脊柱推拿对中枢神经系统影响的研究进展

Research Progress in Influences of Spinal Manipulation on Central Nervous System

大量的临床实践证实,脊柱推拿是防治脊柱退行性疾病的有效手段。对于脊柱推拿的起效机制,既往研究多聚焦在脊柱推拿的生物力学效应,而对其神经生物学效应的关注度不足。然而,根据医学及生物学的基础知识可知,脊柱推拿的生物力学效应并不能直接改善患者的临床症状,疼痛和功能障碍的恢复必然有神经系统的介导,尤其是中枢神经系统介导脊柱推拿在镇痛和改善脊柱功能方面的作用机制是基础研究必须解决的问题。因此,就脊柱推拿对中枢神经系统影响的研究进行了梳理,分别从脊柱推拿的中枢易化作用、中枢性疼痛耐受和抑制疼痛传递作用及其对脑相关功能活动的影响三个方面进行了论述,并指出了未来相关领域的研究方向。

Confirmed by a large number of clinical practice, spinal manipulation is an effective modality for prevention and treatment of spinal degenerative disease. Most of the previous researches on effective mechanism of spinal manipulation focus on biomechanics, while lack of neurobiology. The biomechanical effects of spinal manipulation can not directly improve clinical symptoms on the basis of the knowledge of medicine and biology, and the recovery of pain and dysfunction must involve in nervous system, especially the mechanisms of spinal manipulation on analgesia and spinal functional improvement mediated by central nervous system must be solved in basic research. This paper reviews the research progress in influences of spinal manipulation on central nervous system from the following aspects： central facilitation, central pain tolerance and transduction inhibition, and the influence of spinal manipulation on brain function, and Points out the research direction of correlative field.