痛觉适应性的实验研究

问题由于刺激物作用时间延长或次数的增加,感受器官的感受性可呈现出增高或降低的趋势。这统称为感觉的适应现象。当一刺激连续或多次作用于感官并经历一段时间之后,如果感受性出现下降的现象,那么这种现象便被称为负适应(negative adaptation)。在触觉、压觉和温度觉中,这种现象是很明显的。很早以前,韦伯(Weber 1846)以及E·Gertz(1921)就进行过经典的研究并且有所结论。可是在痛觉中,按传统的观点认为,“

青龙木叶皂苷的镇痛作用及其机制

目的:探讨青龙木叶皂苷的镇痛效应及其机制。方法:60只Wistar大鼠随机分为5组(每组12只):青龙木叶皂苷15、30、60μg.kg-1组,青龙木叶皂苷加纳洛酮组及生理盐水对照组。通过预先手术埋置的脑室套管向侧脑室注射青龙木叶皂苷,用辐射热甩尾法测定大鼠痛阈。结果:侧脑室注射3种不同剂量青龙木叶皂苷组的痛阈在注射5 min后与生理盐水对照组比较有不同程度的提高。15μg.kg-1组的痛阈虽然有提高,但与对照组比较差异无显著性(P>0.05);30μg.kg-1组的痛阈提高持续50 min,60μg.kg-1组的痛阈提高可持续60 min以上,与对照组比较差异有显著性(P<0.05或P<0.01)。对照组大鼠的痛阈在60 min内无明显变化(P>0.05)。且青龙木叶皂苷镇痛效应可被纳洛酮所翻转。结论:青龙木叶皂苷具有较强镇痛效应及剂量-镇痛效应关系,其镇痛作用(痛阈升高)是通过脑内μ阿片受体实现的。

痛觉测试笔的临床研究

目的通过应用痛觉测试笔测试痛觉平面,探讨其临床应用的实用性。方法选择100名志愿者观察痛觉测试笔产生刺痛感的定性描述,另500例行硬膜外阻滞的患者用针刺法和测试笔同时间同检查部位测试。结果100名志愿者认为痛觉测试笔对皮肤只引起如针刺样疼痛,每次测试产生刺痛程度一致,不产生肌肉抽搐、不放散。500例行硬膜外阻滞患者针刺法和测试笔测得的麻醉平面一致,测试笔无划痕反应。结论测试笔可替代锐器针刺法检测麻醉平面,可减少针刺法引起的皮肤损伤。

老年带状疱疹患者急性期T细胞亚群变化及其与疱疹相关性疼痛的关系

目的检测老年带状疱疹患者急性期外周血T细胞亚群水平，观察患者急性期机体细胞免疫状态与带状疱疹急性期疼痛（AHP）和后遗神经痛（PHN）的关系。方法选择急性期老年带状疱疹患者60例，根据AHP视觉模拟评分（visual analogue scales，VAS）分为轻中度AHP组：VAS评分≤6分，重度AHP组：VAS评分〉6分；再根据随访结果是否发生带状疱疹后PHN分为非PHN组和PHN组。选取年龄、性别相匹配的门诊健康体检者25例作为对照组。记录患者AHP最严重时VAs评分，采用流式细胞测定技术测定急性期外周血T细胞亚群CD3＋、CD4＋和CD8＋百分比及计算CD4＋／CD8＋比值。结果各组年龄、性别差异无统计学意义（P〉0．05）；轻中度AHP组、重度AHP组、非PHN组和PHN组CD3＋、CD4＋、CD8＋表达与对照组比较均降低（P〈0．05），重度AHP组CD4＋表达低于轻中度AHP组（P〈0．05）；CD4＋／CD8＋比值轻中度AHP组、非PHN组均高于对照组（P〈0．05），重度AHP组低于轻中度AHP组（P〈0．05），PHN组低于非PHN组（P〈0．05）；PHN组AHPVAS评分高于非PHN组（P〈0．05）。结论老年带状疱疹患者急性期普遍存在细胞免疫功能低下，表现为T细胞亚群百分比降低；重度AHP患者细胞免疫状态更低。PHN患者在疱疹急性期存在更严重的局部损害和更低下免疫应答。

Efficacy study on pestle needle combined with Chinese herbal fumigation for cervical spondylosis

Objective：To observe the clinical effect of pestle needle combined with Chinese herbal fumigation on cervical spondylosis and provide a safe effective therapy for this condition.Methods：A total of 54 cases were randomly allocated into two groups（27 cases in each group） according to their sequence of consultation.Patients in both groups were treated with the same Chinese herbal fumigation.Patients in the treatment group were additionally treated with pestle needle therapy on a unique set of Ba Zhen points around Dazhui（GV 14）,Fengfu（GV 16） and the distance between Naohu（GV 17） and Dazhui（GV 14） along the He Che pathway,whereas patients in the control group were additionally treated with routine acupuncture therapy.Then the short-term and long-term efficacies were observed and compared after treatment using the visual analog scale（VAS） and pain rating index（PRI）.Results：At the end of treatment,VAS scores were significantly decreased in both groups,and the VAS score in the treatment group was lower than that in the control group（P〈0.05）.The intra-group differences were statistically significant in VAS scores 1 month,3 and 6 months after treatment（all P〈0.05）.At the end of treatment,the sensory and total PRI scores in the treatment group were significantly lower than those in the control group,showing statistically significant differences（both P〈0.01）;and there was no significant between-group difference（P〈0.05） in the affective PRI score.At the end of treatment,the total effective rate was 85.2% in the treatment group,versus 65.4% in the control group,showing a statistical significance（P〈0.05）.The follow-up six months later showed that the total effective rate was 92.6% in the treatment group,versus 76.9% in the control group,showing a statistical significance（P〈0.05）.Conclusion：Pestle needle therapy is a stable and positive therapy for cervical spondylosis.

Clinical efficacy of sticking-needle acupuncture plus tendon-regulating manipulation in the treatment of acute ankle sprain

Objective To explore the treatment effect of sticking-needle acupuncture plus tendon-regulating manipulation on pain,swelling and joint dysfunction due to acute ankle sprain.Methods A total of 80 patients with acute ankle sprain were recruited and divided into a control group and a treatment group according to the random number table method,with 40 patients in each group.Both groups received the same conventional interventions.The control group was treated with additional tendon-regulating manipulation,and the treatment group was treated with tendon-regulating manipulation plus sticking-needle acupuncture.The pain,swelling and joint dysfunction of the ankle were observed in both groups before and after 3 d,7 d and 14 d of treatment.Results Before treatment,there was no statistically significant difference in the visual analog scale(VAS)score of pain between the two groups(P>0.05).After treatment,the VAS scores of both groups showed a decreasing trend over time,and the differences within the groups were statistically significant(P<0.05).After 3 d,7 d and 14 d of treatment,the VAS scores in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).Before treatment,there was no statistically significant difference in the degree of swelling between the two groups(P>0.05).After treatment,the degrees of swelling in both groups showed a decreasing trend over time,and the differences within the groups were statistically significant(P<0.05).After 3 d and 7 d of treatment,the degrees of swelling in the treatment group were lower than those in the control group,with statistically significant differences(P<0.05).There was no statistical difference in the degree of swelling between the two groups after 14 d of treatment(P>0.05).Before treatment,there was no statistically significant difference in the American Orthopedic Foot Ankle Society(AOFAS)ankle-hindfoot scale score between the two groups(P>0.05).After treatment,the AOFAS ankle-hindfoot scale scores of both groups showed an increasing trend over time,and all the differences within the groups were statistically significant(P<0.05).After 3 d,7 d and 14 d of treatment,the AOFAS ankle-hindfoot scale scores in the treatment group were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion Based on the routine intervention,the addition of sticking-needle acupuncture and tendon-regulating manipulation was better in alleviating pain and swelling and improving joint function in patients with acute ankle sprain than the addition of tendon-regulating manipulation alone.