以往研究表明腺苷类物质在针刺镇痛中发挥重要作用，咖啡因是重要的腺苷类受体拮抗剂。与国内针刺镇痛效应的报道不同，西方有学者认为针刺对慢性痛疗效普遍存在不确定性，这也成为他们否认针刺疗法有效性的依据。已有初步报道显示，西方人饮用咖啡的习惯可能影响针刺的镇痛效应。本研究拟通过人体试验和临床研究，系统观察习惯性饮用咖啡对正常人痛阈的改变，及对神经病理性痛患者针刺镇痛效应的影响，阐明咖啡对针刺镇痛效应的削弱。动物实验采用行为学、电生理学、免疫印迹等方法，在正常大鼠、坐骨神经慢性压迫的神经病理性痛模型大鼠、不同腺苷受体亚型基因敲除小鼠，观察痛阈、脊髓背角WDR神经元电活动、不同腺苷受体亚型表达变化，拟从整体、神经元及分子水平阐明咖啡因影响针刺镇痛效应的机制。本研究不仅能系统阐明造成针刺镇痛效应差异的原因与机制，而且可进一步为针刺镇痛效应的科学性、有效性提供坚实依据，对针刺疗法推广和应用具有指导意义。

Adenosine plays an important role in the acupuncture analgesia, and caffeine is an adenosine antagonist. Previous reports from China provide a consistent acupuncture analgesia whereas western reports show an elusive effect which is an important reason to deny acupuncture. Preliminary reports demonstrated that caffee could reduce the acupuncture analgesia. In the present study, we will further address the effect of caffeine on acupuncture analgisia through clinical trials including health volunteers and lumbocrural pain patients who drink coffee and do not drink it. Using behavioral and electrophysiological methods, we will elucidate the spinal and molecular mechanism by which caffeine decreases acupuncture analgesia through detecting the pain threshold, WDR neuron activities, adenosine receptor subtype expressions in normal and CCI neuropathic pain model rats as well as A1R, A2AR gene knockout mice.The predictable results will not only elucidate the difference of acupuncture analgesia in people who drink coffee or not and the underlying mechanisms,but also provide solid evidence for acupuncture analgesia, and will thus improve the application of acupuncture analgesia in the clinic.