电针治疗神经病理痛的临床疗效及其相关机制研究进展
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摘要
电针治疗神经病理痛如坐骨神经痛、三叉神经痛及带状疱疹后遗痛疗效确切,其可通过促进阿片类物质释放、调节5-HT、去甲肾上腺素、氨基酸、抑制胶质细胞或细胞因子等作用从而产生镇痛效应。本文将就电针治疗神经病理痛的临床疗效及其相关机制进行综述。
Electroacupuncture therapy has definite curative effect on neuropathic pain such as sciatica, trigeminal neuralgia and post-herpetic neuralgia, which can produce analgesic effect by promoting opioid release, regulating 5-HT, norepinephrine, amino acid, inhibiting glial cells or cytokines.This article will review the therapeutic effect of electroacupuncture therapy on neuropathic pain and its mechanisms.
Electroacupuncture therapy has definite curative effect on neuropathic pain such as sciatica, trigeminal neuralgia and post-herpetic neuralgia, which can produce analgesic effect by promoting opioid release, regulating 5-HT, norepinephrine, amino acid, inhibiting glial cells or cytokines.This article will review the therapeutic effect of electroacupuncture therapy on neuropathic pain and its mechanisms.
引文
[1]Jensen TS,Baron R,Haanp??M,et al.A new definition of neuropathic pain[J].Pain,2011,152(10):2204-2205.
[2]李银武,孟凡一.电针治疗原发性坐骨神经痛的临床疗效观察[J].针灸临床杂志,2011,27(9):28-29.
[3]李凯,许辛寅,丁德光.电针加穴位注射治疗根性坐骨神经痛的疗效观察[J].针灸推拿医学(英文版),2015,(1):32-35.
[4]金晶,秦慧娟.不同频率电针治疗坐骨神经痛的临床观察[J].中西医结合心血管病杂志,2016,18(4):186-187.
[5]刘璇,刘志顺,黄石玺.电针治疗坐骨神经痛刺激参数的文献分析[J].中国针灸,2009,29(12):1026-1028.
[6]郭勤,王振宇,尹洪娜,等.电针夹脊穴治疗原发性三叉神经痛临床观察[J].上海针灸杂志,2017,36(4):392-396.
[7]刘坤,郭锦华,王丽娟,等.高频电针联合卡马西平治疗三叉神经痛32例临床观察[J].江苏中医药,2016,48(5):68-69.
[8]王宗江.高频电针治疗原发性三叉神经痛30例[J].实用中医药杂志,2014,30(1):48-49.
[9]徐斯伟,胡蔚琼.电针配合温灸治疗三叉神经痛疗效观察[J].上海针灸杂志,2010,29(2):97-98.
[10]姜丽芳,顾一煌.深刺夹脊穴结合等电势电针围刺治疗带状疱疹神经后遗痛的临床观察[J].中国中医急症,2016,25(5):913-915.
[11]石育才.电针治疗带状疮疹后遗神经痛1例[J].针灸临床杂志,2007,23(5):27-28.
[12]刘铭,马晖,谢春光.电针联合经皮神经电刺激治疗带状疱疹后遗神经痛32例[J].辽宁中医杂志,2015,42(7):1318-1320.
[13]杨志刚,潘春联.加巴喷丁联合电针疗法治疗带状疱疹后遗神经痛的临床疗效分析[J].临床医学工程,2016,23(1):43-44,47.
[14]康朝霞.电针夹脊穴配合穴位注射治疗带状疱疹后遗神经痛的临床研究[D].湖北中医药大学,2016.
[15]顾莎.电针透穴刺法对原发性三叉神经痛中P物质和β-内啡肽水平影响的临床研究[D].黑龙江省中医药科学院,2014.
[16]周杰,陈贞羽,龚杰,等.不同参数组合电针对SNL大鼠镇痛效应观察及对下丘脑内啡肽的影响[J].中国医药导报,2017,14(23):18-21.
[17]Meng X,Zhang Y,LI A,et al.The effects of opioid receptor antagonists on electroacupuncture-produced anti-allodynia/hyperalgesia in rats with paclitaxel-evoked peripheral neuropathy[J].Brain Res,2011,1414:58-65.
[18]Kim SK,Park JH,Bae SJ,et al.Effects of electroacupuncture on cold allodynia in a rat model of neuropathic pain:Mediation by spinal adrenergic and serotonergic receptors[J].Exp Neurol,2005,195(2):430-436.
[19]Zhang Y,Zhang RX,Zhang M,et al.Electroacupuncture inhibition of hyperalgesia in an inflammatory pain rat model:Involvement of distinct spinal serotonin and norepinephrine receptor subtypes[J].Br J Anaesth,2012,109(2):245-252.
[20]闫丽萍,吴辛甜,殷忠勇,等.电针对坐骨神经慢性压迫性损伤大鼠脊髓氨基酸类递质水平的影响[J].针刺研究,2011,36(5):353-356,379.
[21]马骋,李翠贤,易建良,等.电针对神经病理性疼痛大鼠背根神经节和脊髓谷氨酸和天门冬氨酸含量的影响[J].针刺研究,2008,33(4):250-254.
[22]Park JH,Han JB,Kim SK,et al.Spinal GABA receptors mediate the suppressive effect of electroacupuncture on cold allodynia in rats[J].Brain Res,2010,1322:24-29.
[23]曾杰.电针对神经病理痛模型大鼠脊髓兴奋性氨基酸转运体的影响[D].华中农业大学,2016.
[24]马骋,李翠贤,闫丽萍.电针对大鼠神经病理痛SNI模型脊髓背角传人神经末梢Glu影响的微透析和免疫组化分析[C].//中国针灸学会经络分会第十届学术会议论文集,南京中医药大学,2009:190-193.
[25]Gim GT,Lee JH,Park E,et al.Electroacupuncture attenuates mechanical and warm allodynia through suppression of spinal glial activation in a rat model of neuropathic pain[J].Brain Res Bull,2011,86(5-6):403-411.
[26]Choi DC,Lee JY,Lim EJ,et al.Inhibition of ROS-induced p38MAPK and ERK activation in microglia by acupuncture relieves neuropathic pain after spinal cord injury in rats[J].Exp Neurol,2012,236(2):268-282.
[27]Liang Y,Qiu Y,Du J,et al.Inhibition of spinal microglia and astrocytes contributes to the antiallodynic effect of electroacupuncture in neuropathic pain induced by spinal nerve ligation[J].Acupunct Med,2016,34(1):40-47.
[28]Cha MH,Nam TS,Kwak Y,et al.Changes in cytokine expression after electroacupuncture in neuropathic rats[J].Evid Based Complement Alternat Med,2012,2012:792765.
[29]Lau WK,Chan WK,Zhang JL,et al.Electroacupuncture inhibits cyclooxygenase-2 up-regulation in rat spinal cord after spinal nerve ligation[J].Neuroscience,2008,155(2):463-468.
[30]Park JH,Kim SK,Kim HN,et al.Spinal cholinergic mechanism of the relieving effects of electroacupuncture on cold and warm allodynia in a rat model of neuropathic pain[J].J Physiol Sci,2009,59(4):291-298.
[31]Dong ZQ,Ma F,Xie H,et al.Changes of expression of glial cell line-derived neurotrophic factor and its receptor in dorsal root ganglions and spinal dorsal horn during electroacupuncture treatment in neuropathic pain rats[J].Neurosci Lett,2005,376(2):143-148.
[32]蒋永亮,尹小虎,沈亚芳,等.低频电针改善SNL模型大鼠早期神经痛背根神经节辣椒素受体的机制[J].上海针灸杂志,2014,33(5):476-479.
[33]Jiang YL,Yin XH,Shen YF,et al.Low Frequency Electroacupuncture Alleviated Spinal Nerve Ligation Induced Mechanical Allodynia by Inhibiting TRPV1 Upregulation in Ipsilateral Undamaged Dorsal Root Ganglia in Rats[J].Evid Based Complement Alternat Med,2013,2013:170910.
[34]何晓芬,蒋永亮,叶佳瑜,等.低频电针对SNI神经痛大鼠脊髓背角P物质表达的影响[J].上海针灸杂志,2017,36(12):1469-1474.
[35]Yu J,Zhao C,Luo X.The effects of electroacupuncture on the extracellular signal-regulated kinase 1/2/P2X3 signal pathway in the spinal cord of rats with chronic constriction injury[J].Anesth Analg,2013,116(1):239-246.
[36]He XF,Wei JJ,Shou SY,et al.Effects of electroacupuncture at 2and 100 Hz on rat type 2 diabetic neuropathic pain and hyperalgesia-related protein expression in the dorsal root ganglion[J].J Zhejiang Univ Sci B,2017,18(3):239-248.
[37]Rong PJ,Ma SX.Electroacupuncture Zusanli(ST36)on release of nitric oxide in the gracile nucleus and improvement of sensory neuropathies in Zucker diabetic fatty rats[J].Evid Based Complement Alternat Med,2011,2011:134545.
[38]Cha MH,Bai SJ,Lee KH,et al.Acute electroacupuncture inhibits nitric oxide synthase expression in the spinal cord of neuropathic rats[J].Neurol Res,2010,32(Suppl 1):96-100.
[2]李银武,孟凡一.电针治疗原发性坐骨神经痛的临床疗效观察[J].针灸临床杂志,2011,27(9):28-29.
[3]李凯,许辛寅,丁德光.电针加穴位注射治疗根性坐骨神经痛的疗效观察[J].针灸推拿医学(英文版),2015,(1):32-35.
[4]金晶,秦慧娟.不同频率电针治疗坐骨神经痛的临床观察[J].中西医结合心血管病杂志,2016,18(4):186-187.
[5]刘璇,刘志顺,黄石玺.电针治疗坐骨神经痛刺激参数的文献分析[J].中国针灸,2009,29(12):1026-1028.
[6]郭勤,王振宇,尹洪娜,等.电针夹脊穴治疗原发性三叉神经痛临床观察[J].上海针灸杂志,2017,36(4):392-396.
[7]刘坤,郭锦华,王丽娟,等.高频电针联合卡马西平治疗三叉神经痛32例临床观察[J].江苏中医药,2016,48(5):68-69.
[8]王宗江.高频电针治疗原发性三叉神经痛30例[J].实用中医药杂志,2014,30(1):48-49.
[9]徐斯伟,胡蔚琼.电针配合温灸治疗三叉神经痛疗效观察[J].上海针灸杂志,2010,29(2):97-98.
[10]姜丽芳,顾一煌.深刺夹脊穴结合等电势电针围刺治疗带状疱疹神经后遗痛的临床观察[J].中国中医急症,2016,25(5):913-915.
[11]石育才.电针治疗带状疮疹后遗神经痛1例[J].针灸临床杂志,2007,23(5):27-28.
[12]刘铭,马晖,谢春光.电针联合经皮神经电刺激治疗带状疱疹后遗神经痛32例[J].辽宁中医杂志,2015,42(7):1318-1320.
[13]杨志刚,潘春联.加巴喷丁联合电针疗法治疗带状疱疹后遗神经痛的临床疗效分析[J].临床医学工程,2016,23(1):43-44,47.
[14]康朝霞.电针夹脊穴配合穴位注射治疗带状疱疹后遗神经痛的临床研究[D].湖北中医药大学,2016.
[15]顾莎.电针透穴刺法对原发性三叉神经痛中P物质和β-内啡肽水平影响的临床研究[D].黑龙江省中医药科学院,2014.
[16]周杰,陈贞羽,龚杰,等.不同参数组合电针对SNL大鼠镇痛效应观察及对下丘脑内啡肽的影响[J].中国医药导报,2017,14(23):18-21.
[17]Meng X,Zhang Y,LI A,et al.The effects of opioid receptor antagonists on electroacupuncture-produced anti-allodynia/hyperalgesia in rats with paclitaxel-evoked peripheral neuropathy[J].Brain Res,2011,1414:58-65.
[18]Kim SK,Park JH,Bae SJ,et al.Effects of electroacupuncture on cold allodynia in a rat model of neuropathic pain:Mediation by spinal adrenergic and serotonergic receptors[J].Exp Neurol,2005,195(2):430-436.
[19]Zhang Y,Zhang RX,Zhang M,et al.Electroacupuncture inhibition of hyperalgesia in an inflammatory pain rat model:Involvement of distinct spinal serotonin and norepinephrine receptor subtypes[J].Br J Anaesth,2012,109(2):245-252.
[20]闫丽萍,吴辛甜,殷忠勇,等.电针对坐骨神经慢性压迫性损伤大鼠脊髓氨基酸类递质水平的影响[J].针刺研究,2011,36(5):353-356,379.
[21]马骋,李翠贤,易建良,等.电针对神经病理性疼痛大鼠背根神经节和脊髓谷氨酸和天门冬氨酸含量的影响[J].针刺研究,2008,33(4):250-254.
[22]Park JH,Han JB,Kim SK,et al.Spinal GABA receptors mediate the suppressive effect of electroacupuncture on cold allodynia in rats[J].Brain Res,2010,1322:24-29.
[23]曾杰.电针对神经病理痛模型大鼠脊髓兴奋性氨基酸转运体的影响[D].华中农业大学,2016.
[24]马骋,李翠贤,闫丽萍.电针对大鼠神经病理痛SNI模型脊髓背角传人神经末梢Glu影响的微透析和免疫组化分析[C].//中国针灸学会经络分会第十届学术会议论文集,南京中医药大学,2009:190-193.
[25]Gim GT,Lee JH,Park E,et al.Electroacupuncture attenuates mechanical and warm allodynia through suppression of spinal glial activation in a rat model of neuropathic pain[J].Brain Res Bull,2011,86(5-6):403-411.
[26]Choi DC,Lee JY,Lim EJ,et al.Inhibition of ROS-induced p38MAPK and ERK activation in microglia by acupuncture relieves neuropathic pain after spinal cord injury in rats[J].Exp Neurol,2012,236(2):268-282.
[27]Liang Y,Qiu Y,Du J,et al.Inhibition of spinal microglia and astrocytes contributes to the antiallodynic effect of electroacupuncture in neuropathic pain induced by spinal nerve ligation[J].Acupunct Med,2016,34(1):40-47.
[28]Cha MH,Nam TS,Kwak Y,et al.Changes in cytokine expression after electroacupuncture in neuropathic rats[J].Evid Based Complement Alternat Med,2012,2012:792765.
[29]Lau WK,Chan WK,Zhang JL,et al.Electroacupuncture inhibits cyclooxygenase-2 up-regulation in rat spinal cord after spinal nerve ligation[J].Neuroscience,2008,155(2):463-468.
[30]Park JH,Kim SK,Kim HN,et al.Spinal cholinergic mechanism of the relieving effects of electroacupuncture on cold and warm allodynia in a rat model of neuropathic pain[J].J Physiol Sci,2009,59(4):291-298.
[31]Dong ZQ,Ma F,Xie H,et al.Changes of expression of glial cell line-derived neurotrophic factor and its receptor in dorsal root ganglions and spinal dorsal horn during electroacupuncture treatment in neuropathic pain rats[J].Neurosci Lett,2005,376(2):143-148.
[32]蒋永亮,尹小虎,沈亚芳,等.低频电针改善SNL模型大鼠早期神经痛背根神经节辣椒素受体的机制[J].上海针灸杂志,2014,33(5):476-479.
[33]Jiang YL,Yin XH,Shen YF,et al.Low Frequency Electroacupuncture Alleviated Spinal Nerve Ligation Induced Mechanical Allodynia by Inhibiting TRPV1 Upregulation in Ipsilateral Undamaged Dorsal Root Ganglia in Rats[J].Evid Based Complement Alternat Med,2013,2013:170910.
[34]何晓芬,蒋永亮,叶佳瑜,等.低频电针对SNI神经痛大鼠脊髓背角P物质表达的影响[J].上海针灸杂志,2017,36(12):1469-1474.
[35]Yu J,Zhao C,Luo X.The effects of electroacupuncture on the extracellular signal-regulated kinase 1/2/P2X3 signal pathway in the spinal cord of rats with chronic constriction injury[J].Anesth Analg,2013,116(1):239-246.
[36]He XF,Wei JJ,Shou SY,et al.Effects of electroacupuncture at 2and 100 Hz on rat type 2 diabetic neuropathic pain and hyperalgesia-related protein expression in the dorsal root ganglion[J].J Zhejiang Univ Sci B,2017,18(3):239-248.
[37]Rong PJ,Ma SX.Electroacupuncture Zusanli(ST36)on release of nitric oxide in the gracile nucleus and improvement of sensory neuropathies in Zucker diabetic fatty rats[J].Evid Based Complement Alternat Med,2011,2011:134545.
[38]Cha MH,Bai SJ,Lee KH,et al.Acute electroacupuncture inhibits nitric oxide synthase expression in the spinal cord of neuropathic rats[J].Neurol Res,2010,32(Suppl 1):96-100.