近20年夹脊穴针刺镇痛机制探讨

Exploration about Analgesia Mechanism of Needling Jiaji Points in Recent Twenty Years

综述近20年来夹脊穴针刺镇痛的动物实验与临床研究报道,从对神经-内分泌-免疫系统的影响、对疼痛相关基因表达的影响、对p38MAPK、cAMP-PKA、ERK/NK-1信号通路的影响这3个主要方面,分析针刺夹脊穴的镇痛机制。认为针刺夹脊穴有良好的镇痛效果,但仍存在缺乏多中心、大样本、高质量的临床随机对照试验研究、缺乏对细胞分子学、生物化学水平的深入研究、侧重于镇痛的即时与短期效应、对长期镇痛效果的维持关注不够等不足。今后应在循证医学的指导下,开展严谨科学的研究来提高研究质量,进一步探索针刺夹脊穴的镇痛机制。

The animal experimental and clinical researches of recent 20 years were reviewed in terms of acupuncture analgesia with Jiaji points.The analgesic mechanism was analyzed and explained from three main aspects: the influence to nerve-endocrine-immune system,the influence to the expression of pain-related genes,and the influence to signaling pathways of p38MAPK,cAMP-PKA and ERK/NK-1.It is found out that acupuncture has good analgesic effect,but there is still a lack of randomized clinical trials of multi-center,large-sample and high-quality,a lack of in-depth study of molecular biology levels.The researches mainly focused on the immediate and short-term analgesic effect,long-term analgesic effect and maintenance of analgesic effects were not paid more attention to.More high-quality studies should be carried out to further explore the analgesic mechanism of needling Jiaji points under the guidance of evidence-based medicine.