针灸通过介导轴突再生治疗脊髓损伤的研究进展  

Research progress of acupuncture-moxibustion in treatment of spinal cord injury through mediatingaxonal regeneration

作　　者：尚文雅 任亚锋[2] 黄靖 李冰[2] 黄晓萌 张芝兰 SHANG Wen-ya;REN Ya-feng;HUANG Jing;LI Bing;HUANG Xiao-meng;ZHANG Zhi-lan(Henan University of Chinese Medicine,Zhengzhou 450000,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000)

机构地区：[1]河南中医药大学,郑州450000 [2]河南中医药大学第一附属医院,郑州450000

出　　处：《针刺研究》2025年第1期96-103,共8页Acupuncture Research

基　　金：河南省中医药科学研究专项(No.2022JDZX015、2021JDZY022)。

摘　　要：本文基于生长因子理论、外部抑制理论、神经元内在理论,阐述了针灸介导轴突再生治疗脊髓损伤的潜在机制。针灸通过调节生长因子表达支持神经元存活和轴突生长;通过抑制星形胶质细胞瘢痕形成、减少髓鞘生长抑制因子Nogo蛋白和OMgp表达、调控轴突引导分子Sema3A和Wnt家族,为轴突再生创造有利的外部环境;通过调控PTEN/mTOR、Rho/ROCK、MAPK/ERK、cAMP/PKA信号通路,激发轴突的内在生长能力。本文对上述机制进行了总结,以期为针灸治疗脊髓损伤的深入机制研究提供一定的依据和思路。Based on the growth factor theory,external inhibition theory,and neuronal intrinsic theory,we,in this paper,summed up the potential mechanisms of acupuncture in the treatment of spinal cord injury(scl)by promoting the axonal regeneration in recent years.Acupuncture can promote the repairment of Scl by(1)regulating the expressions of spinal cord growth factors(such as nerve growth factor,brain derived neurotrophic factor,neurotrophin-3,glial cell line-derived neurotrophic factor,ciliary neurotrophic factor,insulin-like growth factor,etc.)to support neuronal survival and axon growth;(2)inhibiting the expression of spinal cord myelin growth inhibitor Nogo protein and oligodendrocyte myelin glycoprotein(OMgp),requlatingaxonguidemoleculesSema3A and Wntfamily,etc.,and inhibiting the formation of astryocyte scar to create a favorable local microenvironment for axon regeneration;and(3)regulating spinal phosphatase and tensin homolog deleted on chromosome ten(PTEN)/mammalian target of rapamycin(mTOR)signaling,down-regulatingRashomologgenefamily member A(RhoA)/Rho-associated protein kinase II(ROCK II)signaling,up-regulating mitogen-activated protein kinase kinase(MAPK)/extracellular signal-regulated kinase(ERK)signaling,cAMP/protein kinase A(PKA)signaling,etc.In addition,we also found that by modulating axon regeneration,acupuncture therapy can not only effectively restore motor function in Scl patients,but also improve neurogenic bladder symptoms.

关 键 词：脊髓损伤 针灸 轴突再生 机制 综述 

分 类 号：R246.2[医药卫生—针灸推拿学]