针刺治疗脑卒中后抑郁机制研究进展  

Research progress on mechanism of acupuncture treatment for post-stroke depression

作　　者：李文鑫 何聪 刘征 LI Wenxin;HE Cong;LIU Zheng(College of Graduate,Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学研究生院,哈尔滨150040 [2]黑龙江中医药大学附属第一医院

出　　处：《环球中医药》2024年第8期1679-1684,共6页Global Traditional Chinese Medicine

基　　金：黑龙江省自然科学基金联合引导项目(LH2022H083);黑龙江省中医药管理局国医大师学术思想传承科研课题(GY2022-06);黑龙江中医药大学“优秀创新人才支持计划”(2018RCD10)。

摘　　要：针刺是目前临床用于治疗脑卒中后抑郁的常用疗法,疗效显著、不良反应低是其作用特点。本文对近年来针刺治疗脑卒中后抑郁的机制进行概述,发现针刺有以下作用:(1)通过调节单胺类及氨基酸类神经递质水平;(2)增加神经生长因子(nerve growth factor,NGF)表达及调节CREB/BDNF/TrkB信号通路保护受损神经元;(3)调控Bcl-2家族蛋白表达抑制神经细胞凋亡;(4)通过激活PI3K/Akt/mTOR通路降低自噬;(5)调控大麻素受体1(cannabinoid receptor 1,CB1R)增加线粒体再生及增加活性氧(reactive oxygen species,ROS)、丙二醛(malonaldehyde,MDA)、谷胱甘肽(glutathione,GSH)改善氧化应激损伤;(6)调节促炎因子表达抑制炎症反应发生;(7)调控下丘脑—垂体—肾上腺轴亢进;(8)调节肠道菌群等多途径发挥抗抑郁作用。研究表明针刺治疗脑卒中后抑郁具有多靶点、全方位调控的特点,本文旨在为针刺治疗脑卒中后抑郁症的基础研究提供参佐。Acupuncture is a common therapy used in clinical practice to treat post-stroke depression,and its characteristics are remarkable efficacy and low adverse reactions.This article summarized the mechanisms of acupuncture in treating post-stroke depression in recent years,and founds that acupuncture had the following effects:(1)Regulating the levels of monoamine and amino acid neurotransmitters.(2)Increasing the expression of nerve growth factor(NGF)and regulating the CREB/BDNF/TrkB signaling pathway to protect damaged neurons.(3)Regulating the expression of Bcl-2 family proteins to inhibit neuronal apoptosis.(4)Activating the PI3K/Akt/mTOR pathway to reduce autophagy.(5)Regulating the expression of cannabinoid receptor 1(CB1R)to increase mitochondrial regeneration and increase reactive oxygen species(ROS),malonaldehyde(MDA),glutathione(GSH)to improve oxidative stress damage.(6)Regulating the expression of pro-inflammatory factors to inhibit the occurrence of inflammatory response.(7)Regulating the hyperactivity of the hypothalamic-pituitary-adrenal axis.(8)Regulating the intestinal flora and other pathways to exert anti-depressant effects.Research shows that acupuncture therapy for post-stroke depression has the characteristics of multi-target and comprehensive regulation.This article aims to provide references for the basic research of acupuncture therapy for post-stroke depression.

关 键 词：针刺 脑卒中后抑郁 神经递质 保护神经元 氧化应激 炎症 基础研究 

分 类 号：R245[医药卫生—针灸推拿学]