最新刊期
1981年第2期
- 摘要：全国针麻学术座谈会于1980年12月3～9日在广西南宁市召开。参加会议的有来自27个省、市、自治区的针麻临床、原理研究、科研管理工作者及有关领导共148人。(一)会议的特点和主要收获会议以专业分组交流和大会发言相结合,就针麻研究发展的现状和前景进行了专门地,热烈地讨论,讨论中贯彻了“双百”719|16|0更新时间：2023-08-11
- 摘要：针麻用于颅脑手术是可取的麻醉方法之一。但针麻对颅内压的影响如何,尚未见有数据的报导。为探索针麻对颅内压的影响,借以进一步掌握针麻用于颅脑手术的适应证,自1980年6月至9月共对9例针麻颅脑手术病人进行了颅内压监测。初步报导如下:The effect of acupuncture anesthesia on ICP has not been repoted asyet.In 1980,ICP in 9 patients with intracranial operations under acupun-cture anesthesia were monitored.All of them were male,aged from 25 to57,with patent cerebral spinal fluid(esf)pathway and in calm spirits.Before anesthesia,there were no clinical sign of significantly increased ICPbeing observed.Any drugs that can lower the ICP would not be used for 12hours before anesthesia,and that can depress the respiration would be avo-ided in premedication.The csf pressure of 18 cases were measured directlythrough a catheter in the subarachinoid space,while the 9th one who suffur-red from posterior fossa lesion was measured directly through a cannula in thelateral ventricle.The pressure gauge we used is specially made for the measur-ement of csf pressure only,which is highly sensitive and precise.During the procedure of puncture,we did our best to avoid too much loss of csf.After the successful catheterization,a small amount of normal saline csf wasinjected slowly into the subarachinoid space,so as to make the csf complete.After the patient well lying on his back,we began to connect the catheterto the pressure-gauge and waited at least for 5 minutes in order to allowthe csf pressure becoming stable.Then,acupuncture anesthesia was started,and the data were recorded.The csf pressure measured before acupuncture anesthesia was used as thecontrol Value.The control values were:less than 200 mmH_2O in 5 cases,slightly higher than 200 mmH_2O in 3,and 260 mmH_2O in one.After obviousneedling-sensation was experienced,there were a slight incrase in ICP in 7cases,but in one of them the increase in ICP was up to the highest control value(260 mmH_2O).The mean value of increase was 20±22.64 mmH_2O,andpresumably this increase was due to pain or strong needling-sensation.Therange of increase was comparable to the effect of venous puncture on ICP(10—30mmH_2O).During the induction period,the ICP bell very little andgradually,the mean value of decrease was 4.44±2o.46 mmH_2O at the 15thminute of induction.ICP unchanged or decreased in 5 cases when 50 mg ofpethidine was given intravenously;but ICP increased in 4 cases with 75 mginstead of 50 mg.The mean value of increase for all the 9 cases was 11.55±21.93 mmH_2O,Gertainly it was related to the slight depression of respi-ration.When the scalp was infiltrated with adrenaline-normal saline solu-tion,ICP increased only in 3 cases,the mean value of increase for 9 caseswas 0.55±14.66 mmH_2O.Provided there is no significant increase in arterialblood pressure because of the infiltration of adrenaline,adrenaline could notinfluence the cerebral blood flow per se.When incision being made,ICP in-creased slightly in 3 cases,the range of increasing was eqivalent to that ofinserting needles,and the mean value for 9 cases was 6.66±20.68 mmH_2O.Thereafter,when the introducer of gurgling saw was introduced,the meanof increase of ICP was 7.77±20.28 mmH_2O because of the external pressure.When the skull and dura Were opened,ICP decreased significantly.According to the result mentioned above,we believe that such an increasein ICP is of no importance to patients without significantly increased ICPbefore anesthesia,but for patients with significantly increased ICP,anyfactor that can raise the ICP might result in dangerous increase.Thereforeit is necessary to consider all the conditions of the patients and judge whetheracupuncture anesthesia is suitable for such patients.522|0|0更新时间：2023-08-11
- 摘要：祖国医学认为针刺的治疗作用主要在于对机体的调整,针麻剖腹产的临床实践也证明了这一点.因此我们考虑用针麻为中毒症患者行剖腹产术应具有弥补因中毒症病理而致的血管运动机能紊乱,保持术中生理功能的稳定,减少术中出血,于是我们扩大了临床应用范围,逐步把针麻亦列为中毒症剖腹产常规麻醉。今就72～79年6月底八年来所作的部分资料总结如下,并取66～70年在硬Two hundred and ninety-six cases of toxemia of pregnancy under-goingcesarean section under acupunoture anesthesia from 1972 to 1979 were anal-yzed,among which 23.3%(69 cases)was mild,56.4%(167 cases)moderate and 20.3%(60 cases)severe.Before operation all cases had received varioustreatments for toxemia.At the time of operation patient's toxemia conditionwas improved and stationary in 71.4%.METHOD OF ACUPUNCTORE ANESTHESIAPrescription:There were three main prescriptions of acupuncture anest-hesia points:1.Sanyinjiao(Sp.6),external anesthesia point and para-incision needles.2.Renzhong(Du 26),Chengjiang(Ren 24)and para-incision needles.3.Sanyinjiao(Sp.6)Taichong(Liv.3)Xiajuxu(St.39)and para-inc-ision needes.The frequency of stimulation,time of induction and supplementarymedication were the same as in ordinary cesarean section under acupunctureanesthesia.EFFECTIVENESS AND CLINICAL OBSERVATIONSThe effective rate was 99%.The combined rate of Grade Ⅰ and GradeⅡ was 71.3%.Blood pressure:Throughout the course of operation the blood pressurewas fairly stable.For example,during the delivery of baby the averagevalues of fluctuation of blood pressure in systolic pressure and diastolic pres-sure were 15.2 mmHg and 9.9 mmHg respectively which were close to thoseof the control group.Pulse Rate:In the whole course of operation the pulse rate was sta-tionary.During delivery of baby the average change was 12.56 time/min,which was close to the 12.1 time/min,in the control group.Amount of Blood Loss:The average amount of blood loss during opera-tion in toxemia and control group were 205.96 ml and 278.3 ml respectively.The blood loss in toxemia group was less than the control group.Postoperative Recovery:The blood pressure began to drop within twodays in 77.5%(200 cases)and returned to normal in 64.7%(167 cases)within three days after operation.The recovery of blood pressure postopera-tively was closely related to the type of toxemia.In mild cases the bloodpressure started to drop and returned to normal earlier.THE COMPARISON BETWEEN ACUPUNCTURE ANESTHESIA ANDEPIDURAL ANESTHESIADuring delivery of baby the fluctuation of blood pressure in acupunctureanesthesia group was less than in epidural anesthesia group.The average bloodloss during operation in acupuncture anesthesia group was less.It is evident that acupuncture anesthesia is a safe and effective anestheticmethod to be used in cesarean section for patients with toxemia of pregnancy.676|0|0更新时间：2023-08-11
- 摘要：我们于1980年1月～10月采用针药结合施行胃大部切除及对照组共39例。现初步报告如下:方法一、观察对象:选取单纯溃疡病,手术难度大致相等的胃大部切除术的病员共39例,分成针药结合麻醉组19例,女2例,男17例;年龄最小23岁,最大55岁,硬膜外麻醉组20例,女4例,男16例;年龄最小25岁,最大60岁。816|0|0更新时间：2023-08-11
- 摘要：针刺麻醉具有方法简便、安全、术后病人恢复快等优点,但因其镇痛不全,即使应用适量中枢性止痛剂,手术无痛率也较低。我们自1979年2月至1980年9月,应用针药复合麻醉作胸科手术297例,手术无痛率较针麻显著提高。现报导如下。803|0|0更新时间：2023-08-11
- 摘要：针刺麻醉的大量临床实践和实验研究表明针麻效果存在着明显的个体差异,这种差异是可以预见的。例如、不少工作看到患者针前痛阔和耐痛阈水平及其针后提高情况、患者的针感和耐针情况都和针麻效果有关。针感和耐针即人对酸、麻、胀、痛、沉的感觉和耐受情况,可以认为是某种与皮肤有关的驱体感觉。因此、皮肤某些感觉的特点可能是与针麻效果有联系的。734|0|0更新时间：2023-08-11
- 摘要：激光穴位麻醉的临床及激光穴位镇痛的实验研究巳证明,激光穴位照射能使人体出现显著的镇痛作用,并具有全身性镇痛和镇痛后效应的特点。在针麻原理的研究中,曾经发现针刺对某些皮肤感知觉,例如两点辨别觉等有显著地变化。本文通过实验研究探索这个问题。这对于了解激光照射穴位后This method of experiment is used in Latin Square design,whichstudies the effect and characteristics of two-point discrimination in manbefore and after laser point.The results indicate that laser point heighten two-point threshold.Thedifferences are statistically significant.The laser point modification of two-point discrimination manifests itselfin 3 characteristcs,namely general physical effect,the non-extinct natureof threshold and follow-up effect.764|0|0更新时间：2023-08-11
- 摘要：大量临床和实验研究表明,神经系统多个水平共同参与丁针刺镇痛过程。过去我们的工作已证实大脑皮层参与针刺镇痛。Hecaen 等1949年首先报导了破坏中央中核能缓解丘脑痛,以后一些资料进一步表明破坏丘脑中央中核能缓解顽固性疼痛。毁损束旁核(pf)、中央中核(CM)或附近其他连接的丘脑核团能有效地取消猫In the present work,we recorded the evoked potentials of cerebralsomatosensory area,nucleus CM and the action potentials of nervi perona-eus communis simultaneously,while unilateral nervi peronaeus communiswas stimulated by noxious electric stimuli in rabbits.We observed and compared the responses of three levels before and after acupuncture.Besi-des,we also observed the change of the evoked responses of three levelswhen nucleus CM was damaged by the eletrolytic lesion.Furthermore,weanalysed the interaction of three levels and their roles in acupunctureanalgesia.The amplitude of multi-components of cerebral evoked potentials(after70ms.)and N21,p180 components of the evoked potentials of CM weredecreased while “Sanyinjiao” and “Yinlin quan” were stimulated by elec-tro-acupuncture for 5min.(13 rabbits,22 times).It showed that thedecrease of amplitude was with significant difference(p<0.05),15-20miu.after ceasing acupuncture,the amplitude of p354 component of the evokedpotentials of CM was decreased and showed significant difference p<0.02.The amplitude of C wave of the action potentials of nervi peronaeus com-munis was decreased.This inhibitory mechanism might not be produced inperiphery;but it was realized through the descending inhibition of the centre.The amplitude of the evoked potentials of cortex and CM were decr-eased after electrolytic lesion of CM(5 rabbits);but the amplitude of Cwave of the action potentials of nervi peronaeus communis was increased.The results suggest that the high centre may exert a tonic inhibitorycontrol on the transmission of peripheral noxions afferent impulse throughthe descending pathway.1010|0|0更新时间：2023-08-11
- 摘要：大量研究证明,针刺麻醉是痛觉传入信号和针刺传入信号在中枢神经系统各个水平内相互作用的结果。众所周知,任何感觉信号进入中枢神经系统后,最后必须到达大脑皮层才能形成感觉。因而,作为神经系统的高级中枢——大脑皮层在感觉的整合过程中也起着重要作用。然而,对于大脑皮层是否参与针刺镇痛过程,大脑皮层诱发电位能否反映痛觉等问题存在着不同的看法。1011|0|0更新时间：2023-08-11
- 摘要：在中枢神经系统内,内源性阿片样物质的镇痛作用引起了人们的广泛注意。如果阿片样物质对痛觉具有调制作用,则阿片受体阻断剂纳洛酮应能改变正常动物的痛感受或痛反应。许多人试图通过纳洛酮的处理来揭露对伤害性刺激的传递或反应是否存在紧张性调控作用,可惜现有的一些研究资料仍存在许多相互矛盾的地方。有人证明外源性阿片样物质可抑制一些Experiments were done in 25 rabbits.Glass microelectrodes were usedto record the discharges of nociceptive neurons in the nucleus parafascicu-laris of thalamus.It was found that intraventricular or intravenous injec-tion of naloxone could facilitate selectively the nociceptive discharges inparafascicular nucleus without any effect on the activity of non-nociceptiveneurons.In addition,naloxone could have reversal of the inhibitory effectof morphine on the nociceptive discharges.From the results of the presentstudy it seems to suggest that the endogenous opiate-like substances probablyhavea tonic regulatory role on the transmission of the pain impulses in th-alamus.768|0|0更新时间：2023-08-11
- 摘要：关于针刺镇痛的原理,许多资料说明脑干中缝核系统在针刺镇痛中起重要作用,中缝核色胺能神经元轴突末梢的神经递质5-羟色胺(5-HT)是针刺镇痛的重要物质基础。中缝核神经元的轴突分布很广,其上行纤维经内侧前脑束(MFB)上达间脑和端脑各部,下行纤维广泛分布于脊髓的灰质,在脑干部分还与兰斑核,巨细胞核等其他网状结构神经核团有广泛联系.以往的工作证Experiments were performed on adult female rats with tail-flick responseas the antinociceptive test.The effects of destruction of ascending 5-HTpathways by mechanical lesions of MFB were similar to these by specificchemical lesions with 5,6-DHT as formerly reported.The 5-HT and 5-HIAAcontents of the telencephalon and diencephalon were lowered markedly aswell as the effect of acupuncture and morphine analgesia.Intraspinal micro-injection of 5,6-DHT lowered selectively the 5-HT content of the spinalcord.It showed that the descending 5-HT pathways were destroyed in certaindegree.Under such condition,the effect of morphine analgesia were lower-red but the effect of acupuncture analgesia remains unchanged.The resultsof these experiments suggest that the ascending 5-HT pathways are moreimportant for acupuncture analgesia than descending 5-HT pathways butboth ascending and descending 5-HT pathways are necessary for morphineanalgesia.990|0|0更新时间：2023-08-11
- 摘要：按祖国医学理论,针刺作用为外因通过体内各调节系统产生效应,针刺镇痛则可能是通过体内抗痛调节系统而实现。国内外通过吗啡镇痛的研究提出体内存有一内在的抗痛系统。富有阿片受体的脑室—导水管周围灰质(pAG)是吗啡镇痛的高效区,电刺激该区也能获得强的镇痛效应,毁损该区则可减弱镇痛效应,Our previous experiments revealed that both the endogeneous opiate systemand the descending serotonergic inhibitory system take part in acupunctureanti-visceralgia.In the present study the correlation between the actions ofthese two systems was further investigated.Experiments were carried out on male,awake and restrained rats.When aconstant current of 100 μA was used to stimulate the through implanted concen-tric electrode laid beforehand in NRM,an anti-visceralgia effect(expressed bysupression of splanchnic nociceptive defensive reflex)could be seen.However,this inhibitory effect was markedly blocked(n=11,p<0.01)by 20 minutespretreatment of naloxone(1mg/kg i.p.).At 60-150 minutes after adminis-tration,NRM stimulation produced analgesia was gradually intensified butnot completely recovered.According to these findings,it is speculated that 5-HT released fromserotonergic terminals in spinal cord exerts inhibitory control on nociceptiveinformation,at least in part,by activating the enkephalinergic nurones torelease enkephalin which may be involved in primary afferent depolarization.However,the mode of action in detail remains to be investigated.987|0|0更新时间：2023-08-11
- 摘要：脑内阿片受体及内啡肽系统的发现,对针刺镇痛原理研究提供了新的线索,关于针刺所致各种效应,特别是镇痛效应和阿片受体及其递质系统有何关系的问题,引起人们广泛的兴趣。Mayer 和上海市人体针刺镇痛实验协作组分别在人体用吗啡拮抗剂—纳洛酮阻断了针刺镇痛效应。然而动物实验的结果却存在分歧,Pomerang 报导纳洛酮能明显拮抗小鼠的电针镇痛作用;上It is reported in this paper that naloxone 0.4mg/Kg intravenously signi-ficantly antagonized the analgseic effect of moderate strength elecroacupuncturebut did not antagonize superstrength electro-acupuncture.In forty nine rabbits,ipsilateral “He-Gu” and “Wai Guan” were electri-cally needled.The frequency of the electric stimulaton was 2-4 c/s,and theanimals were divided into two groups according to the strength of stimulat-ion:1.The moderate strength electro-acupuncture group animals were givenelectro-acupuncture with electric current of 7.5-8.0mA.The stimulations weresufficient to cause moderate muscle contration but mild enough to keep theanimals in quiet state.2.The superstrength electro-acupuncture group ani-mals were treated with a superstrength(12.5-15 mA)electro-acupuncture asa stress stimulation.The animals showed agitation and struggled hard.Rabbits with more than two-fold rise of pain threshold at the 20th minute after electro-acupuncture were conidered as “acupuncture effective”and werechosen for further studies.The acupuncture group and the superstrength acu-puncture group were 70% and 66% respectively,and the raised percentagesof pain threshold in these two groups were also withot any statistic differ-ence.At the 20th min.after acupuncture,part of the animals of these twogroups were given naloxone 0.4mg/Kg intrevenously,and the others weregiven normal saline.It was found that the analgesic effects of moderatestrength acupuncture were markedly reversed by naloxone in 10 out of 14animals.The total decrease rate at the 5th min.after naloxone was 41%which significantly differed fnom that in the saline group(P<0.005).Thereversed pain threshold then rose again gradually and nearly reached thepre-injection level 15 min.after naloxone.In the meantime,the analgesiceffects of superstrength acupuncture were not reversed by naloxone.Therewas only 1 out of 10 animals showed a decreased pain threshold at the 5thmin.after naloxone,the average pain threshold at that time was not statis-tically different from that before naloxone.The pain threshold of the saline group and the naloxone group remainedstable.The present experiment suggests that the analgesic effect of moderatestrength acupuncture results partially from the activity of opiate receptors,and its mechanism differs at least in some aspects from that of “stress anal-gesia”935|0|0更新时间：2023-08-11
- 摘要：我们在大白鼠皮下组织和骨骼肌等部位在阻力血管旁发现主要是由非特异胆碱酯酶反应的胆碱酯酶阳性神经及其终末分枝——各种形式的游离神经末梢以后,我们就把这一结果用来探讨与针刺传入的关系,由于临床针麻手术也常常把针刺入组织中,特别是切口旁针完全是在皮下组织中。我们首先实验了针剌相当于穴位的皮下组织,在动物提高痛阈生理指标的基础上,探讨与针刺镇痛有关的感受器和传入神经。948|0|0更新时间：2023-08-11
- 摘要：祖国医学认为针刺的镇痛和治疗作用,在于通经脉,调气血.在针麻过程中,有人用血管反应和容积脉搏波作为针麻导引正气,疏导气血的指标,看到针麻诱导后出现外周血管舒张,容积脉搏波加大等变化.针麻对外周血流的影响,启示我们考虑到针刺对脑中枢内与镇痛和调整作用有关核团的微循环是否也有影响,它与吗啡的作用有无不同,因此,我们进行了以下的实验观察.Based upon our previous study of acupuncture analgesia and the effeet ofmorphine upon locus coeruleus and raphe nucleus,Bu ChE histochemical reactionwas applied to fresh brain sections from cryostat for demonstrating the changesof the capillary calibers,with the purpose of observing the influence ofbothtypes of analgesia upon above nuclei.142 healthy,adult,male rats were selected and then divided at random into acupuncture,morphine,and control groups.After measuring the painthreshold,the brains were taken out immediatly for histochemical observationof Bu ChE reaction.The calibers of capillaries of the both nuclei of thesegroups were then measured with a spiral auto-micrometer and treated statis-tically.In comparison with the control,the mean distension of calibers of acu-punctured nucleus raphe dorsalis was measured without any statistical sig-nificance.But that of the locus coeruleus presents a prominent difference.The mean distension of calibers in both nuclei of the morphine group wasalso prominent.The result showed that both acupucture and morphine produced effectiveanalgesia,though there were no statistical significance between AChE amo-uunts in locus coeruleus and raphe nucleus of the morphine group and the acu-punctured group in the previous study.In this study,it presented a significantincrease of distension of calibers in both nuclei of morphine group,and yetonly thecalibers in the locus coeruleus were distended by acupuncture.Ther-efore it indicates that there are either differences or similarities in these twokinds of analgesia.The mechnism of acupuncture analgesia and regulation was discussed inthis paper.821|0|0更新时间：2023-08-11
- 摘要：胆石症是常见的急腹症之一,发病率较高。近十几年来,开展中西医结合的排石疗法,国内为胆石病的治疗方法开创了新局面,且在诊疗规律及理论认识上提出了新见解。据文献报告针刺可以治疗胆石症,并收到一定的疗效.但针刺排石的作用机理如何?通过什么途径作用?关于这方面的资料目前报导不多。考虑到胆石的排出,须经总In this paper the effects on the electrical activity of the sphincter ofOddi in rabbits by puncturing the Riyue and Qimen points were studied.Resu-lts were as follows:(1)Two forms of the Oddi's electromyography were recorded:onewith the spark potential of single and low voltage,and the other,crowedand high;(2)Under the normal functional condition,the effects of acupunctureobserved were not the same:inhibition in 34.5%,rising in 28.1% and noobservable change in 37.4%;(3)When neostigmine or atropine was injected intravenously to alterthe electric activity of Oddi's sphincter in the state of activity,the effectsof puncturing the Riyue and Qimen,and the potentials decreasing or increasingwere observed respectively.789|0|0更新时间：2023-08-11
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