgesic effect, leading to a state of tolerance to 2 Hz EA analgesia. These rats, however, still responded to 100 Hz EA. Likewise, rats made tolerant to 100 Hz EA were still effective to 2 Hz EA stimulation, showing not significant cross tolerance between 2 Hz and 100 Hz EA analgesia. (2) Rats made-tolerant to 100 Hz EA analgesia showed a diminished response to intrathecal dynorphin A (1-13), a kappa agonist, whereas the analgesic effect of the delta agonist [D-Pen2, D-pen5] enkephalin (DPDPE) remained intact. (3) Rats made tolerant to 2 Hz EA analgesia showed a cross tolerance to DPDPE, but not to dynorphin A (1-13). Results obtained from aforementioned cross tolerance studies suggest that 2 Hz and 100 Hz EA analgesia are mediated by delta and kappa opioid receptors, respectively, at the spinal cord of the rat.