脑缺血后钙稳态失衡及针刺调节机制探析  

Exploration on Calcium Homeostasis Imbalance after Cerebral Ischemia and Acupuncture Regulatory Mechanism

作　　者：赵若琳 李礼[1,2] 王瑞琦 杨沙 王舒[2,3] 武虎 沈燕 ZHAO Ruolin;LI Li;WANG Ruiqi;YANG Sha;WANG Shu;WU Hu;SHEN Yan(The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300381,China;Tianjin Key Laboratory of Acupuncture and Moxibustion,Key Laboratory of Cerebropathy Acupuncture Therapy of State Administration of Traditional Chinese Medicine,Tianjin 300381,China;Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine,Tianjin 300381,China;Tianjin Rehabilitation and Recuperation Center of the Joint Logistics Support Force of the Chinese People's Liberation Army,Tianjin 300191,China)

机构地区：[1]天津中医药大学第一附属医院国家中医针灸临床医学研究中心,天津300381 [2]天津市针灸学重点实验室国家中医药管理局脑病针刺疗法重点研究室,天津300381 [3]天津市中医药研究院附属医院,天津300381 [4]中国人民解放军联勤保障部队天津康复疗养中心,天津300191

出　　处：《针灸临床杂志》2023年第5期1-6,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家自然科学基金,编号:81804189;天津市科技计划项目,编号:21JCQNJC01560;天津中医药大学研究生科研创新项目,编号:YJSKC-20211010。

摘　　要：细胞钙稳态失衡是脑缺血后早期损伤关键环节,与缺血性脑卒中(IS)损伤程度密切相关。针刺减轻或延缓缺血后神经元损伤的作用机制已有广泛研究,但针刺对钙稳态调控的认识尚不充分。系统梳理国内外相关研究发现:针刺可通过调节细胞膜离子型谷氨酸受体、L型电压依赖性钙通道、酸敏感离子通道和瞬时受体通道抑制外源性Ca^(2+)内流,通过调节质膜钙ATP酶和钠钙交换体表达促进胞内[Ca^(2+)]i排出,通过调节线粒体电压依赖性ATP酶和内质网IP3Rs通道促进线粒体的钙摄取、抑制内质网的钙释放,从而多途径、多靶点减轻缺血后Ca^(2+)超载;并通过抑制钙调蛋白、钙调蛋白依赖性蛋白激酶Ⅱ和磷脂酶A2等Ca^(2+)受体及下游靶蛋白表达减轻钙超载所致的细胞损伤。后续应当从人体自适应性、整体调节和动态发展的视角,继续深入研究针刺减轻脑缺血后钙稳态失衡的机制,阐释针刺脑保护作用的科学内涵。The imbalance of cellular calcium homeostasis is the key link of early injury after cerebral ischemia,which is closely related to the degree of ischemic stroke(IS)injury.The mechanism of acupuncture in relieving or delaying neuronal injury after ischemia has been widely studied,but the understanding of acupuncture on calcium homeostasis regulation is still insufficient.A systematic review of relevant researches at home and abroad shows that acupuncture can inhibit exogenous Ca^(2+)influx by regulating ionic glutamate receptors,L-type voltage dependent calcium channels,acid sensitive ion channels and transient receptor channels on cell membrane,promote[Ca^(2+)]i excretion in cells by regulating plasma membrane calcium ATPase and sodium calcium exchanger expression,promote mitochondrial calcium uptake by regulating mitochondrial voltage dependent ATPase and endoplasmic reticulum IP3Rs channels,and inhibit calcium release of endoplasmic reticulum,so as to reduce Ca^(2+)overload after ischemia in multiple ways and targets.It can also reduce the cell damage caused by calcium overload by inhibiting Ca^(2+)receptors and downstream target proteins expressions,including calmodulin,calmodulin dependent protein kinase II and phospholipase A2.In the future,the mechanism study of acupuncture in reducing calcium homeostasis imbalance after cerebral ischemia from the perspective of human adaptation,overall regulation and dynamic development should be deeply explored to explain the scientific connotation of acupuncture’s protection effect on brain.

关 键 词：缺血性脑卒中 钙稳态 针刺 脑保护机制 

分 类 号：R246.6[医药卫生—针灸推拿学]