针刺改善创伤后应激障碍海马损伤的机制研究进展  

Research Progress on Mechanism of Acupuncture Improving Hippocampal Injury in Post-Traumatic Stress Disorder

作　　者：吕涛 吴玉梅 LYU Tao;WU Yumei(Shaanxi University of Chinese Medicine,Xianyang 712046,Shaanxi,China;Air Force Medical University,Xian 710032,Shaanxi,China)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]军空军军医大学,陕西西安710032

出　　处：《中华中医药学刊》2023年第3期147-153,共7页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82071515);陕西省国际合作重点项目(2020KWZ-021)。

摘　　要：创伤后应激障碍(post-traumaticstressdisorder,PTSD)是指个体在遭受强烈刺激之后所产生的一种精神障碍性疾病。研究证实,海马是与学习记忆密切相关的脑区,海马损伤会导致机体在面对创伤事件时做出过度应激反应,最终产生PTSD样症状。导致PTSD海马损伤的机制多而复杂,主要包括HPA轴功能异常、神经递质系统异常改变、内源性大麻素系统紊乱以及脑源性神经营养因子减少等。基于对PTSD发病机制的认识,临床治疗主要采用药物治疗和心理干预。然而,由于药物在治疗中的不良反应以及疾病的易复发性,药物治疗效果并不理想。心理干预也只能暂时或在一定时间内改善症状,并没有一劳永逸之效。针刺作为我国中医药中的独特疗法,具有操作简便、不良反应小等优势,在改善PTSD的海马损伤方面具有显著作用。总结了近年来针刺治疗PTSD的相关文献,对针刺改善PTSD海马损伤的作用机制进行综述,从而能够更好地指导临床治疗PTSD,使这一严重影响人类健康和生活质量的疾病不再成为困扰社会的问题。Post-traumatic stress disorder(PTSD)is a mental disorder caused by intense stimulation.Studies have confirmed that the hippocampus is a brain region closely related to learning and memory,and hippocampal injury will lead to excessive stress response facing traumatic events,and eventually produce PTSD-like symptoms.There are many and complex mechanisms leading to hippocampal injury in PTSD,including the dysfunction of HPA axis,the abnormal changes of neurotransmitter system,the disorder of endogenous cannabinoid system and the reduction of brain-derived neurotrophic factor.Based on the understanding of the pathogenesis of PTSD,medication and psychological intervention are mainly used in clinical treatment.However,the therapeutic effect is not ideal due to the adverse drug reactions in the treatment and the recurrence of the disease.Psychological intervention only improves symptoms temporarily or within a certain period of time,but can not maintain for a long time.As a distinctive therapy of traditional Chinese medicine in China,acupuncture takes the advantages of simple operation and few side effects,and plays a significant role in improving the hippocampal injury of PTSD.This paper summarized the relevant literatures on acupuncture treatment of PTSD published in recent years,and summarized the mechanisms of acupuncture improving hippocampal injury in PTSD,so as to better guide the clinical treatment of PTSD which seriously affects human health and life quality and make it no longer become a problem perplexing the society.

关 键 词：创伤后应激障碍 海马损伤 针刺 HPA轴 神经递质系统 内源性大麻素系统 

分 类 号：R245.31[医药卫生—针灸推拿学]