推拿治疗膝骨关节炎疼痛机制研究进展

Research Progress on Pain Mechanism of Tuina in Treatment of Knee Osteoarthritis

外周伤害性刺激和中枢神经系统对疼痛信号的传导和调控是膝骨关节炎(knee osteoarthritis,KOA)疼痛的关键病理机制,而推拿可显著缓解KOA患者的膝关节疼痛,其机制与减少外周伤害性刺激、调控脑中枢密切相关。目前,推拿治疗KOA疼痛的现代科学机制有待明确,需进一步加强系统性、多层面的机制研究;脊髓中枢在KOA疼痛信号的传导及调控中具有重要作用,需从分子生物学、神经功能影像学层面进一步研究;KOA推拿干预方案在实验动物上可操作性较差,或可将神经功能影像学相关技术作为推拿干预KOA疼痛活体、可视、无创伤性研究的新工具。未来可追踪KOA疼痛病理生理研究最新进展,采用新技术手段,开展推拿治疗KOA疼痛从外周到中枢多层次、多维度的高质量研究,更加全面具体地阐述其作用机理。

Peripheral nociceptive stimuli and the conduction and regulation of pain signals by the central nervous system are the key pathological mechanisms of knee osteoarthritis(KOA)pain,and Tuina can significantly relieve knee pain in patients with knee osteoarthritis,and its mechanism is closely related to reducing peripheral nociceptive stimuli and regulating brain center.At present,the modern scientific mechanism of Tuina in treating KOA pain needs to be clarified,and systematic and multi-level mechanism research needs to be further strengthened;Spinal cord center plays an important role in the transmission and regulation of KOA pain signal,which needs further study from the aspects of molecular biology and neurofunctional imaging.The intervention scheme of KOA Tuina is not feasible in experimental animals,or the related technology of neurofunctional imaging can be used as a new tool for the in vivo,visual and non-invasive study of Tuina intervention in KOA pain.In the future,we can trace the latest progress in the pathophysiology of KOA pain,adopt new technical means,carry out high-quality research on massage treatment of KOA pain from the outside to the center,and explain its mechanism more comprehensively and concretely.