25/05/2026
https://www.facebook.com/share/18P4CCfPSs/?mibextid=wwXIfr
【科學家終於破解了針灸緩解疼痛的原理】 ByDaniel Seifert
【Scientists are finally decoding how acupuncture eases pain】
一根針刺看來似乎無法平息劇烈的疼痛，但在某些情況下，它確實做到了——能緩解偏頭痛、減輕痛感，甚至幫助產婦忍受分娩之苦。在一項針對急診環境的隨機對照試驗中，針灸緩解急性疼痛的速度和效果皆優於靜脈注射嗎啡，且副作用更少。
針灸這一根植於傳統中醫（TCM）的療法，長期以來一直處於醫學與神秘之間的灰色地帶：雖然被廣泛用於治療疼痛，卻也常被貶低為純粹的安慰劑效應。
然而，影像學和臨床研究的進步正改變這一觀點。科學家們正在揭示一根細針如何引發體內的連鎖反應，進而活化免疫細胞、釋放調節疼痛的化學物質，並改變大腦活動。一個清晰的輪廓正在浮現：這是一種可測量的、全身性的反應——這正幫助針灸在全球疼痛管理中，被定位為一種低成本且不具成癮性的選擇。
A needle prick doesn’t seem like it should quiet severe pain. But in some cases, it does—easing migraines, dulling pain, even helping patients endure childbirth. In one randomized trial in emergency settings, acupuncture relieved acute pain more quickly and effectively than intravenous morphine, with fewer side effects.
Acupuncture, a practice rooted in Traditional Chinese Medicine (TCM), has long occupied a gray zone between medicine and mystery: widely used to treat pain, yet often dismissed as a placebo.
But advances in imaging and clinical research are shifting that view. Scientists are uncovering how a needle can trigger a chain reaction inside the body, activating immune cells, releasing pain-modulating chemicals, and altering brain activity. What’s emerging is a clearer picture of a measurable, body-wide response—one that is helping position acupuncture as a low-cost, non-addictive option in pain management worldwide.
『細針背後的奧秘』
幾個世紀以來，傳統中醫的語言——如「經絡」和「氣」（生命能量）等概念——一直讓許多西方研究人員難以信服。
如今，這種隔閡正在縮小。新加坡南洋理工大學助理教授楊明曉表示，隨著臨床研究的推進，科學家對針尖與組織接觸時發生的情況有了更清晰的了解。他的整合健康實驗室正利用尖端科技探索傳統中醫。
針灸的反應始於局部。細針輕微的機械拉扯（稱為——機械信號轉導），會在周圍的結締組織中引發一連串的生化信號。這種活動會促使皮膚的肥大細胞（可將其視為人體的第一道防線）向周圍組織釋放組胺、血清素和腺苷等化合物。隨後，這些信號會刺激神經末梢，將訊息傳遞給負責處理和調節疼痛的大腦區域。
楊明曉解釋，針灸還可能啟動更廣泛的疼痛調節路徑，包括一種「以痛止痛」的感知機制，即一種刺激可以減弱對另一種刺激的感知。
其他基於觸覺的療法（如按摩），也可能透過對結締組織的機械刺激引發重疊的反應，不過其具體機制仍有待研究。
The mystery of the needle
For centuries, the language of Traditional Chinese Medicine—concepts like meridians and qi, or vital energy—left many Western researchers unconvinced.
That disconnect is now narrowing. As clinical research has progressed, scientists are gaining a clearer picture of what happens when a needle meets tissue, says Mingxiao Yang, an assistant professor at Nanyang Technological University in Singapore, whose integrative health lab explores TCM through cutting-edge technology.
(How ancient remedies are changing modern medicine.)
The response begins locally. The slight mechanical tug of a needle, known as mechanotransduction, sets off a cascade of biochemical signals in the surrounding connective tissue. This activity causes skin mast cells (think of them as your body’s first line of defense) to release compounds such as histamine, serotonin, and adenosine into nearby tissue. Those signals then stimulate nerve endings, sending messages to brain regions involved in processing and modulating pain.
Acupuncture may also engage broader pain-regulation pathways, including a “pain inhibits pain,” sensation, in which one stimulus can dampen the perception of another, Yang explains.
Some touch-based therapies, such as massage, may trigger overlapping responses through mechanical stimulation of connective tissue, though the mechanisms remain under study.
『顯微鏡下的傳統中醫』
近年來，影像技術的進步讓針灸過去隱形的效果變得越來越清晰可見。高場強功能性磁振造影（fMRI）掃描顯示，刺激特定穴位與大腦活動的變化息息相關，其中包括涉及疼痛處理和情緒調節的區域。
同時，軟X射線成像捕捉到了免疫細胞向針灸針聚集並釋放疼痛調節物質的畫面。甚至超音波也在幫助研究人員即時觀察針尖拉扯所產生的漣漪效應，以及這些效應如何因施針部位的不同而有所差異。
這些工具結合在一起，開始描繪出局部刺激如何激盪至全身的藍圖——將週邊組織、免疫反應和大腦的疼痛處理網路連結起來。楊明曉補充，在心理學上，僅僅是對潛在療效的期待也扮演著重要角色。「透過大腦獎勵迴路介導的治療預期與信念，也可能對針灸引起的疼痛緩解有所貢獻。」
雖然目前還無法提出一個完全涵蓋針灸的綜合性理論，但研究人員已開始找出有助於預測誰能獲益最多的模式。楊明曉說：「我特別感興趣的是，能否找出預測治療反應的生物標記，以幫助我們更清楚了解哪些患者最有可能從中受益。」
此外，一些研究也探索了傳統針灸地圖與解剖結構的契合度。研究人員報告指出，「傳統經絡路徑與結締組織網絡之間有高達 80% 的重合」，而這些區域的神經纖維密度似乎高於周圍區域。一項分析發現，這些高密度穴位所含的神經纖維數量可能是非穴位的 1.4 倍。
伊利諾大學芝加哥分校護理學院教授茱迪斯·施萊格爾（Judith Schlaeger）表示：「傳統的經絡圖應該被重新解讀為一幅深奧而古老的人體神經與筋膜網路藍圖。最有效的穴位，往往是那些作為神經系統『高存取權限端口』的部位。」
TCM under the scope
In recent years, advances in imaging have made acupuncture’s once-hidden effects increasingly visible. High-field fMRI scans show how stimulation at specific acupoints is associated with changes in brain activity, including regions involved in pain processing and emotional regulation.
Meanwhile, soft X-ray imaging has captured immune cells drifting toward acupuncture needles, where they release pain mediators. Even ultrasounds are helping researchers observe the ripple effect of a needle’s tug in real time and how those effects may vary depending on where a needle is placed.
Together, these tools are beginning to map how a localized stimulus can ripple across the body—linking peripheral tissue, immune responses, and the brain’s pain-processing networks. Psychologically, the mere anticipation of potential healing plays its own role too, Yang adds. “Treatment expectancy and belief, mediated partly through the brain’s reward circuitry, may also contribute to acupuncture-induced pain relief.”
A comprehensive theory of acupuncture remains out of reach, but researchers are beginning to identify patterns that could help predict who benefits most. “In particular, I’m interested in the possibility of identifying biomarkers that predict treatment response and help us better understand which patients are most likely to benefit,” says Yang.
(See the diverse ingredients in traditional Chinese apothecaries.)
Some studies have also explored how traditional acupuncture maps align with anatomy. Researchers have reported an 80 percent overlap between classical meridian pathways and connective tissue networks, regions that appear to contain higher densities of nerve fibers than surrounding areas. One analysis found that these dense points may contain 1.4 times as many nerve fibers as non-acupoints.
“The traditional map of the meridians should be reinterpreted as a profound, ancient blueprint of the body’s neural and fascial networks,” says Judith Schlaeger, a professor at the College of Nursing at the University of Illinois Chicago. “The most effective points are often those that act as high-access ports to the nervous system.”
『假針，真緩解？』
數十年來，有一個問題始終揮之不去：針灸的效果是否超越了安慰劑效應？要回答這個問題已被證實極其困難。
「針灸的『廬山真面目』一直難以捉摸，」施萊格爾說。「研究人員過去缺乏使用決定性臨床方法——雙盲隨機對照試驗——的能力，來將針灸真正的生理效應與安慰劑效應區分開來。」
這個障礙現在可能終於被打破了。她的團隊剛剛完成了一項他們形容為全球首創的雙盲針灸試驗（在這項試驗中，無論是遭受慢性外陰疼痛折磨的 89 名女性受試者，還是研究人員本身，都不知道施加的是真針還是假針）。
這項試驗得以成行，歸功於東京有明醫療大學的的高倉伸有（Nobuari Takakura）所研發的一種特殊設計安慰劑針，這種針隱瞞了扎針的深度。他解釋道：「如果沒有雙盲的試驗環境，要解密針灸的機制是不可能的，因為研究人員將無法區分其真正的生理效果與預期心理的力量。」
該團隊的發現近期發表在《疼痛期刊》（Journal of Pain）上，結果顯示真針和假針針灸都能提供緩解，只是效果並不對等。真正的針灸能提供更長效的緩解，在某些病例中可長達 12 週，而安慰劑的緩解效果在 4 週後就開始減退。施萊格爾解釋，由於真正的針灸會造成微小損傷並釋放出一股化學物質，「中樞神經系統會因此受到激發，進而觸發人體天然的長期修復機制。」
高倉伸有補充，這表明雖然由「醫療儀式感」驅動的安慰劑緩解確實存在，但「緩解感消退得很快，因為它缺乏持久的刺激。這就是安慰劑的短暫本質與真正治療的持久效果之間，一條清晰的分界線。」
即便如此，疑問依然存在。未來還需要更大規模的研究和重複驗證，來證實這些發現並確定其適用的廣泛程度。
Fake needles, real relief
For decades, one question has lingered: Does acupuncture work beyond the placebo effect? Answering that has proved difficult.
“The ‘true face’ of acupuncture remained elusive,” says Schlaeger. “Investigators lacked the ability to use the definitive clinical methodology—the double-blind randomized controlled trial—to separate acupuncture’s genuine physiological effects from the placebo effect.”
That barrier may finally be shifting. Her team has just completed what they describe as the world’s first double-blind acupuncture trial (where neither the participants, 89 women suffering from chronic v***a pain, nor the researchers themselves knew if real or sham needles were administered).
The trial was made possible by a specially designed placebo needle, developed by Nobuari Takakura of Tokyo Ariake University of Medical and Health Sciences, which conceals the depth of needle pe*******on. He explains that “without a double-blind study environment, the decoding of the mechanisms of acupuncture would be impossible, because investigators wouldn’t be able to distinguish its true physiological effect from the power of expectation.”
(Scientists are learning how to interrupt pain before it forms.)
The team’s findings, recently published in the Journal of Pain, show that both real and sham acupuncture work can provide relief, just not equally. True acupuncture offers much longer-lasting relief of up to 12 weeks in some cases, while relief from the placebo diminished after four weeks. Since true acupuncture creates a micro-injury that releases a burst of chemical substances, “the central nervous system is excited,” Schlaeger explains, “triggering the body’s natural long-term repair mechanisms.”
Takakura adds, this shows that while the placebo-powered relief of ‘the ritual of care’ exists, “relief fades quickly because there is no lasting stimulus. This is the clear boundary between the fleeting nature of placebo versus the sustained effect of a true intervention.”
Even so, questions remain. Larger studies and replication will be needed to confirm these findings and determine how broadly they apply.
『當古老醫療遇上現代科學』
理解針灸的運作原理，其意義不僅止於滿足科學的好奇心。它可能會重塑全球治療疼痛的方式——在各國醫療體系積極尋找藥物替代方案之際，提供一個低成本且不具成癮性的選擇。針灸長期以來已融入中國及亞洲其他地區的醫療體系中，在德國等國家也得到了更廣泛的應用，當地的公共保險自 2007 年起就已將針灸納入某些慢性疼痛疾病的給付範圍。
世界衛生組織（WHO）傳統、補充與整合醫學處處長金承哲（Kim Sungchol）正期盼這樣的演變能持續下去。他的團隊正全力推動世衛組織的《全球傳統醫學戰略 2025–2034》，旨在將有證據支持的傳統療法整合到現代醫療體系中。金承哲指出：「根據世衛組織關於傳統與補充醫學的最新全球報告，針灸目前是該領域在全球範圍內使用最廣泛的干預手段。」
隨著證據庫的不斷擴大，針灸也可能成為其他傳統療法（從草藥醫學到冥想）獲得更廣泛認可的敲門磚——其中許多療法目前正以越來越嚴謹的臨床標準接受研究。
其帶來的成果可能是顛覆性的。在美國，自 2000 年以來阿片類藥物危機已奪走超過一百萬條人命，非藥物的疼痛管理方法正重新受到高度關注。一些研究表明，針灸可能會減少手術後的疼痛以及對阿片類藥物的需求，儘管研究結果各有差異。
金承哲表示：「歸根結底，2034年的願景並非要推崇某一種醫療系統而貶低另一種，而是要建立更強大的醫療體系，以切實反映人們尋求醫療照顧的真實方式。」
Ancient healthcare meets new
Understanding how acupuncture works does more than satisfy scientific curiosity. It could reshape how pain is treated globally—offering a low-cost, non-addictive option even as health systems search for alternatives to pharmaceuticals. Long embedded in healthcare systems across China and other parts of Asia, acupuncture is also used more widely in countries such as Germany, where public insurance has covered it for certain chronic pain conditions since 2007.
Kim Sungchol, unit head for Traditional, Complementary, and Integrative Medicine at the World Health Organization (WHO), is hoping such evolutions continue. His team is propelling the WHO’s Global Traditional Medicine Strategy 2025–2034, which aims to integrate evidence-based traditional practices into modern healthcare systems. “According to the most recent WHO global reports on traditional and complementary medicine, acupuncture is now the most extensively used intervention worldwide within this field,” notes Kim.
(Will mainstreaming traditional Chinese medicine threaten wildlife?)
As the evidence base grows, acupuncture may also serve as a gateway for broader acceptance of other traditional therapies, from herbal medicine to meditation—many of which are now studied with increasing clinical rigor.
The results could be transformative. In the United States, where the opioid crisis has claimed more than a million lives since 2000, non-pharmacological approaches to pain management are gaining renewed attention. Some studies suggest acupuncture may reduce both postoperative pain and the need for opioid medications, though results vary.
“Ultimately, the vision for 2034 is not about promoting one system over another, but about stronger health systems that reflect how people seek care,” says Kim.
#中醫 #針灸 #科學
https://www.nationalgeographic.com/health/article/acupuncture-evidence-pain-management?cmpid=org=ngp::mc=social::src=instagram::cmp=editorial::add=ig20260523health-acupunctureevidencepainmanagementpremiumhedcard&fbclid=PAVERFWAR_WwRleHRuA2FlbQIxMQBzcnRjBmFwcF9pZA8xMjQwMjQ1NzQyODc0MTQAAaenzi8ZmdOIUKxa_T2rU8jUWecQ_Fb4wnFkeKsd6G1ga0o1ZXnOwTDyjyO-AA_aem_-ypVzOxWybq0RnJBhmjhOA
