针刺双向调节效应及可能机制

Bidirectional regulation of acupuncture and its plausible mechanisms

针刺对机体机能的调节作用及其机制研究已积累了大量资料,并引起国际生物医学界的兴趣。针刺双向调节效应即相同穴位相同刺激对系统功能亢进或低下状态均可产生纠正作用,是中国生物医学工作者多年来在不同实验研究中观察到的机能调节现象。此现象近年也被国际同行观察到。针刺双向调节效应多见于病理状态的事实提示,外周神经刺激产生的生物调节效应在生理状态与病理状态下的反应模式不尽相同,其即刻效应与长时效应的机制也不同。这不仅对针刺疗法及其疗效的理解和发展有重要意义,而且对生物调控过程本身的认识有所启示。本文从针刺效应之靶系统固有特性、靶系统功能状态、穴位特性及刺激参数等4个方面总结了针刺双向调节效应的基本特点和产生条件,并从外周纤维类型和中枢适应性调节两个关键环节分析针刺双向调节效应的可能机制。不同类型的外周神经纤维刺激后可产生相反的调节效应,若针刺混合纤维,则可能在不同病理状态下显示不同方向的效应。针刺也可能通过激发中枢适应性控制机制调节各生理系统的负反馈功能而表现出双向调节效应。

The effects of acupuncture on functional regulation of biological systems have been studied extensively. The most interesting feature of acupuncture is the bidirectional regulatory ability to restore homeostatic values of body systems from either up or down states,which was found by Chinese biomedical researchers several decades ago,and has recently been observed by peers internationally. Acupuncture can produce two physiological response patterns,an immediate short-term response or/and a long-lasting response. The bidirectional regulatory effects of acupuncture are rarely observed under physiological states(normal homeostasis),rather,they are usually observed under pathological states(abnormal homeostasis)with long-lasting response patterns. This suggests that the effects of acupuncture under pathological states are different from the mechanisms under normal physiological states. This is important for understanding and developing acupuncture therapy,and also gives insight into understanding the biological control process itself.The present paper reviews the experimental literature and discusses the four conditions that produce bidirectional regulation of acupuncture,i. e. the inherent properties of the target systems,the functional states of the target system,the acupoint characteristics,and the stimulation parameters. Finally,two hypotheses are proposed to explain the mechanisms of bidirectional effects of acupuncture. The possible peripheral mechanism is that acupuncture can stimulate different types of peripheral nerve fibers to produce opposite regulatory effects;and the possible central mechanisms is that acupuncture might activate the adaptive control process of the central nervous system to restore homeostatic balance.