以针导“药”、靶向趋病的针药并用研究新策略  

New strategy for combination of acupuncture and drugs including guiding drugs by acupuncture and target to reach the lesion site

作　　者：陈波 李柠岑[2] 陈双莉 郭义 CHEN Bo;LI Ningcen;CHEN Shuangli;GUO Yi(School of Acupuncture&Moxibustion and Tuina,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;Research Center of Experimental Acupuncture Science,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 301617,China)

机构地区：[1]天津中医药大学针灸推拿学院,天津301617 [2]天津中医药大学实验针灸学研究中心,天津301617 [3]国家中医针灸临床医学研究中心,天津301617

出　　处：《中华中医药杂志》2024年第4期1878-1883,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金青年科学基金项目(No.82004467);第五届中国科协青年人才托举工程项目(No.2019-2021ZGZJXHQNRC001);国家自然科学基金重点基金项目(No.82030125)。

摘　　要：基于中医针灸经典理论“刺之要,气至而有效”,结合本团队前期针刺后血清外泌体的研究发现,笔者认为,“气至病所”是提高针灸临床疗效的关键,而“至病所”的“气”可能是治疗疾病相关的活性物质,既可以是针刺调动机体内源性活性物质靶向病所,也可以引导外源性药物活性靶标到达病所。提出以针导“药”、靶向趋病的可能机制是疾病以需求为驱动,疾病需求是“气至病所”的内源性牵引力,以针导“药”(“药”:内源性或外源性活性成分),针刺通过刺激穴位使治疗疾病的相关活性成分靶向到达疾病所需部位,针刺穴位是“气至病所”的外源性驱动力,需求驱动、以针导“药”,从而发挥协同增效的作用。本研究为拓展针灸临床应用,特别是针刺更广泛地结合现代临床用药,发挥增效减毒作用提供转化思路与理论依据。According to the classical theory of acupuncture in traditional Chinese medicine:‘the essence of acupuncture is qi and effective’,explore the idea of clinical transformation of basic research on acupuncture.According to the team’s previous research findings on serum exosomes after acupuncture,we believe that‘qi reaching affected area’is the key to improve the clinical efficacy of acupuncture,and the‘qi’of‘reaching the affected area’may be the active substance related to the treatment of diseases,which can be the active substance released by acupuncture to mobilize the body to target the disease site.It can also guide the active target of exogenous drugs to the disease site.It is proposed that the possible mechanism of acupuncture navigation and targeted disease tendency is that the disease is driven by demand,the disease demand is the endogenous traction of‘qi reaching affected area’,the acupuncture guides the medicine(medicine:endogenous or exogenous active ingredients),and the acupuncture stimulates the acupoints to make the relevant active ingredients of the disease targeted to the required parts of the disease,and the acupuncture acupoints are the exogenous driving force of‘qi reaching affected area’,which is driven by demand and guided by acupuncture,so as to play the role of synergy.It provides transformation ideas and theoretical basis for expanding the clinical application of acupuncture,especially for acupuncture to be more widely combined with modern clinical medication,and to play the role of increasing efficiency and reducing toxicity.

关 键 词：气至病所 以针导“药” 针药并用 靶向趋病 针刺导航 

分 类 号：R246[医药卫生—针灸推拿学]