针刺调控脊髓损伤后免疫炎症微环境研究进展  

Research Progress of Acupuncture in Regulating Microenvironment of Immune Inflammation after Spinal Cord Injury

作　　者：任月乔 徐家淳 吴珺 胡董健 周震[2] 李岩[3] REN Yueqiao;XU Jiachun;WU Jun;HU Dongjian;ZHOU Zhen;LI Yan(Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300250,China;Tianjin Gong’an Hospital,Tianjin 300042,China)

机构地区：[1]天津中医药大学,天津301617 [2]天津中医药大学第二附属医院,天津300250 [3]天津市公安医院,天津300042

出　　处：《辽宁中医药大学学报》2023年第7期80-84,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82174191)。

摘　　要：脊髓损伤(spinal cord injury,SCI)是一种中枢神经系统损伤性疾病,具有高致残性,可引起包括肌肉萎缩在内的多种系统并发症,是亟待解决的临床问题。根据病理因素将其分为原发性SCI和继发性SCI,原有损伤受免疫炎症反应的持续影响,引起脊髓继发性损伤,这一过程刺激脊髓常驻小胶质细胞、脑内特化星形胶质细胞以及巨噬细胞为主的免疫细胞活化,激活炎症小体,释放炎症因子,启动并调控炎症反应,引起脊髓组织内免疫炎症微环境失衡,导致神经元再生与修复受限。毫针、电针以及火针疗法作为临床治疗SCI的常用针刺手段,通过诱导脊髓相关免疫细胞向抑炎型极化、抑制炎症小体表达以及调控促炎/抗炎因子释放,平衡促炎/抗炎反应,调控脊髓免疫炎症微环境恢复稳态,进而达到脊神经再生、修复目的。因此,该文阐释免疫炎症微环境改变对SCI神经再生、修复的影响,总结针刺疗法治疗SCI的现有研究成果,归纳针刺调控脊髓免疫炎症微环境的可能作用机制,以期为调控脊髓免疫炎症微环境防治继发性SCI的临床针刺应用提供参考。Spinal cord injury(SCI)is a devastating disease of the central nervous system,which is highly disabling and can cause a variety of systemic complications,including muscle atrophy,and it is an urgent clinical problem to be solved.According to pathological factors,they are divided into primary SCI and secondary SCI.The original injury is continuously affected by the immune inflammatory response,causing secondary injury to the spinal cord.This process stimulates the activation of immune cells mainly composed of microglia,brain-internalized astrocytes and macrophages in the spinal cord,activates inflammasomes,releases inflammatory factors,initiates and regulates the inflammatory response,causing an imbalance of the immune and inflammatory microenvironment in the spinal cord tissue,leading to limited neuronal regeneration and repair.Filiform needle,electric acupuncture and fire needle therapies are the common acupuncture means for clinical treatment of SCI.They can balance the pro-inflammatory and anti-inflammatory responses and regulate the immune and inflammatory microenvironment of the spinal cord to restore steady state by inducing the polarization of spinal cord-related immune cells to the anti-inflammatory type,inhibiting the expression of inflammasomes and regulating the release of pro-inflammatory and anti-inflammatory factors,thereby achieving the purposes of spinal nerve regeneration and repair.Therefore,this paper explains the effects of changes in the immune and inflammatory microenvironment on the regeneration and repair of SCI nerves,summarizes the existing research results of acupuncture therapy for SCI,and summarizes the possible mechanism of acupuncture in regulating the immune and inflammatory microenvironment in the spinal cord,in order to provide reference for promoting the clinical acupuncture application in preventing and treating secondary SCI by regulating the immune and inflammatory microenvironment in the spinal cord.

关 键 词：脊髓损伤 免疫炎症微环境 毫针疗法 电针疗法 火针疗法 

分 类 号：R245.31[医药卫生—针灸推拿学]