夹脊穴电针与脊髓电刺激治疗疼痛的异同探析

Analysis of the similarities and diff erences between Jiaji electroacupuncture and spinal cord stimulation in the treatment of pain

夹脊穴电针与脊髓电刺激是临床上常用于疼痛的非药物治疗方式,二者在镇痛治疗上均以电刺激为手段,在脉冲电流、刺激频率与波宽有重合之处,同时受疼痛门控理论的影响,且刺激量大小可根据病情调节。夹脊穴电针与脊髓电刺激植入刺激部位相同,但两种方法植入的方式不同;具有部分类似的镇痛机制,如5-羟色胺、γ-氨基丁酸和乙酰胆碱的介导,镇痛机制的区别是脊髓电刺激可调节脊柱-脑干-脊髓环发挥作用;夹脊穴电针镇痛机制为调节疼痛相关蛋白基因的表达、调控信号通路。此外,夹脊穴与脊髓神经节段有对应关系,二者作用的靶器官存在联系。

Electroacupuncture at Jiaji points and spinal cord stimulation are commonly used in clinical non-drug treatment for pain.Both of them use electrical stimulation as a means of analgesic treatment,and there are overlaps in pulse current intensity,stimulation frequency and wave width.They are both infl uenced by the gate control theory on pain,and the amount of stimulation can be adjusted according to patients’conditions.Jiaji electroacupuncture and spinal cord stimulation are implanted at the same site,but the two stimulations are implanted in diff erent ways.The two methods have some partly similar analgesic mechanism,such as through the mediation of 5-hydroxytrypserotonin,gamma-aminobutyric acid and acetylcholine.The difference in their analgesic mechanism lies in that spinal cord stimulation acts by regulating the spine-brainstem-spinal cord loop,while electroacupuncture at Jiaji points functions by regulating the expression of pain-related protein genes and regulating signal pathways.In addition,Jiaji points have a corresponding relationship with the spinal nerve segments,and the target organs the two therapies act on are related to each other.