PDF(Pubmed)
Abstract：
Visceral pain is a complex and heterogeneous pain condition that is often associated with pain-related negative emotional states, including anxiety and depression, and can exert serious effects on a patient\'s physical and mental health. According to modeling stimulation protocols, the current animal models of visceral pain mainly include the mechanical dilatation model, the ischemic model, and the inflammatory model. Acupuncture can exert analgesic effects by integrating and interacting input signals from acupuncture points and the sites of pain in the central nervous system. The brain nuclei involved in regulating visceral pain mainly include the nucleus of the solitary tract, parabrachial nucleus (PBN), locus coeruleus (LC), rostral ventromedial medulla (RVM), anterior cingulate cortex (ACC), paraventricular nucleus (PVN), and the amygdala. The neural circuits involved are PBN-amygdala, LC-RVM, amygdala-insula, ACC-amygdala, claustrum-ACC, bed nucleus of the stria terminalis-PVN and the PVN-ventral lateral septum circuit. Signals generated by acupuncture can modulate the central structures and interconnected neural circuits of multiple brain regions, including the medulla oblongata, cerebral cortex, thalamus, and hypothalamus. This analgesic process also involves the participation of various neurotransmitters and/or receptors, such as 5-hydroxytryptamine, glutamate, and enkephalin. In addition, acupuncture can regulate visceral pain by influencing functional connections between different brain regions and regulating glucose metabolism. However, there are still some limitations in the research efforts focusing on the specific brain mechanisms associated with the effects of acupuncture on the alleviation of visceral pain. Further animal experiments and clinical studies are now needed to improve our understanding of this area.
摘要：
内脏疼痛是一种复杂且异质的疼痛状况，通常与疼痛相关的负面情绪状态有关，包括焦虑和抑郁,并且会对患者的身心健康产生严重影响。根据建模刺激协议，目前内脏痛的动物模型主要包括机械扩张模型,缺血模型，和炎症模型。针刺可以通过整合和交互来自穴位和中枢神经系统疼痛部位的输入信号来发挥镇痛作用。参与调节内脏疼痛的脑核主要包括孤束核，臂旁核（PBN），蓝斑(LC)，延髓头端腹内侧段(RVM),前扣带皮质（ACC），室旁核（PVN），还有杏仁核.涉及的神经回路是PBN-杏仁核，LC-RVM,杏仁核-脑岛,ACC-杏仁核,claustrum-ACC,终末纹-PVN和PVN-腹侧隔回路的床核。针刺产生的信号可以调节多个脑区的中枢结构和相互连接的神经回路，包括延髓,大脑皮层,丘脑,还有下丘脑.这种镇痛过程还涉及各种神经递质和/或受体的参与，如5-羟色胺，谷氨酸,和脑啡肽.此外,针刺可以通过影响不同脑区之间的功能连接和调节糖代谢来调节内脏痛。然而,集中于与针刺减轻内脏痛作用相关的特定脑机制的研究工作仍然存在一些局限性。现在需要进一步的动物实验和临床研究来提高我们对这一领域的理解。
