摘要:全子宫切除术是妇科常见的手术,麻醉要求除要有良好的镇痛效果外,肌肉松弛及抗牵拉反应等亦很重要。针麻子宫切除术虽然具有生理干扰小、术后恢复快等优点,但部分病例由于镇痛不全,肌肉紧张,鼓肠等影响手术操作,进而影响针麻的临床应用。而最常用的硬膜外麻醉,虽然麻醉效果好,但术中生理干扰大,术后恢复较慢。本文用针刺及硬膜外腔注入小剂量局麻药相结合的针刺复会麻醉方法,以期扬长避短,探求改This paper reported about the acupuncture anesthesia combined with low dosage of medicine for epidural anaesthesia for the abdominal hyste- rectomy. The low dosage of medicine is 1 per cent lidocaine containing 1:400000 of adrenalin and we use 1 ml per 10 kg of body weight, 45 minutes later we will add in half of the dosage as the former. It is the standard of su- ccess during operation, the patient feels no pain, the relaxation of the muscles are better so the exposing of the field of operstion is excellent, the stretch effect of the pelvic and abdominal viscera is light, no intestinal tympanites. The success rate of acupuncture combined group (AC group) is 86.25% but control group is 8%. After operation the patient of AC group calls pain and needs the ana- lgesic medicine are less than the other methods of anesthesia(p<0.05). The time of expell gas is earlier(p<0.01). During operation the average systolic pressure in two groups are also tends to decrease than preoperatiom but contrast group is more than AC group. Itwas recognized that the acupuncture combined anesthesia collected the merit of both method of epidural and acupuncture anaesthesia.
摘要:近年来,随着对针刺镇痛原理的深入研究,发现海马在针刺镇痛过程中起一定作用。神经生理学实验证明:刺激大鼠背侧海马可提高针刺镇痛效应,损毁背侧海马电针镇痛效应降低;刺激双侧海马可提高痛反应域,并可加强电针效应。对于海马的传入联系前人曾用溃变方法做了大量工作,近年来segal和阪中等先后用HRP逆行传递法进行了研究,但结果不尽The afferent connections of the hippocampus in the rat were examined by means of a retrograde axonal transport method of horseradish peroxi- dase (HEP). During injections of HRP in the dorsal or ventrolateral hi- ppocampus, labeled areas did not show any difference, except for the me- dial septal nucleus. Numerous labelled cells were consistently found in the ipsilateral medial septal nucleus, the diagonal band nucleus, the entorhinal cortex, the posterior hypothalamic nucleus, the supramammillary area, the supraoptic area and, bilaterally, the lateral hypothalamus area. when in- jections were made into the dorsal hippocampus, HRP-labelled cells of the medial septal nucleus were observed in medial aspect, but injections made into the ventrolateral hippocampus, revealed HRP-labelled cells of the me- dial septal nucleus in the lateral aspect. After injection into the hippoca- mpus, the supraoptic area was labelled, as first reported. The many areas above-mentioned have a relations with acupuncture analgesia, it is proba- ble that the hippocampus is one of the centres regulating pain in the cent- ral nervous system. Hippocampal function therefore requires further inve- stigation.
摘要:胃运动的付交感神经纤维一般认为是从迷走神经运动背核发出的。在HRP示踪法出现以前,不少学者曾对这一问题有很多争论,有人认为迷走神经内脏运动节前纤维起始于迷走结状节;有人认为迷走神经运动背核不参与对内脏平滑肌的支配。在HRP示踪法应用于神经解剖的研究以后,很多学者对一课题进行了重新研究,多数学者赞同迷走神经运动背核是胃付交感内The origins of the parasympathetic preganglia fibers of stomach in ra- ts were traced with HRP method in this study. After HRP were injected into the wall of the stomach of rats, the labeled cells were found in the dorsal motor nuclni of vagas, intermediate zone. ambigous nuclei of medulla and in pars paraependytnalis, pars nuclei intercalatus, retroambigous nuc- lei, pars funicularis lateralis of the supra-cervical cord. This result shows those nuclei possess a direct nervous connection with stomach. The relati- on of the labelled cells between the medulla and the supra-cervical cord a- nd the reason of the change of their distributive shape were briefly discu- ssed in this paper.
摘要:针刺信息激活中枢神经系统各个水平的抗痛结构以及通过下行抑制系统来对抗伤害性传入冲动而产生镇痛效应已有许多实验研究资料。电针对外周神经的作用如何,目前资料不多。有人观察到电针刺激对外周神经有压抑作用,但多数为“同纤维”效应,即A纤维被兴奋时,动作电位A波受压抑。少数实验中也出现“异纤维”效应。即仅有A类纤维被兴奋但压抑效应却可涉及C波。还有人观察到电针大鼠“足三里”、“环跳”对It was known that the anti-pain organization of each level in central nerve system could be activated by acupuncture. But it isn't quite clear if the inhibitory effect of acupuncture can appear on peripheral afferent C fibre. We observed that acupuncture at right side made the amplitute of the C potential of left common peroneal nerve(CPN)decreased. The purpose of this work isto observe the effect of acupuncture on a- fferent impulses of CPN at opposite side after cutting off the relationship between centre and periphery, and go further into the priciples governing acupuncture anesthesia and the effect of distant acupoints. In the present experiments, the C potential wes strictly distingiushed by measuring conduction velocity of nerve, changing the distance of CPN between stimulative and recording electrodes, paralyzing the animal, cu- tting off the distal end of CPN and injecting procaine into the nerve. Right acupoints "Sanyinjiao" and "Yinlingchuan" were stimulated by EA in rabbits, the A potential of the complex action potential induced by ele- ctric stimulation on left CPN didn't show the significant change, P>0.25, but the C potential showed the inhibitory effect(n=13). It showed that the decrease of C potential was with significant difference at the weak EA(5.7 V) for 5 min and 10 min after ceasing EA, P<0.05 (n=25); at strong EA (45V) for 5 min and 10 min after ceasing EA, P<0.001(n=9). However. the amplitude of C potential increased after that sciatic nerve was cut. At this condition, neither A potential nor C potential showed the inhibitory effe-ct by EA(n=15). The results suggest that the effect of the distant acupoints are perfo- rmed by resisting the trasmission of peripheral noxious afferent via the descending inhibitory system. While peripheral nerve was separated from centre, the inhibitory effect of EA on peripneral noxious afferent of oppo- site side disappeared. The amplitude of C wave increased after cutting off sciatic nerve, it indicates that the high centre exerts a tonic inhibitory control on the noxions afferent of peripheral nerve in normal.
摘要:针刺治疗冠心病心绞痛和心肌梗塞确有疗效,并能使冠心病人的缺血性心电图得到不同程度的改善。为了验证上述效应,我们采用心外膜电图和硝基四氮唑蓝(简称N-BT)染色法,观察了电针对实验性心肌梗塞的损伤范围和心肌坏死面积大小的影响。方法采用杂种健康犬,平均体重15.08±4.1公斤,雌雄不限,随机分为对照组和针刺组The purpose of the present investigation was to demonstrate effect of acupuncture on coronary heart diseases. The mongrel dogs were anestheti- zed with pentobarbital sodium. The left anterior desending coronary artery of dog was ligated between their second and third branches. The epicardial ECG with 12 leads were recorded by means of saline-cotton-electrode. The number of leads with S-T segment elevation beyond 2 mv (N-ST) would show the extent of the ischemic damage and the sum of the S-T elevation from all 12 leads and would represent lesion. The heart was removed 2 ho- urs after ligation and then weighted. The left heart was cut into 5-6 para- llel slices and stained with nitroblue-tetrozolium (N-BT). The normal heart muscle was stained as blue colour while the necrotic area could not be stained. The infarct tissue was separated and weighed, and the perce- ntage of weight and size of left ventricle tissue was then culculated. procedure: Epicardial ECG of 12 points were recorded before the liga- tion, then the coronary arterywas tied for 120 min. At 15, 45, 60, 90 and 120 min after ligation. The epicardial ECG of the 12 points were recored respectively. In the electroacupunnure group, at 15 min after ligation, the electric square wave impulse with 2-20 Hz and 6 volts were applied on Neiguan as positive pole aid Jianshi as zero potential for 30 min. Result: 1)At 15 min ligation, the N-ST of both groups increased from 3 (before ligation) to 8.62, and the ∑ST increased from 10 (before ligati- on) to 53 mv. (P<0.01). There was no statistical difference between the two groups (P>0.5). 2) In control group, the average N-ST was 8.84 at 15 min. after l_1- gation, and increased 0.07 at 120 min. There was no statistical difference between them. In electroacupuncture group, the average N-ST was decr- eased 2.37(P=0.05). 3) In control group, the average ∑-ST was 53.04 at 15 min. after li- gation, and increased 19 mv at 120 min in electroacupuncture group the average ∑-ST was 51.19 at 15 min after ligation and decreased 11.23 mv at 120 min. (P<0.05). There was statistical significance at 120 min between the two groups (P<0.05). 4) According to the changes in ST segment of the 12 leads, it was indicated that the degree of damage was increased in control group and re- duced in electroacupuncture group. 5) The result of histological observation of myocardial infarct by N- BT staining method showed that electroacupuncture treatment could signi- gicantly decrease the extent of heart infarct. To sum up electroacupuncture treatment could save the critical margi- nal zone of the ischemic myocardium and reduce the size of infarct and the severity of myocardial damage and necrosis.
摘要:近年来我们实验室以猫丘脑髓板内核群(中央中核CM;束旁核Pf;中央外侧核CL)神经元的伤害性放电反应为指标,观察到大脑皮层体感Ⅱ区(SⅡ)对上述神经元的伤害性反应及针刺镇痛效应有下行调节作用。从皮层到丘脑髓板内核群的这条下行通路中有一中间结构—尾核。尾核参与疼痛的调节,在形态上,尾核与CM、Pf、CL有直接的纤维联系,也有纤维投射到皮层,并接受来自皮层的纤维投An observation about the effect of stimulation SII or electroacupunct- ure on nociceptive reponse of CM neurons after lesion of the head of caud- atum bilaterly was performed. The experimental were carried out on ad- ult cats. The glass microelectrode technique was used and the discharges of CM neurons were attanuated within 1-3.5' after ceassion of stimulation of SII(n=19) or electroacupuncture Zusanli and Huantiao (n=13). There was a statistical significance it was compared with that of the result before sti- mulation(P<0.005). So it was suggested that the caudate nucleus may not be involved in the influence of SII on the effect of pain acupuncture analgesia in intralaminar nuclei.
摘要:近年来,国内大量研究表明蓝斑(LC)参与了针刺的镇痛与调整过程,但对于蓝斑神经元在此过程中的机能状态和作用机制尚有争议:有人提出蓝斑与中缝核作用相反,是拮抗针刺镇痛的;而另一部分学者则认为蓝斑神经元可为针刺信号所激活,从而发挥了协同镇痛的积极作用。一般认为,神经元的机能活动可能与其内某些有关的酶活性变化密切相关。因此,本实验即以与神经元内代谢水平和机能活动相关的81 healthy, adult, male rats were selected and divided into the acupun- cture and the control groups for this experiment. The pain threshold of the acupuncture group was elevated significantly than the control. The optic densities (OD) of the histochemical components of Acid pho- sphatase(AcP), Nonspecific Esterase (NsE) of the Locus Coeruleus in bo- th groups were determined with a microelectrophotometer and treated stati- stically. The result indicated that the enzymatic activity of AcP and NsE of acupuncture group in the Locus Coeruleus was significantly increased than that of the control. It was suggested that the neurons in the Locus Coeruleus might be in an active state of analgesia-accelerating and organi- smregulating.
摘要:自从Terenius及Hughes等人发现脑组织中存在着天然的镇痛物质—内源性吗啡肽以来,学者们注意到该物质与镇痛的关系。临床上看到某些慢性疼痛病人脑脊液中的吗啡样物质的含量减少,用电针治疗后,疼痛缓解,吗啡样物质的含量增加,动物实验发现针刺镇痛后脑组织或其灌流液中吗啡样物质升高,但当用吗啡拮抗剂纳洛酮后,不但阻断了针刺的镇痛作用,且The met-enkephalin-like immunofluorescence reactivity was oberserved in nerve cell bodies (except their nuclei) and nerve fibers. More strong fluorescence was found in ventral, lateral and dorsal horns of cervical spi- nal cord. Moreover, the reactivity in nerve of middle or small sizes was stronger than that in large ones. Fluorescence in medulla oblongata was more intensive than in cervical spinal cord. More strong fluorescence was observed in reticular structure, some cerebral nerve nuclei, nucleus gracilis and nucleus cuneatus. Immunofluorescence reactivity in cases mentioned above was more inte- nsive in the cases of electron acupuncture alone and of operation under acupuncture anaesthesia than in the cases of normal. The reactivity was much weaker in the cases of operation without any anaesthesia. On the basis of our experimental results, we belive that acupuncture plays important roles in stimulating the formation of endogenous morphi- ne-like substances during operntion and in preventing them from excessive consumption.
摘要:我们曾经报道过,在临床针麻胃大部切除术过程中,血中游离5-HT的含量改变与针麻手术效果密切相关。针麻效果好的病人,大多数血浆中游离5-HT的含量明显下降,交感神经的活动处于相对稳定状态。在狗针麻胃大部切除术动物模型中,观察到针麻效果优级的,术中全血5-TH的升高率(与针前血中5-HT的含量比)也比针麻效果差的为低(P<0.05),在同一模型上,用组织荧光化学的方法观察到,针麻效When the electroacupuncture was given with the 6-OHDA(30mg/kg or 100mg/kg)the contents of 5-HT and 5-HIAA in the whole blood was sign- ificantly decreased as compared with those in saline control groups (P< 0.05) , Moreover, acupuncture analgesia was reinforee by 6-OHDA, while in 6-OHDA or acupuncture groups, they had only a tendency to deerease. The results suggest that there is a cooperative action on the regulatory mechanism of storage and release of 5-HT and acupuncture analgesia be- tween electroacupuncture and 6-OHDA. A possibility of peripheral mechanism of acupuncture analgesia is di- scussed in this paper.
摘要:我室曾观察到针麻下胃大部切除的病人,在针麻效果好时,血浆中游离的5-HT偏低、血小板向血浆内释放5-HT较少和病人的交感神经处于相对抑制或稳定状态。后又在针麻胃大部切除的实验模型上测定狗全血5-HT的含量具有类似现象。同时还观察到胃粘膜APUC细胞内的5-HT和交感神经末稍荧光强度在针麻效果好时均较强,并且两者在分布上存在紧密关系。以上结果提示,针刺调整交感神经以保证针麻手术顺利进行的内在机理之一可能与调节APUD细胞5-HT的储存Fluorohistochemical changes of 5-HT in the APUD cells of mucosal membrane of pyloric antrum after injecting 6-OHDA intraperitoneally and their relationship with acupuncture were investigated in rats by the combi- nation of glyoxylic-acid fluorescence method with physiological and bioc- hemical methods. The fluorescence of sympathetic nervous endings in the ti- ssues of gastrointestinal walls, adrenal glands, vagal nervous trunks, ctc., were almost disappeared 5 days after a single injection of 6-OHDA intrape- ritoneally, while the fluorescent intensity of 5-HT in the APUD cells was increased compared with that of 5-HT in the APUD cells of control ani- mals. In 6-OHDA plus electroacupuncture group especially in 100mg/kg 6- OHDA plus electroacupuncture group the fluorescent intensity of 5-HT in the APUD cells was increased much more than that in only giving 6-OH- DA group. The present results indicate that sympathetic nerve might participates in the regulation of the storage and release of t-HT in the APUD cells of the mucosal membrane of gastrointestinal tracts and the existence of syne- rgistic action of acupuncture and 6-OHDA on the storage and release of 5- HT in these cells. It is assumed that the regulation of sympathetic nerve on the APUD cells might be one of its peripheral active ways affecting acupuncture analgesia.
摘要:足三里穴常用于针麻手术和治疗胃肠道疾病。中医认为该穴既有健脾胃作用也有调补气血的作用。早在五十年代和六十年代初期,国内临床针刺治疗实践中表明,针刺一定穴位对心血管活动具有调整作用。Lee M.O.等曾报道在氟烷浅麻醉下,针刺狗“足三里”穴后,每搏输出量和心输出量减少而外周阻力增加,但平均动脉压却无影响。林树新等报道电针“足三里”穴对This experiment was carried out on 47 rabbits anesthesized with uret- han. It had been observed that needling with electrostimulation at "Zusa- nli" of the animals gave rise to prnmpt and obvious lowering of blood pr- essure, which was in strong contrast to that at random points other than Stomach Channel, where almost no changes of blood pressure could be eli- cited, indicating that the effect was relatively specific. The depressor re- sponse was found to be very much attenuated or totally eliminated after severing of sciatic nerve. So the nerve was the main afferent pathway. No influence of the response was further found after section of depressor ne- rve, carotid sinus nerve or cervical vagus, and there was no change of he- art rate comig along with blood pressure lowering. The results showed that the transient but obvious depressor effect after needling with electro- stimulation at "Zusanli" in anesthesized rabbits might be the effect of inhi- bition of sympathetic vasoconstriction activity giving rise to lowering of peripheral resistance.
摘要:五十年代的生化研究就已证实,失血性休克时儿茶酚胺(CA)发生很大变化,起初由于交感-肾上腺髓质系统兴奋,使血中CA明显增加,但随着休克时间的延长,病情的严重,器官出现CA耗竭现象(包括心、肝等内脏),并认为CA耗竭对心脏交感神经活动不利。而以往的研究表明,针刺“人中”对失血性休克动物心脏功能有恢复作用。那么,这种恢复是否与CA以及交感神经的功能状态有关?故本文以组32 healthy male rabbits were selected and divided at random into 4 gro- ups---hemorrhagic shock, acupuncture, sham operation and normal contol. After measuring the normal blood pressure and electrocardiograph, the ra- bbits in hemorrhagic and acupuncture group were bleeding 20ml/kg, 10ml/ min till the blood pressure dropped to 40-50 mmHg. Then acupuncture at "Renzhong" point was given 5 minuts per 20 minuts in acupuncture group. At the end of the experiment, ventricular myocardiums were excised and immediatly put into isopentane cooled by dryice-acetone (-70℃) and made cryostat section for histochemical observations of catecholamine flourescence ribonucleic acid and acid fuchsin-methyl green method. The result shows that the CA amount in hemorrhagic group(measured with Leitz MPV2 microflometry) is much lower than normal control and sham operation(with statistic significance), and it is much higher in acupu- ncture group than hemorrhagic group (with statistic significance), nearly the same as the normal level. So it was seen that the CA flourescent ne- rves in acupuncture group is much denser and brighter than the nerves in hemorrhagic group. Therefore it is considered that acupuncture can incre- ase the CA amount and regulate the sympathetic adrenergic nerves to make the heart working in a nearly normal state.