内脏疾病背根节感觉交感偶联参与穴位敏化并放大针刺效应[*]

Sensory sympathetic coupling of dorsal root ganglion participates in acupoint sensitization and amplification of acupuncture effect in visceral diseases*

摘要:

早在十九世纪，动物模型中就已观察到背根神经节（dorsal root ganglion, DRG）交感神经末梢芽生现象，后续研究逐渐证实交感神经末梢在神经病理痛或神经纤维损伤后被异常激活，并发生形态改变。近年来，学者注意到内脏病变如心肌缺血情况下，背根节及相应交感节神经间亦发生交感-感觉偶联，伴随心交感神经功能亢进。我们团队以往的研究发现内脏疾病时功能受到损伤，引起体表痛觉过敏或牵涉痛。交感神经系统通过发展异常交感功能或者通过影响传入神经异常活动参与上述的病理性变化。牵涉痛在疾病向愈时减轻，针刺这些敏化穴位放大了穴位本身的生物学效应。本文将阐述交感-感觉偶联与穴位敏化之间的联系以及针刺是否可以通过交感-感觉偶联对内脏疾病产生调控作用。

Abstract:

Since the 19th century, observations in animal models have documented the existence of sympathetic nerve endings in the Dorsal Root Ganglion (DRG). Subsequent investigations have confirmed that these endings undergo abnormal activation and morphological alterations in response to neuropathic pain or nerve fiber damage. Recently, it has been noted that visceral pathologies such as myocardial ischemia give rise to sympathetic-sensory coupling between the DRG and corresponding sympathetic ganglion, often leading to cardiac sympathetic hyperfunction. Our prior research has demonstrated that visceral diseases can disrupt normal physiological functions, ultimately manifesting as hyperalgesia or referred pain on the body surface. The sympathetic nervous system plays a pivotal role in these pathological processes, either by developing aberrant sympathetic function or by influencing afferent nerve activity. As the disease progresses, referred pain typically diminishes, and acupuncture at sensitized points enhances the biological effects of these acupoints. The present article aims to explore the intricacies of sympathetic-sensory coupling and acupoint sensitization, ultimately examining whether acupuncture can regulate visceral diseases via this coupling mechanism.