针灸治疗神经病理痛:聚焦交感神经系统

Acupuncture for neuropathic pain: focusing on the sympathetic nerve system

周围神经损伤后,交感神经系统与诱发或加重疼痛的伤害性输入产生相互作用;背根神经节(DRG)内交感神经发芽,芽生的交感神经包绕感觉神经元,引发感觉神经元异常放电;此外,大脑中与疼痛相关的脑区与交感神经系统的高级中枢存在部分重叠。针灸已广泛用于治疗神经病理痛,且针灸对自主神经系统有积极的调节作用。在既往研究的基础上,本文提出针灸通过调节经系统缓解神经病理痛的几种可能。针灸可作用于疼痛与交感神经系统相关的脑区;可抑制病理状态下交感神经的异常兴奋;可抑制交感神经的发芽;可减少感觉神经元的异常放电。未来还需要更加深入的研究来证实这些假设,这将有助于更好地理解针灸治疗神经病理痛的潜在机制。

Following peripheral nerve injury,the sympathetic nervous system responds to noxious inputs that induce or exacerbate pain.Dorsal root ganglion(DRG)sympathetic sprouting after peripheral nerve injury may induce abnormal firing of neurons.Moreover,the areas of the brain that respond to nociceptive stimuli overlap with those areas activated by the sympathetic nervous system.Acupuncture is a widely used alternative therapy for neuropathic pain.It has been demonstrated that it has positive effects on the regulation of function in the autonomic nervous system.Based on previous studies,there are several possibilities for the regulation of sympathetic nerves by using acupuncture to relieve neuropathic pain.Acupuncture may act on the brain areas of pain and the sympathetic nervous system,decrease sympathetic nerve activity during neuropathic pain,attenuate sympathetic sprouting,and reduce the abnormal firing of neurons.Further studies are required to confirm these hypotheses.This review will help to better understand the potential mechanisms of acupuncture in neuropathic pain.