缺血性按压与针刺激痛点镇痛机理与临床应用

Mechanisms and clinical applications of ischemic compression and acupuncture of trigger point for analgesia

疼痛是一种主观感觉,其客观指征有肌电活动、血流量变化、心理变化等,临床上使用缺血性按压手法和针刺治疗收到了较好的治疗效果。本文分别从疼痛与止痛方面予以概述,主要包括:钙离子理论:肌纤维损伤或者被施加过多非正常压力时,胞浆内钙离子增多,肌纤维发生自动收缩、变短,加剧了能量代谢障碍,不良循环继续恶化,出现紧张性条索状物,局部出现疼痛等不适,针刺使中脑中央灰质细胞内钙离子浓度降低,痛觉阈值升高,痛觉减退;生理生化改变;运动终板:运动终板出现机能障碍,敏感病灶接受到刺激后可引起一系列疼痛症状,针刺激痛点产生负性电位波,化解疼痛;经络理论;针刺止痛;针刺与病损性疼痛信号在大脑整合,针刺信号与疼痛等伤害刺激信号传至到巨细胞核,两种信号相互叠加作用,产生干扰,抑制伤害性疼痛刺激;针刺与神经传导通路理论;缺血性按压使局部缺氧改善,肌电图改变等;激痛点与针灸穴位的相关性;针灸使交感神经活动度降低;针灸与缺血性按压治疗肌筋膜等疼痛的临床应用等。

Pain is a subjective feeling,and its objective indications include electromyographic activity,changes in blood flow,psychological changes,and so on.The clinical use of ischemic compression and acupuncture of trigger point has also received a good therapeutic effect.This article is summarized from the aspects of pain and analgesia.It mainly includes:calcium ion theory:calcium ion theory,when muscle fiber is damaged or applied too much abnormal pressure,the calcium ion increases in the cytoplasm,muscle fiber occurs automatic contraction and shorten,aggravate the energy metabolism disorder,the adverse circulation continued to worsen,the appearance of tension cords,local pain and other discomfort,acupuncture reduced the concentration of calcium ion in the central gray matter cells of the midbrain,increased the pain threshold,decreased pain sensation,physiological and biochemical changes;motor end-plate:motor end-plate dysfunction,sensitive focus can cause a series of pain symptoms after receiving stimulation,acupuncture of trigger point produces negative potential wave to resolve the pain;meridian theory;acupuncture analgesia;the integration of acupuncture and pathological pain signals in the brain,and the transmission of acupuncture and pain signals to the giant cell nucleus,the two signals superimposed on each other,resulting in interference and suppression of nociceptive pain stimulation;acupuncture and nerve conduction pathway theory,improvement of local anoxia and changes of electromyography by ischemic compression,correlation between trigger points and acupoints,reduction of sympathetic nervous system activity by acupuncture;clinical application of acupuncture and ischemic compression in the treatment of myofascial pain.