最新刊期
1981年第1期
- 摘要：本文就国内近年来研究大脑皮层在针刺镇痛中作用原理的文献作简要综述。针刺麻醉是在中医经络脏腑理论及针刺疗法的丰富实践,尤其是镇痛实践基础上发展起来的。众所周知针麻手术是在病人清醒状态下完成的。因此,这一课题在理论上和实践上都具有一定的意义。本文从临床和实验室,生理和生物化学等方面总结了针刺对大脑皮层功能活动影响的一些研究成果。结果表明大脑皮层参与针刺镇痛过程,在针刺镇痛过程中起一定的作用。当然,近年来做了一些研究工作,取得一定的成绩,但总的来说是不够的。进一步的研究将会对阐明针刺镇痛原理作出应有的贡献。参考文献约70篇。1038|0|0更新时间：2023-08-11
- 摘要：上腹部手术中最常见的手术是胃大部切除术,这种手术最常用的麻醉方法在国内是连续硬膜外阻滞,但施行这种麻醉方法发生低血压的机会甚多,提示硬膜外阻滞对循环动力学的影响。自针麻施行于胃大部切除The commonest method of anaesthesia in epigastric surgery in China is the continuous epidural anaesthesia, which has a rather strong effect on the hemodynamics of the patient with a high occurrence of hypotension, whereas acupuncture gives a quite different clinical picture. To make a further comparison of the effects of acupuncture anaesthesia and of epidural anaesthesia on hemodynamics in patients undergoing upper abdominal surgery, 30 subtotal gastrectomy patients were selected and the changes in ballistocardiogram, phonocardiogram, plethysmogram and other data were recorded before and after induction of acupuncture anaesthesia and epidural anaesthesia and the results analyzed. Acupuncture stimulus was applied at the Zhiyang point. Epidural anaesthesia was sustained, giving an anaesthetized area extending proximally to T 4-5 and distally to T10-11. Resultes: After the induction of acupuncture anaesthesia, an increase was seen in dz/dt amplitude, heart stroke volume, cardiac indices, and the frequency of plethysmographic wave, while the amplitude of plethysmographic wave at the ventricular ejection time and the loudness of heart sound did not show any marked change. Following epidural anaesthesia, dz/dt amplitupe was lowered, heart stroke voltme and cardiac indices decreased, ventricular ejection time shortened, the amplitude of plethysmgraphic wave increased, and the heart sound accentuated, but the change in frequency of the plethysmotraphic wave was inconspicuous. Conclusion: Epidural anaesthesia has a striking effect on the hemodynamics of the patient, and factors including the reduction of heart stroke volume and the dilatation of peripheral blood vessels resulted in the fall of the patient's blood pressure. However, acupuncture anaesthesia has rather a stimulating effect on circulatory functions; in spite of the mild dilatation of peripheral blood vessels, the heart stroke volume is markedly increase in blood pressure, and hence, acupuncture anaesthesia proves to be advantageous in patients with relatively poor circulatory functions.778|0|0更新时间：2023-08-11
- 摘要：在麻醉领域里,关于麻醉与免疫,国内外也屡见报导。不过已往的学者多采用单一的麻醉药或一种麻醉术。根据近几年临床上多采用复合麻醉的实际情况,我们观察了强化硬膜外麻醉和针药结合麻醉手术对T细胞功能、血清中的补体和免疫球蛋白的水平The effects of the combined anesthesia of drug and acupuncture on the immune function in 22 patients necessitating gastrectomy or hysterectomy were observed. As a control, the patients were anesthetized by potential epidural anesthesia. The subjects under study were selected to meet the demand of the experiment. The hepatic, renal and endocrine functions of the patient should be normal. Among the 22 cases, 5 were male and 17 female. Age varied between 25 and 58 years. The patients were divided into two groups of eleven each Each. patient in the potential epidural anesthesia group(control)received 15-25 ml mixed solution which was composed of 1.6%lidocaine and 0.2% dicaine. They also received innovar(Fentenyl 0.1 mg and Haloperidol 5mg). In addition, patients in the combined anesthesia were needled at the two Futu points, connecting the apparatus for acupuncture anesthesia. The rates of E-rosette formation and total rosette formation, the total leukocytic count, the percentage of neutrophilic leukocytes and lymphocytes, the IgG, IgA, IgM, C_3 CH50 level of the patients were measured before anesthesia, 20 minutes after innovar administration, one hour after incision of the skin aud 24 hours after operation. The results obtained were compared with those of the controls. It appears that There were no significant effects on humoral immunity in both methods of anesthesia. The combined anesthesia seems to enhance the function of nonspecific immunity and depress the specific cell-mediated immunity.866|0|0更新时间：2023-08-11
- 摘要：长期以来,人们希望能对疼痛感受有一个客观指标,然而一直未能解决。人体实验性疼痛的测定,由于缺少客观测量方法而受到阻碍。自从Dawson创立了累加技术,为在人体无创伤地记录脑诱发电位提供了可能。近年来累加体感诱发反应的研究,为实The developm ent in the study of the cerebral-pain evoked potential has pointed out a way for evaluation of experimental pain. The components of early response(latency about 30 ms)and late response(latency about 160-206 ms)in the cerebral-pain evoked potential were closely related to pain perception. But these studies could not rule out the action of non-pain sensation, such as touch, pressure, temperature etc. So far, we have not seen any report on pure painful components of cerebral evoked potentials. Based on our understanding that the cerebral evoked potential is a complex potential and on the computer average principle, we have designed a new method, inverse average technique, for eliminating the components of nonpain sensation from the cerebral evoked complex potentials. The inverse average technique is a very useful method. It will be reported in another paper. 30 normal subjects were observed. Result: The direct and the inverse cerebral evoked complex potentials elicited by the same stimulation were inversely averaged, producing the inverse-averaged potential. All components of inverse averaged potential offset except the highest amplitude component of cerebral evoked complex potential, 1.3% of which remained. The most remains did not exceed by 9%. A series of experiments were done on 8 of these subjects whose somatosensory evoked potential showed a w shape. Three stimulations with different intensity were applied. They were medium nonpain stimulation—mean 75 V, strong nonpain stimulation—mean 114 V, and light pain stimulation—mean 156 V. The strong non-pain stimulation and light dain stimulation approached the pain threshold. The wave characteristics of the strong non-pain stimulation were: The latency of each of the components was more or less longer than that of strong non-pain stimulation except the initial component; the phase of each of the components did not change and the amplitude of each component was smaller except the components with latencies of more than 300 ms. The characteristics of the waves of the light pain stimulation subtracting the strong non-pain stimulation(both pain and non-pain stimulations approaching the pain threshold)were: Compared with the pain evoked complex potential the phase of each of the components changed; the latency of each of the components increased except the latency of 170-240 ms which contrarily decreased. This technique and results have provided a new way of study for the evaluation of experimental pain in human and for the coding of nervous information.891|0|0更新时间：2023-08-11
- 摘要：自从我国开展针麻原理研究以来,以躯体感觉诱发电为指标在人体上探讨针刺的镇痛作用已有许多报导。我们过去工作中曾观察到痛刺激一侧中指在对侧头皮相应点皮层感觉区引出的大脑诱发电的某些成分与疼痛关系较密切,且与主诉疼痛有较好的平行关系,国外也有类似报This investigation was performed on 45 healthy adults. Two kinds of stimulation intensity(Ⅰ_1, Ⅰ_2)were applied on fingers. According to the signal decision theory, subjects were requested to differentiate four categories of pain perception from the above mentioned stimuli: "slight pain", "moderate pain", "pain", "heavy pain". Cerebral evoked potentials were averaged by means of a computer and the relationship between cerebral evoked potentials and pain rating was analyzed. Pain tolerance by spring pinch was also observed. The preliminary results were as follows: 1. Some parallel relationship exists between the amplitude of evoked potential, the intensity of stimulation and the pain rating. 2. There is a tendency of positive correlation between the difference of amplitude P_1 evoked by Ⅰ_1 and Ⅰ_2 and the difference of the number of heavy pain ratings. 3. No positive correlation has been observed between the difference of amplitude and the d' and Lx.542|0|0更新时间：2023-08-11
- 摘要：现有大量临床及实验材料证明,尾核、丘脑的束旁核、三叉神经脊束核、脊髓背角等核团与针刺镇痛有密切关系。据我们观察,这些核团都接受大脑皮质的传出纤维,即在大脑皮质与核团间存在着直接的下We have made experiments in rats to trace descending nervefibral connections between the cerebral cortex and certain nuclear masses responsible for painful sensation and expected to provide some morphological evidence for studying the mechanism of acupuncture anesthesia. Experiments were carried out On 13 rats. Damage was induced individually to various cortical areas(somato-motor, somato-sensory, auditory and visual areas). The corticofugal fibers terminating into nuclear masses responsible for pain sensation were traced in sections by means of the Nauta-Gygex method. 1. Degenerated corticofugal fibers entering the ipsilateral N. caudatus could be traced in all slides taken from brain sections of the 13 rats with different damaged cortical areas. Preterminal degenerated fibers were distributed aroud the cells in the dorsal-external part of the caput of the N. caudatus. There were no or only scanty degenerated fibers found at the ventral-internal part of the caput of the N. caudatus and the caudal part of the nucleus. What we have found in our experiment is in accordance with clinical practice and demonstrated in physiological experiments, that the dorsal part of the caput of the N. caudatus is the reacting center of electric acupuncture analgesia. The direct connection between the cortex and N. caudatus is a possible anatomic basis for transmitting cortical influences to the nucleus. 2. On sections of the brain with damaged somato-motor and somatosensory areas, preterminal degenerating fibers can be found in the thalamic N. parafascicularis. This means that the above mentioned nucleus directly receives the cortical projecting fibers. As confirmed by electrophysiologic studies, the N. parafascicularis is a structure closely associated with pain sensation or analgesia. The direct projecting fibers may be the pathway by which cortical inhibitory influences are transmitted to the N. parafascicularis. 3. Degenerated corticofugal fibers from the damaged somato-motor, somato-sensory and auditory areas can be demonstrated in all stained brain slides. These degenerated fibers project into the spinal trigeminal nucelus mostly on the opposite sides. The direct convergence of the corticofugal fibers with the trigeminal fibers of first order is suggetted to be the ana tomic basis to explain how the cortex exerts efferent inhibitory action through the pyramidal tract uppon the afferent pain impulses initiated from the cephalic-facial origin. 4. On cross-sections of the spinal cord in rets with damaged somatomotor and somato-sensory areas, the degenerated cortico-spinaltract is located ventrally to the opposite spinal dorsal fasciculus. With the fasciculus as a center, the degenerated fibers spread in a radiating mode toward the spinal dorsal cornu and the intermediate area. Preterminal degenerated fibers are also found around the cells in the vicinity of the nucleus proprius cornu dorsalis, basis cornu dorsalis and intermediate area. Cells in the spinal dorsal cornu are the primary centers admitting afferent pain impulses from the body and extremities. The cortico-spinaltract may be considered as the anatomic basis for cortical efferent impulses acting on spinal dorsal cornu to exert inhibitory influences on the transmition of integration of pain signals.828|0|0更新时间：2023-08-11
- 摘要：根据针麻原理研究工作的需要,动物实验大多在清醒状态下进行。我们参照国外资料和自己的实验经验,研制出大白鼠实验台(参见图)。606|0|0更新时间：2023-08-11
- 摘要：我们曾报导了电针单侧“胃俞”、“足三里”穴可以不同程度地抑制电刺激内脏神经引起的皮层诱发电位,证明了这些诱发电位与内脏痛觉有关以及穴位存在相对特异性,并分析了电针“足三里”穴抑制内脏神经-皮层诱发电位的外周传入途径。为了进1. Evoked potentials could be recorded in some main nuclei of the thalamus [N. ventralis posterolateralis (VPL), N. geniculatus medialis (GM) and N. centralis lateralis(CL)] in addition to the somatic sensory area Ⅰ and Ⅱ of the cerebral cortex in cats. The evoked potentials of thalamic nuclei as well as those of SⅠ and SⅡ in the left side of the brain could be inhibited by electrical acupuncture of either right "Weishu" or "Zusanli" point. It was always completely inhibited by electrical acupuncture of "Weishu" 2. The cortical potentials evoked by splanchnic nerve stimulation were obviously diminished after destroying the VPL or GM by electric cauterization or cutting their connections with somatic sensory areas. There was no obvious effect on the evoked potentials after destroying CLexcept some temporary changes. 3. Two pairs of insulated bipolar electrodes with bare tips were inserted into the same nucleus of the thalamus both for recording and stimulation. The potentials recorded from the thalamie nucleus by one pair of electrodes and the SⅠ cortical potentials both evoked by splanchnic nerve stimulation could be inhibited to various degrees by stimulation of the same thalamic nucleus through another pair of electrodes with currents of appropriate intensity and frequency. This inhibitory effect was very obvious in VPL and GM, but less so in CL. 4. When two pairs of electrodes were inserted into area SⅠ of the cerebral cortex and a rather strong electric stimulus was delivered through one pair of the electrodes, the splanchnic-nerve-evoked cortical potentials recorded by another pair of electrodes were also inhibited but only slightly. A stronger strength and longer time stimulus was needed inducing such inhibition. It is suggested that the thalamus plays an important role in the integration of the afferent impulses of electrical acupuncture and the impulses from the splanchnic nerves which mediate visceral pain and other sensations. The cerebral cortex plays but a minor role. It has also been observed that the potentials of SⅡ evoked by splanchnic nerve stimulation could be inhibited by electric stimulation of SⅠ.860|0|0更新时间：2023-08-11
- 摘要：皮肤电反应为一种交感中枢活动的良好客观指标,它与中枢神经系统的机能活动有着密切关系。汪敬熙曾系统地探讨过脑干网状结构对皮肤电的影响,提出中脑网状结构起易化作用,而延髓网状结构却有着抑制皮肤电反射的效应。本工作采用电刺激内脏大神经向中端模拟内脏痛,以皮肤电反The experiments were performed on 55 cats. The Galvanic Skin Reflex(GSR) caused by splanchnic nerve stimulation was picked up by a pair of silver disc electrodes placed on the foot-pad of the forepaw and recorded on RM-150 polygraph. In order to mimic visceral pain stimuli, the electrical parameter of stimulation of the splanchnic nerve with intensity 3-9V. wave width 0.1 ms. was usually applied in the experiments. The inhibitory effect of electro-acupuncture of "Zusanli" (“足三里”穴) on the splanchnic-GSR was observed in 47 out of 62 experiments on 14 cats(P<0.001). Electrical stimulation of bulbar reticular formation had a similar inhibition effect in 23/31 cats(153 out of 188 experiments). It was found that the amplitude of splanchnic-GSR diminished 33.0% and 35.4% respectively. The inhibitory effect, however, appeared more prompt and efficient when both stimuli were applied simultaneously, decreasing the amplitude of the splanchnic-GSR 57% (P<0.01) The results suggest that some sites in the bulbar reticular formation, including the Nucleus RGC, are activated by the acupuncture signals, and thence descending impulses are transmitted to the spinal cord, thus bringing about an inhibitory effect on visceral pain.784|0|0更新时间：2023-08-11
- 摘要：以往,我们曾观察到吗啡拮抗剂纳洛酮能大部分阻断针刺抑制内脏痛的反应,说明针刺镇痛过程的实现有内源性吗啡样物质的参与。据报导,电刺激大鼠、兔、猫、猴和人体的中脑导水管周围灰质[Mesencephalic pe-Experiments were performed on 59 rats slightly anesthetized with urethane. The activities of 161 units localized in PAG were extracellularly recorded with a glass microelectrode. The splanchnic nerve or tail was stimulated by a brief train of 10-20 rectangular pulses ( duration 0.5-1.0 ms, interval 10 ms, intensity 10-20 V or 2-4 mA) which was used as noxious stimulation. Electro-acupunture was applied to "Zusanli" or "Beishu" points. It was found that the majority of units(about 80O%) responded with increased frequency, about 6% showed decreased frequency and the remainder had no response to nociceptive stimulation(applied to the splanchnic nerve and tail.) It seems to imply that PAG is one of the brain structures which receive somatico-visceral pain impulses. The inputs originated from different stimulating sites of the body and electro-acupuncture points could converge on the same unit and interact in PAG. The effect of electro-acupuncture resembles that of morphine which inhibits nociceptive neuronal discharges in PAG. It shows that PAG is closely related to acupuncture analgesia These results suggest that the integration in paramedianascending system including PAG, and activation of descending inhibitory system down to spinal cord might be considered as two main functional patterns of the inhibition of somatico-visceral pain by electro-acupuncture.969|0|0更新时间：2023-08-11
- 摘要：国内针麻研究的大量工作表明,针刺诱导引起的机体神经体液调节与针刺镇痛原理具有密切关系,植物性神经系统可能是参与“调整气血、疏通经络”,从而达到“通则不痛”作用的因素之一。1066|0|0更新时间：2023-08-11
- 摘要：经络学说在内经中有经典的描述,在针灸临床上观察到经络感传现象。有人报告针感传导现象在人群呈Poisson分布,李定忠在临床上观察到循经出现皮疹的现象,蒋来等用红外呈相仪直接观察到针感循A point electric discharge plate(pED) has been successfully produced according to the method reported by Luciani R. J. who had carried out direct observation and photography of electro-conductive points on human skin. The electrode is transparent, allowing 75% light transmittance. It is a double plated glass with five kinds of space gaps(0.15, 0.5, 0.8, 1.0 and 1.5 cm). and high frenquency as a power source. Experimnts were carted out on ten subjects in a dark room. Spark dischanges were observed but no characteristically different spark discharges were seen on channel and non-channel sites. Experimental results suggest that the specificity showing channel phenomena should be further investigated.846|0|0更新时间：2023-08-11
- 摘要：引言近年来激光已广泛应用于医学领域作为诊断和治疗。激光穴位麻醉已获成功,这就向人们提出了很多问题:激光穴位是否具有镇痛作用?激光穴位镇痛是否具有后效应?激光穴位镇痛是局部的还是全身性的?激光Experiments were carried out according to the Latin square design with the aim to study the efficacy and characteristics of pain perception in man before and after laser anlagesia. The results indicate that man displays a tangible analgesic effect after laser analgesia and this anagesic effect tafer laser analgesia and this analgesic effect is a general physical effect with an after effect. The experimental results are somewhat similar to those of acupuncture analgesia, showing a significant individual variance. Laser analgesia however does not bring about a needling sensation; In laser anelgesia suggestion plays a moderate role, not a dominant one.845|0|0更新时间：2023-08-11
- 摘要：胆碱能生物学的研究,可以追朔到1906年,Hant与Tavean研究胆碱及其类似物的生理功能时,发现胆碱的乙酰衍生物,在降低兔血压方面是作用最强的类似物。后来Dale等指出,乙酰胆碱(ACh)在哺乳动物系统具有神经介质的作用,与此同时,In this paper a microbioassay of acetylcholine is described. The leech dorsal muscle in a microbath(volume 0.05ml) was used to measure acetylcholine. The smallest effective dose(in 0.05 ml) is 50pg of acetylcholine.667|0|0更新时间：2023-08-11
- 摘要：为了观察针刺对大脑皮层机能的影响及针刺体表不同部位的效应,采用了脑电闪光节律同步化的方法进行了研究。实验在24只成年家兔上进行。用慢性埋藏电极的方法在两侧顶骨钻孔,旋入银螺丝2只作记录电极,术后一周进行测定。实验在808|0|0更新时间：2023-08-11
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