摘要
内脏痛(Visceral pain)是临床上常见的一种疼痛现象,主要由于机械牵拉、缺血性改变、痉挛、炎症等刺激引起,其特点为缓慢、持续、定位不清且常伴有牵涉痛(referred pain)。当内脏器官损伤或炎症反应发生时,常有痛觉过敏现象。对于内脏痛及其牵涉痛的发生机理目前存在许多假说,但其确切机理还不明确,而且不同的内脏性疼痛其发病机制不尽相同,因此,关于内脏痛发生机制及其治疗手段的研究也是目前研究的热点之一。以往认为,内脏痛及其伴发的牵涉痛是神经元活动变化引起的,而神经胶质细胞只起到支持、营养、参与代谢和修复的作用。因此认为,神经系统的活动变化主要依赖于神经元。新近研究表明,脊髓神经胶质细胞(主要是星形胶质细胞和小胶质细胞)是神经病理性痛启动和维持的重要因素。胶质细胞不仅仅是神经元“谈话”(信息传递)的倾听者,还参与神经元间的交流。但目前对该方面的研究主要集中在躯体痛引起中枢变化的机制。而对于内脏痛是否影响胶质细胞的反应变化以及和神经元的关系的研究依然鲜见报道。由于内脏痛与躯体痛存在着差异,内脏痛有自己的反应特点。那么
Visceral pain is very common in clinical. It is mainly induced by mechanical drag, changes of ischemia, spasm and inflammation, etc. Viceral pain is a kind of pain that is hard to localize and is always accompanied with referred pain. When the internal organs are injured or inflamed, algesia hypersensitiveness may often occur. There are many hypothesis related with the mechanism of algesia and its-induced referred pain, but the exact one is not clear. We know that different visceralgia has different mechanism. Thus, the mechanism of visceralgia and its therapeutic methods are one of the hot spot of nowadays research. In the past, people thought that the main mechanism of visceralgia and the referred pain accompanied with it is induced by the changes of neuron activity, the functions of glia only provided structural, metabolic and trophic support to central neurons.Today, people think that the changes of central nervous system activity mainly dependent on neurons. Newly researches found that the spinal cord glia (especially astrocyte and microglia) is a critical factor starting and maintaining the neuorpathic pain. Glia is not only the listener of the talk between neurons (message transport), but also is the participant of the communication with neurons. The present many
引文
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