針灸抑制癲癇發作機轉之研究

沈淵瑤 醫師 
馬偕紀念醫
根據文獻報告，癲癇疾病的發作以及對腦部傷害與中樞神經中的興奮性神經傳遞物（glutamate）和抑制性神經傳遞物（g-aminobutyrtic acid;GABA）有密切關係，而針灸的部份效應是經由調整中樞神經之神經傳遞物的濃度變化而產生療效，所以本研究室相當有興趣了解針灸對中樞興奮性神經傳遞物以及抑制性神經傳遞物濃度變化的情形並推及抑制癲癇機轉的探討。SD雄性成熟大白鼠，約250~350公克重，實驗動物主要分為四組，組A 為針灸對照組：實驗流程以施針但不引發癲癇。組B 為癲癇對照組：實驗步驟以引發癲癇但不施針。組C 為實驗組? G則是癲癇引發後再施針。組D 為實驗組：則是施針後再引發癲癇。四組是以 Chloral hydrate 麻醉後，將微量透析探針（Microdialysis probe）植入腦中海馬迴區（hippocampus）或大腦皮質區（cortex）。針灸以手捻針方式（捻針 5 min.）或電針（3 mA;2 Hz,10 Hz,100 Hz;5min.）? 閬′I行，穴位目前選定以人中、伏兔、風市及足三里為主。癲癇則是以 penicillin 120 units 直接注入大腦皮質引發，我們計劃以腦電波監測動物引發的狀況作為指標，以液相層析螢光偵測系統觀察的 glutamate 在透析液中濃度，GABA 則以電化學檢測系統檢測濃度。由上述的研究中? A計劃了解（1）針灸對於正常動物中樞神經glutamate 及 GABA 的影響？（2）針灸是否可經由降低glutamate level 或提高 GABA level 而達抑制癲癇效果？（3）針灸是否有預防癲癇所引起的glutamate level 上升的效果？而藥物引癲癇的情形及手針與電針個別效力（potency）將一併? Q論。
關鍵字：癲癇、針灸、興奮性胺基酸

A Study on the Mechanism of Acupuncture in Suppressing Epileptic Seizure

Ein - Yiao Shen, M.D. 
Mackay Memorial Hospital
Epilepsy is an expression of occasional, sudden, excessive, rapid, local, discharge in the grey matter. Nowaday, epileptic seizures are commonly suppressed by medication. Since medication takes a long period of time, it is impossi ble to avoid the side effect from the anticonvulsants. Therefore, it is merited to find a better way to treat epilepsy in medical research. From clinical evidences, epleptic seizures can be improved by acupuncture application in Mackay Memorial Hospita l, Taipei. According to some previous findings, there are close relationship between excitatory amino acid(EAA) 、inhibitive amino acid（IAA） and epileptic seizures. Because neurotransmitters in central nerve system might change by acupuncture applica tion, we then have great interest to study the mechanism of epileptic seizures suppressed by acupuncture therapy. Adult, male Sprague-Dawley rats will be random divided to four groups. Group A will be stimulated on acupoint without induced epilepsy. Group B are i
關鍵字：: epilepsy, acupuncture, excitatory amino acid.