基于指按法及针刺作用于手三里的痛温觉诱发电位探讨经络小纤维神经感传效应

目的观察比较指按法、针刺及痛温觉诱发电位(CHEPs)刺激器作用于正常人手三里产生的CHEPs,探析经络理论的小纤维神经感传方式。方法纳入16名健康成年志愿者,检测指按法、针刺、CHEPs刺激器作用于手三里产生的CHEPs,进行自身前后对照。结果3种刺激手段作用于受试者手三里均可记录到CHEPs,指按法诱发的N波潜伏期比CHEPs刺激器高120.69 ms(P<0.05),针刺诱发的N波潜伏期比CHEPs刺激器高183.69 ms(P<0.001)。指按法诱发的P波潜伏期比CHEPs刺激器高149.13 ms(P<0.05),针刺诱发的P波潜伏期比CHEPs刺激器高215.69ms(P<0.001),指按法和针刺N、P波潜伏期比较差异无统计学意义(P>0.05)。未见不同刺激手段对N、P波幅存在显著主效应(F=0.424,P=0.658;F=1.289,P=0.290)。结论指按法、针刺均可诱发由小纤维介导的N、P波,且通过与CHEPs刺激器诱发电位比较,指按法及针刺传导的小纤维速度更慢,为无髓鞘的C纤维;指按法、针刺诱发的N、P波波幅改变无明显差异。

Discussion on Patterns of Small Fiber Neurosensory Transmission along Meridians Based on Pain-Temperature Evoked Potentials of Finger-pressing and Acupuncture on Shousanli

Objective To observe and compare the Contact Heat Evoked Potentials(CHEPs)produced by finger pressing,acupuncture and CHEPs stimulator acting on Shousanli acupoint;To explore the small fiber neurosensory transmission method of meridian theory.Methods In this study,16 healthy adults were enrolled.CHEPs were collected when received finger-pressing,acupuncture,and CHEPs stimulator acted on Shousanli acupoint to conduct self-contrast.Results CHEPs were recorded in all 16 volunteers treated with three stimulation methods in Shousanli acupoint.The latency time of N-wave evoked by finger-pressing was 120.69 ms higher than that of the CHEPs stimulator(P<0.05).The N-wave latency induced by acupuncture was 183.69 ms higher than that of CHEPs stimulator(P<0.001).The P-wave latency induced by finger-pressing was 149.13 ms significantly higher than that induced by CHEPs stimulator(P<0.05).The P-wave latency caused by acupuncture was 215.69 ms higher than that induced by CHEPs stimulator(P<0.001).There was no statistical significance in N-wave and P-wave latency of finger-pressing and acupuncture(P>0.05).There were no significant main effects of different interventions on N-wave and P-wave amplitudes(F=0.424,P=0.658,F=1.289,P=0.290).Conclusion Finger-pressing and acupuncture both can induce N and P waves mediated by small fibers,and compared with CHEPs stimulator,the velocity of small fibers transmitted is slower,and they are unmyelinated C fibers.There is no significant difference in the amplitude of N and P waves induced by finger pressing and acupuncture.