基于“嗅脑关联”通路探讨针刺干预三叉神经痛作用机制  

Investigation of the Mechanism of Acupuncture Intervention for Trigeminal Neuralgia Based on the“Olfactory Brain Connection”Pathway

作　　者：刘彤 王海荣[1] 高莹[1] 杨欣欣 梁华 LIU Tong;WANG Hairong;GAO Ying;YANG Xinxin;LIANG Hua(The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300100,China;National Clinical Research Center of TCM Acupuncture and Moxibustion,Tianjin 300100,China)

机构地区：[1]天津中医药大学第一附属医院,天津300100 [2]国家中医针灸临床医学研究中心,天津300100

出　　处：《辽宁中医药大学学报》2025年第3期48-52,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金(82104998);中医药重点学科能力提升项目(2018ZDXK006)。

摘　　要：三叉神经痛(trigeminal neuralgia,TN)又名痛性抽搐,是最常见的脑神经疾病,发作时常表现为面部阵发性刺痛或刀割样痛,可伴有电击样感觉。目前三叉神经痛的治疗与康复仍是世界性的临床难题。三叉神经的分支位于鼻内,与嗅觉密切相关,针刺通过嗅脑关联通路治疗三叉神经痛的临床疗效肯定,但作用机制尚未明确。该文通过梳理三叉神经痛与嗅脑关联通路的联系及嗅觉对三叉神经的影响,从针刺对三叉神经痛及嗅觉的作用、针刺调节中枢神经-免疫网络等多个角度出发,探讨针刺通过调控嗅脑关联通路治疗三叉神经痛的作用机制。发现以嗅脑关联为通路进行针刺能够改善嗅觉,从而间接调节面部感觉神经的兴奋性,影响三叉神经痛的发作频率和强度。同时针刺可以加快病变周围血液循环、改善局部的供氧情况、加速神经水肿吸收、调控免疫细胞因子、消除炎症物质、促进神经重组及愈合、激活内源性物质、调节神经-免疫网络和改变大脑活动等多种方式来减轻疼痛,使三叉神经恢复正常的生理功能,从而治疗三叉神经痛。Trigeminal neuralgia(TN),also known as painful tics,is one of the most common cranial nerve disorders and often presents with paroxysmal facial tingling or knife-like pain that may be accompanied by an electric shock-like sensation.At present,the treatment and rehabilitation of trigeminal neuralgia is still a worldwide clinical problem.The branch of the trigeminal nerve is located in the nose,which is closely related to the sense of smell.The clinical efficacy of acupuncture in the treatment of trigeminal neuralgia through the olfactory brain correlation pathway is certain,but the mechanism of action is not clear.By combing the connection between trigeminal neuralgia and olfactory brain associated pathway and the influence of olfactory on trigeminal nerve,this paper discusses the mechanism of acupuncture in treating trigeminal neuralgia by regulating olfactory brain associated pathway from multiple perspectives,such as the effect of acupuncture on trigeminal neuralgia and olfactory sense,and the regulation of central nervus-immune network by acupuncture.It was found that acupuncture using the olfactory-brain association as a pathway could improve the sense of smell and indirectly regulate the excitability of facial sensory nerves,thereby affecting the frequency and intensity of trigeminal neuralgia.At the same time,acupuncture can speed up the blood circulation around the lesion,improve the local oxygen supply,accelerate the absorption of nerve edema,regulate immune cytokines,eliminate inflammatory substances,promote nerve reorganization and healing,activate endogenous substances,regulate the neuro-immune network and change brain activity and other ways to reduce pain,so that the trigeminal nerve can restore normal physiological function,so as to treat trigeminal neuralgia.

关 键 词：嗅脑关联 三叉神经痛 嗅觉 针刺疗法 综述 

分 类 号：R246.6[医药卫生—针灸推拿学]