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北京市中医研究所经洛室
Published:1982
移动端阅览
He Guang Xin. Effect of Movement on Acupuncture Analgesia and Its Clinical Significance[J]. Acupuncture research, 1982, (1): 1-7.
①本文介绍了针刺运动疗法
讨论了运动对针刺止痛作用的临床研究。运动的速度
运动的方向、运动的角度和运动的幅度主要决定于针感的强度。针刺时运动话动可提高治愈率
实验组与对照组之疗效在统计学上有显著的差异(P<0.01)。针刺后紧跟着的运动活动是使疼痛获得持久缓解的决定因素。②本文讨论了运动控制感觉输入的实验研究工作
近来研究证明运动输出和感觉输入之间在皮层水平发生明显的相互作用。主动运动或被动运动可抑制伤害性刺激诱发的躯体感觉诱发电位
晚成分比早成分受影响更明显
提示随意运动和感觉输入之间的相互作用可能产生于传入系统的非特异部分。③运动系统和感觉系统不是孤立的
互不相关的
而是相互作用、相互影响。运动对感觉的控制作用具有重要的临床意义
针刺运动疗法已成功的运用于临床。④除了运动止痛所特有的作用之外
运动止痛和针刺止痛之间可能有相似的止痛机制。主动运动的运动输出控制伤害性传入是运动止痛的一个特征
运动传入激活中枢疼痛抑制系统发放下行冲动
加强下行抑制是运动止痛的另一个特征。⑤针刺运动疗法包括相互联系的两阶段
第一阶段针刺提高痛阀或耐痛阈
产生疼痛的暂时缓解
为运动患部提供了条件
第二阶段在第一阶段的基础上紧跟着的主动或被动运动是使疼痛获得持久缓解的决定因素。前者作用的部位主要在脊髓
后者作用的部位主要在脊髓上位中枢
脊髓上位中枢发放下行抑制冲动在底节、丘脑、脑干网状結构和脊髓水平控制伤害性传入
使伤害性刺激在中枢神经系统内产生的异常活动模式恢复到正常的活动模式
从而产生疼痛的持久缓解。
1. Methods of acupuncture-movement therapy were introduced. The effect of movement on acupuncture analgesia was clinically discussed. Movement speed
direction
angle and amplitude largely depend on the intensity of needling sensation. Cure rate can be raised by exercise activity combining with acupuncture manipulation. There are statiscally significant different results between experimental and control group (p<0.01). Exercise activity following acupucnture manipulation is a decisive factor which gives persistent pain-relief. 2.Experimental work about the effect of movement controlling sensory inputs were discussed. The recent researches suggested that the evident interaction between movement output and sensory input is existant in cerebral cortex. Somatosensory evoked potential (SEP) elicited by nociceptive efferent is inhibited by active or passive movement. The late elements that were affected were much greater than the elements affected early. It suggested that the interaction between voluntary movement and sensory input was existant in the unspecial element of afferent system. 3.There is a close mutual relation and interaction between the locomotive system and sensory system. This effect of movement controling sesory afferents is important clinically
and the acupuncture-movement therapy has been sucessfully used in medical practice. 4. Besides special mechanism of movement analgesia
movement analgesia can share in some common mechanisms with acupuncture analgesia. It is a special feature that movement outputs of voluntary movement can control sensory afferents
and it is another special feature that movement afferents activate the central pain inhibiting system to send out descending impulses
and to potentiate descending inhibition. 5. There are two interconnection stages in acupuncture-movement therapy. Stage I. Pain threshold and tolerable threshold are raised by acupuncture manipulation
then pain is relieved temporarily
and this effect contributes to the movement of injured part. Stage Ⅱ. On the basis of the Stage I
active or passive movement following acupuncture manipulation is a decisive factor whcih results in a persistent pain-relief. The former operates largely in spinal cord; the latter operates largely in supraspinal centres. The supraspinal centres send out descending inhibitory impulses which modulate nociceptive afferents in all levels (basal ganglia
thalamus
brain stem reticular formation and spinal cord)
turning the abnormol activity model into normal activity model in central nervous system
and thus a persistent pain relief effect is obtained.
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