病理条件下的神经可塑性及在针灸研究中的可能应用

The Pathological Neural Plasticity and Its Application in Acupuncture Research

大脑由可塑性极强的神经元组成。许多病理因素通过神经可塑性的分子细胞学机制诱导出特异性的神经活动模式,从而在细胞学水平引起脑的病理生理变化。这一逐步完善的理论不仅为理解诸多极为复杂的神经系统疾病提供了理论依据,亦为将来的临床治疗提供了可行的途径。针灸效应的生物学机制目前尚不十分清楚,有证据表明:经穴信息可能直接或间接地传入中枢神经系统,并通过重塑神经元活动模式(可塑性)达到某些治疗效果。由于这方面的研究尚处于起步阶段,这里以药物成瘾中神经可塑性作为范例,论述外周刺激如何利用神经可塑性改变脑的功能。药物成瘾是一种中枢神经系统性疾病,通常被定义为无法自拔的药物使用。充分证据表明:反复使用某种依赖性药物后,中脑边缘多巴胺(DA)系统的神经回路会发生一系列病理性的持久变化,从而导致动物情绪上的巨大变化。发现、鉴定和总结成瘾性药物在中脑边缘DA系统引发的长时程细胞学变化,是目前揭开成瘾的神经学机制的一条可行之路。突触可塑性变化是长时程神经变化中进展最快、最深入的研究领域。因此,本文以药物成瘾为例,阐明在特定病理条件下神经系统中可塑性的普遍机制和在针灸研究中的可能应用。

The central nervous system （CNS） is involved in a variety of disease conditions. Some seeming peripheral diseases, like chronic pain and disorders in major organs, indeed have clear pathological basis in the CNS, On the other hand, some clinically-beneficial peripheral stimulation, such as acupuncture and massage, exerts significant influence on central neurons. This review attempts to summary recent findings in neuroscience about how pathological insults long-term plastic changes within neural circuits, leading to maladaptive behaviors. This neuroplasticity-based theory not only conceptualizes a cellular mechanism for a plethora of neuropathophysiology but also provides clinical strategies for treating neural diseases. Drug addiction is a chronic brain disease, defined as compulsive drug-seeking, drug-craving, and drug-taking behaviors. Extensive experimental evidence suggests that following exposure to drugs of abuse, neurons within the mesolimbic dopamine system undergo a series of plastic changes that may lead to compulsive emotional and motivational states. It is believed that the first step to unlock the secret of drug addiction is to identify, evaluate, and conceptualize drug-induced neural plasticity. Synaptic plasticity is one form of neuroplasticity that has been best characterized. Using addiction-related synaptic plasticity as a working model, this review attempts to depict the general concept and experimental approach in studying the pathophysiological neural basis of acupuncture.