【作者】 黄晓媛；

【导师】 孙申田；

【作者基本信息】 黑龙江中医药大学 ， 针灸推拿学， 2007， 博士

【摘要】 目的：通过观察针刺头穴双侧感觉区对大鼠三叉神经痛样反应模型在行为反应，神经递质，及电生理方面的影响，验证针刺头穴治疗三叉神经痛的有效性并推断其产生疗效的机理，指导三叉神经痛的临床治疗及针刺选穴。方法：1、脑闩下蛛网膜下腔注射微量青霉素G-K制造大鼠三叉神经痛样反应模型。2、三叉神经痛样反应模型成立后，观察针刺头穴组、卡马西平组、模型组的疼痛总发作次数，自发反应持续时间及诱发反应阳性时间。3、用放射免疫法测定针刺头穴组、卡马西平组、模型组、假手术组血浆P物质(SP)，β-内啡肽(β-EP)的含量。4、用肌电图仪测定针刺头穴组、卡马西平组、模型组，因刺激大鼠眶下神经所诱发的咬肌肌电反应的潜伏期及基础痛阈(引起咬肌诱发电位的最小刺激量)。结果：1、在行为学方面：针刺头穴组与模型组比较，可明显减少大鼠三叉神经痛样反应的疼痛发作次数，缩短白发反应持续时间及诱发反应阳性时间(P＜0.01)；针刺头穴组与卡马西平组比较，各项指标无显著性差异(P＞0.05)。2、在血浆SP含量方面：针刺头穴组明显低于模型组(P＜0.01)；与卡马西平组比较无显著性差异(P＞0.05)。3、在血浆β-EP含量方面：针刺头穴组明显高于假手术组、模型组(P＜0.01)；与卡马西平组比较无显著性差异(P＞0.05)。4、在由刺激眶下神经诱发的咬肌肌电反应的潜伏期方面：针刺头穴治疗组与模型组比较：由眶下神经刺激诱发的咬肌肌电反应的潜伏期明显延长(P＜0.01)，30min-60min达到高峰，然后逐渐下降；针刺头穴组与卡马西平组比较：前30min潜伏期较卡马西平组明显延长，90min后明显缩短，余时段无显著性差别(P＞0.05)。卡马西平组与模型组比较：即时潜伏期延长(P＜0.05)，30min、60min、90min、120min潜伏期明显延长(P＜0.01)，无明显峰值。5、在由眶下神经刺激诱发的咬肌肌电反应的基础痛阈方面：针刺头穴组与模型组相比：基础痛阈明显提高(P＜0.01)，30min-60min达峰值，然后开始逐渐下降；针刺头穴组与卡马西平组比较：前30min基础痛阈较卡马西平组明显提高(P＜0.01)，90min后基础痛阈明显降低(P＜0.01)，余时段无差别(P＞0.05)。卡马西平组与模型组相比：各时刻基础痛阈均显著提高(P＜0.01)，无明显峰值。结论：1、针刺头穴具有减少大鼠三叉神经痛反应模型疼痛发作次数，缩短自发反应持续时间及诱发反应阳性时间。为其治疗三叉神经痛提供了行为学方面的理论依据。2、针刺头穴能使大鼠三叉神经痛反应模型血浆中SP含量减少，β-EP含量显著增加。为针刺头穴治疗三叉神经痛提供了神经递质方面的理论依据。3、针刺头穴可延长三叉神经痛大鼠眶下神经受刺激诱发的咬肌肌电反应的潜伏期，提高基础痛阈。为针刺头穴治疗三叉神经痛提供了电生理方面的理论依据。更多还原

【Abstract】 Objectives: the main objective of this thesis is to provide a guidance for acupuncture-treating trigeminal neuralgia (TN) with proper acupuncture points by studying the therapeutic effect of the scalp acupuncture on the trigeminal neuralgia (TN) and its function mechanism through the experiment on model rats in which the effect of the head-point needling of both-side sensing part on the response, the neurotransmitter and the electrophysiological issues.Methods:1. The microinjection of penicillin G-K into arachnoid space at obex is used to get the model of the rat trigeminal neuralgia (TN).2. The number of the aching and its lasting time, and the induced reaction masculine time were recorded for the head-needling samples, the carbamazepine-samples and the model samples, respectively, after the model of the rat trigeminal neuralgia (TN) was obtained.3. The content of the blood plasma substance P (SP) and theβ-EP were measured for the head-needling samples, the carbamazepine-samples, the model samples, and the artificial operation samples, respectively, using the radiation-immunity method.4. The delitescence and the basic pain threshold of the infraorbital nerve induced masseter muscle electronic reaction were measured with the electromyography for the head-needling samples, the carbamazepine-samples, and the model samples, respectively.Results:1. In terms of the ethology issues, the head-needling obviously reduced the number of the aching and its lasting time, and the induced reaction masculine time (P<0.01), as compared with model samples; however, the head-needling showed no obvious difference from the carbamazepine-samples (P>0.05)2. The head-needling obviously reduced the content of SP (P<0.01), as compared with model samples; however, the head-needling showed no obvious difference from the carbamazepine-samples (P>0.05) .3. The head-needling obviously increased the content ofβ-EP (P<0.01), as compared with model samples and artificial operation samples; however, the head-needling showed no obvious difference from the carbamazepine-samples (P>0.05).4. The delitescence was obviously lengthened in the case of the head-needling, as compared with model samples, with the peak at 30-60 min; in the staring 30 min, the head-needling increased the delitescence, as compared with carbamazepine-samples; the instant delitescence was increased in the carbamazepine-samples as compared with model samples, with a lengthened delitescence in the case of 0min, 30min, 60min, 90min, 120min, and no peaks observed.5. The basic pain threshold was obviously increased in the case of the head-needling, as compared with model samples, with the peak at 30-60 min; in the staring 30 min, the head-needling increased the basic pain threshold, as compared with carbamazepine-samples; the basic pain threshold was increased in the carbamazepine-samples as compared with model samples, with a lengthened delitescence in the case of 0min, 30min, 60min, 90min, 120min, and no peaks observed.Conclusions:1. Scalp acupuncture can reduce the attack number in the model animal of TN, shorten the duration of spontaneous reaction, lighten the degree of the attack ,which provides an ethological guidance for treating the trigeminal neuralgia (TN).2. Scalp acupuncture can decrease the content of SP, and increase the content ofβ-EP, which provides a theoretical basis for treating the trigeminal neuralgia (TN) based on the neurotran-smitter.3. Scalp acpuncture can increase the delitescence and the basic pain threshold, which provides an electrophysiological theoretical basis for treating the trigeminal neuralgia (TN).更多还原