针刺镇痛的外周经穴离子机理研究

Study on an Ionic Mechanism of Peripheral Acupoint on Acupuncture Analgesia

本文主要从中医理论观点出发，从生物化学的角度，紧紧抓住与机体生理调节密切相关的K+、Na+、Ca2+，以单纯胃脏的功能性疼痛为模型，以足三里等穴位为刺激点，分别对单纯胃痛、胃痛并行针刺时穴位处K+、Na+、Ca2+浓度进行了检测，在此基础上又对改变穴位处K+、Na+、Ca2+浓度时对针刺疗效的影响进行了进一步的观察。结果发现，胃痛时足三里穴处的K+、Na+、Ca2+浓度存在着K+升，Na+、Ca2+降的变化趋势。当针刺足三里时，胃经线上它穴的K+、Na+、Ca2+浓度又都恢复正常，且这种离子变化具有经穴脏腑相关的特异性。当人为改变穴位处离子浓度时表现为，降低时针效减弱或消失，增加时能替代针效。说明K+、Na+、Ca2+确实参与了针刺镇痛时的外周经络活动。并与针刺镇痛效果有密切关系，值得我们进一步深入研究。

To primarily discuss peripheral mechanism of acupuncture, the ionic selective needle-shapedelectrode technology was used to observe the changes of K+、Na+、Ca2+ concentration on meridian line due to visceralgia and acupuncture analgesia. Furthermore, the influence of changing acupoint ionic concentration or blocking ionic channel in acupoint on effect of acupuncture analgesia also studied.(1) Visceralgia can cause the changes of K+、 Na+、 Ca2+ concentration in meridian, while acupuncture can inhibit this kind of changes, when visceralgia happened, the K+、Na+、Ca2+ concentration under' Zusanli' (ST 36 ),' Futu' (ST 32 ),' Qichong' (SB 25 ) points and 1 cm inferior to' Tianshu' (ST 25) point showed a different changing tendency, K+ concentration risen while that of Na+and Ca2+ decreased, with the reliviation of pain, the concentration recovered to normal state. Above results implied that visceralgia accompanied the concentration changes of K+、 Na+、 Ca2+ in corresponding points, the tendency of the changes showed a synchronous relation with the development of the pain, when acupuncture analgesia was effective, above changes were inhibited.(2) The concentration changes of K+、 Na+、 Ca2+ in corresponding peripheral meridian line can influence the effect of acupuncture analgesia. Effect of acupuncture analgesia could be inhibited by acupoints injection of the Ca2+ complexing agent EDTA, channel blocking agents such as Mn2+, nimodine lerapamil hydrochloride, Na+ channel blocking agent TTX and K+ channel blocking agent TEA. The similar effect of acupuncture analgesia could be obtained by exteriorly increasing the Na+ and Ca2+ concentration in local acupoints. Above results demonstrated that there was a close relationship between the generation of acupuncture analgesia effect and the concentration changes of K+、 Na+、Ca2 +, which indicate that K +、Na+、Ca2 + on peripheral meridian line is involved in the modification of pain.