针灸治疗痛性糖尿病周围神经病变多模态脑影像学研究进展  

Advances in multimodal brain imaging of acupuncture for painful diabetic peripheral neuropathy

作　　者：钟祯 王雨 黄海鹏[1] 马诗棋 郑海珠 李孟媛 姚琳 王洪峰[1] 丛德毓[2] ZHONG Zhen;WANG Yu;HUANG Haipeng;MA Shiqi;ZHENG Haizhu;LI Mengyuan;YAO Lin;WANG Hongfeng;CONG Deyu(Changchun University of Chinese Medicine,Changchun 130117,China;Affiliated Hospital of Changchun University of Chinese Medicine,Changchun 130021,China)

机构地区：[1]长春中医药大学,长春130117 [2]长春中医药大学附属医院,长春130021

出　　处：《吉林中医药》2025年第1期117-123,共7页Jilin Journal of Chinese Medicine

基　　金：国家重点研发计划(2018YFC1706000);吉林省科技发展项目(YDZJ202301ZYTS165)。

摘　　要：痛性糖尿病周围神经病变(painful diabetic peripheral neuropathy,PDPN)是糖尿病并发症之一。痛性糖尿病周围神经病变发病机制复杂,涉及代谢紊乱、血管损伤、神经损伤、氧化应激损伤、炎症反应等多个方面。外周敏化和中枢敏化在痛性糖尿病周围神经病变的产生和维持过程中具有重要作用。多模态脑影像学技术为痛性糖尿病周围神经病变中枢机制研究提供了新的方向。磁共振成像(magnetic resonance imaging,MRI)技术成为深入揭示痛性糖尿病周围神经病变发病机制与病变程度的重要研究手段。针灸治疗痛性糖尿病周围神经病变的中枢作用机制有待进一步明确。从痛性糖尿病周围神经病变的诊断及风险因素、中枢敏化概述痛性糖尿病周围神经病变的发展现状,梳理针灸治疗痛性糖尿病周围神经病变的临床证据及中枢机制,从灰质体积萎缩、白质结构受损、脑区激活改变、脑功能网络异常、脑内代谢物质浓度变化等角度,分析基于多模态磁共振成像技术的痛性糖尿病周围神经病变中枢神经系统改变研究现状,阐述针灸治疗本病的中枢效应机制。Painful diabetic peripheral neuropathy(PDPN)is one of the complications of diabetes.The pathogenesis of PDPN is complex,involving multiple aspects such as metabolic disorders,vascular damage,nerve damage,oxidative stress damage,and inflammatory response.Peripheral sensitization and central sensitization play important roles in the generation and maintenance of PDPN.Multimodal brain imaging techniques provide a new direction for the study of the central mechanism of PDPN.Magnetic resonance imaging(MRI)technology has become an important research means to deeply reveal the pathogenesis and lesion degree of PDPN.The central mechanism of acupuncture in the treatment of PDPN needs to be further clarified.This paper outlines the development status of PDPN from the diagnosis and risk factors of PDPN and central sensitization,sorts out the clinical evidence and central mechanism of acupuncture in the treatment of PDPN,analyzes the current research status of central nervous system changes in PDPN based on multimodal MRI technology from the perspectives of gray matter volume atrophy,white matter structure damage,brain region activation changes,brain function network abnormalities,and changes in the concentration of brain metabolites,and elaborates the central effect mechanism of acupuncture in the treatment of this disease.

关 键 词：针灸 痛性糖尿病周围神经病 磁共振成像 中枢机制 

分 类 号：R246[医药卫生—针灸推拿学]