颈交感神经节与脊神经节间中枢外反射弧的结构与生理功能研究

Our clinical observations found that cervical vertigo is correlated with neck pain, and clinical sympotons of cervical vertigo can be remitted by blocking this nerve fiber connection, our previous experiments also confirmed the neural connection between cervical sympathetic and spinal ganglia in rabbits, Based on our previous reports,we believe that there is a reflection arcexited btween cervical sympathetic and spinal ganglia.This proposal was aimed to calrifythe detailed structrural and functional connections between cervical sympathetic and spinal ganglia through:① using fluorescence tracer techniquesto analyze the fiber connection intensities between the cervical sympathetic and spinal ganglia and to determine the patterns of this connection in different cervical levels;② using immunohistochemical methods to determine the neurotransmitter content changes in the sympathetic ganglia and spinal ganglia under different electrical stimulationto define their releasing characteristics and the contributions to the connection;③ using neural electrophysiological techniques to test signal strengths among the soft tissue, spinal and sympathetic ganglia to investigate the transmiting manners of electrical signals and compare these signal strengths with sympathetic innervation physiological changes including vertebral artery blood flow, basilar artery blood flow and heart rate to determine the relationship among electrical signal transmission and the blood flow and heart rate changes. Successful acomplishment of this project will reveal the roles of the fiber connections between cervical sympathetic and spinal nervesin cervical vertigo, and lay foundations to further study the sympathetic nerve doctrine of cervical vertigo pathogenesis.

我们临床发现颈性眩晕与颈部疼痛存有相关性，椎板旁阻滞脊神经可减轻患者颈性眩晕，动物实验也发现颈交感神经节与脊神经节之间存在直接的纤维联系，由此推断在颈性眩晕发病转归过程中存在着由颈交感神经节和脊神经节参与的中枢外反射弧。在此基础上我们拟采用荧光金示踪、免疫组化、神经电生理等技术：①进一步确认颈部交感神经节与脊神经节之间的神经联系及其联系方式，确定其联系强度；②测定不同电刺激下交感神经节及脊神经节内神经递质的含量变化，分析神经递质的释放特点及在此反射弧中的贡献；③检测颈部电信号在软组织、脊神经节及交感神经节的强弱，明确电信号传导路径和方式，同时与椎基底动脉血流等交感性生理变化相比较，确定躯体症状与内脏症状之间的关系。藉通过上述研究，确认颈交感神经节和脊神经节之间中枢神经外反射弧的存在及功能，探讨颈交感神经与脊神经联系在颈性眩晕发病中作用，为提高颈性眩晕临床治疗效果提供理论基础。

颈性眩晕与颈部疼痛存有相关性，推断在颈性眩晕发病转归过程中存在着由颈交感神经节和脊神经节参与的中枢外反射弧，课题组前期证实了颈交感神经节与颈脊神经节间直接的双向神经联系，且其分布具有节段性，国内外对于颈部中枢外反射弧研究未有报道，对这一直接联系的相互作用生理表现认识较少。据此，本研究：1.利用荧光金的示踪技术，研究发现颈上交感神经节与同侧相应节段脊神经存在神经纤维联系，其中C2、C3脊神经节主要与同侧颈上交感神经节存在神经纤维联系存在， C6、C7脊神经节主要与同侧颈下交感神经节存在神经纤维联系。2.采用免疫组化方法，分析不同电刺激下颈交感神经节及脊神经节内神经递质神经肽Y（NPY）和去甲肾上腺素(NE）的含量变化，研究发现通过电刺颈上交感神经节或颈脊神经节，免疫组化法检测同侧C2、C3的脊神经节内NPY、NE增多，电刺颈下交感神经节，免疫组化法检测同侧C6、C7的脊神经节内NPY、NE增多。电刺激C2、C3脊神经节，同侧颈上交感神经节内的NPY、NE是增多的；电刺激C6、C7脊神经节，同侧颈下交感神经节内的NPY、NE是增多的。3.电刺激颈脊神经能够在颈交感神经节监测到动作电位及电传导，反之电刺激颈交感神经能在脊神经节监测到动作电位及电传导，同时在排除脊髓内反射通路及颅脑通路后仍能监测到动作电位及电传导，证实颈交感神经与颈脊神经间存在电生理功能性联系。电刺激椎旁组织、颈脊神经节及颈交感神经节，电刺激后能够引起心率变化，从而能够说明从颈部软组织到颈脊神经节到颈交感神经节再到椎基底动脉形成完整的颈脊髓外神经反射弧途径。综上所述，本研究系统阐述了颈交感神经节和脊神经节之间神经纤维联系强度，可以初步确立在颈性眩晕发病转归过程中存在着这样一个中枢外反射弧，进一步明确该反射弧在颈性眩晕发病中的作用，并为临床颈性眩晕的治疗提供理论基础。