摘要
针刺在调节胃肠动力、恢复胃肠微生物群稳定结构、消除炎症反应、修复受损粘膜屏障等方面发挥着双向调节效应。肠—脑轴作为胃肠道与脑的双向调节通道,通过肠—脑轴途径可调节中枢神经系统、自主神经系统和肠神经系统的功能,由脑及肠或由肠及脑双向调整胃肠功能,从而改善餐后饱胀、恶心、食欲不振等多种消化不良症状。本文对目前针刺治疗功能性消化不良(functional dyspepsia,FD)的临床证据及内在作用机制进行总结,通过检索并梳理近年来针刺治疗FD的相关文献,发现针刺治疗FD疗效确切、安全且无不良反应。但鉴于目前研究的局限性,针刺作用于十二指肠嗜酸性粒细胞的免疫调节途径仍在进一步探索中。笔者认为今后有必要进行高质量的实验研究,制定严谨、合理的实验方案,建立更理想的动物模型,深入挖掘针刺对肠—脑轴的神经免疫调节机制,针刺对肠道菌群种类及数量的调控,以及迷走神经在针刺治疗FD中的具体机制等,提供更有说服力和可信的实验证据,以便更好地优化临床治疗。
Acupuncture plays a bidirectional regulating effect in regulating gastrointestinal motility,restoring the stable structure of gastrointestinal microbiome,eliminating inflammatory response and repairing the damaged mucosal barrier.Moreover,the gut-brain axis is a bidirectional regulatory channel between the gastrointestinal tract and the brain.The functions of the central nervous system(CNS),autonomic nervous system(ANS)and enteric nervous system(ENS)can be regulated through the gut-brain axis pathway,and the gastrointestinal functions can be adjusted from the brain to the intestine or from the gut to the brain bidirectional,so as to improve various dyspepsia symptoms such as postmeal fullness,nausea and loss of appetite.The present clinical evidence and internal mechanism of acupuncture in the treatment of functional dyspepsia(FD)were summarized in this paper.Through searching and combing related literature on acupuncture in the treatment of FD in recent years,it was found that acupuncture was effective,safe and without adverse reactions.However,in view of the limitations of current studies,the immunomodulatory pathway of acupuncture on duodenal eosinophils is still being further explored.The author believed that it was necessary to conduct high-quality studies in the future,formulate rigorous and reasonable experimental protocols,establish a more ideal animal model,and dig deeper into the neuroimmunomodulatory mechanism of acupuncture on the gut-brain axis.The regulation of the type and quantity of intestinal flora by acupuncture,as well as the specific mechanism of vagus nerve in acupuncture treatment of FD,provided more convincing and credible experimental evidences,so as to better optimize clinical treatment.
作者
陈璐
邸嘉玮
杜元灏
CHEN Lu;DI Jiawei;DU Yuanhao(Department of Acupuncture and Moxibustion,The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center of Traditional Chinese Acupuncture and Moxibustion,Tianjin 300381,China)
出处
《环球中医药》
CAS
2023年第11期2371-2377,共7页
Global Traditional Chinese Medicine
基金
国家自然科学基金面上项目(82074543)。
作者简介
陈璐(1996-),2021级在读硕士研究生。研究方向:针灸对缺血性脑病机制的研究。E-mail:cl1172369432@163.com;通信作者:杜元灏(1965-),博士,教授,主任医师。研究方向:针灸对缺血性脑病机制的研究。E-mail:jpjs_cn@sina.com;邸嘉玮,硕士研究生。
