针刺治疗脑缺血再灌注损伤机制研究

Research on the Mechanism of Acupuncture in the Treatment of Cerebral Ischemia Reperfusion Injury

针刺对脑缺血再灌注损伤的防治具有确切的疗效,其机制可能与抑制炎性反应、抗氧化应激、抑制兴奋氨基酸毒性作用、抑制脑水肿形成、抑制细胞凋亡、促进神经与血管再生等相关。脑缺血再灌注损伤是缺血性脑血管病的重要病理基础,抑制再灌注损伤、保护脑组织已成为治疗缺血性脑血管疾病的重要环节。该文综述近年针灸治疗脑缺血再灌注研究认为,脑缺血再灌注涉及的病理生理机制十分复杂,针刺治疗CIRI从各个方面应对其复杂性:①在CIRI形成机制方面通过抑制炎性反应、阻滞钙超载、减轻过氧化反应、促进神经与血管再生等方面着手;②采用针刺的不同针法,眼针、电针、颅针、头皮针等不同针法进行治疗,并取得了客观的成果;③从不同的穴位进行治疗,常用的穴位有风府、水沟、百会、足三里、大椎、人中等穴位,取得了良好的疗效;④其他,比如针刺时间长短、针刺与运动、针刺与方剂、电针的刺激强度等相结合的方法,全面体现了针灸作用的综合性。但是目前在取得进展的同时,也有些许不足之处:①实验取得成果的模型大多数为大鼠,从而很难肯定,给人给予同样的针刺方法是否会取得同样的疗效;②在脑缺血再灌注中,缺血时间的掌握是一个比较棘手的问题,如何在有效的时间进行治疗,仍然需要探索;③将实验有效的应用于临床,使实验与临床紧密结合也是值得实践的。

Acupuncture has definite effect on the prevention and treatment of cerebral ischemia-reperfusion injury.Its mechanism may be related to inhibiting inflammatory response,anti-oxidative stress,inhibitingt the toxicity of exciting amino acids,inhibiting the formation of brain edema,inhibiting apoptosis,and promoting nerve and vascular regeneration.Cerebral ischemia-reperfusion injury is an important pathological basis of ischemic cerebrovascular disease.Inhibiting reperfusion injury and protecting brain tissue have become an important link in the treatment of ischemic cerebrovascular disease.This article reviews the recent studies on acupuncture and moxibustion in the treatment of cerebral ischemia-reperfusion,and provides new icdeas for clinical treatment of ischemic cereb rovasoular diseases.It is believed that the pathophysiological mechanism involved in cerebral ischemia reperfusion is very complicated.Acupuncture treatment of CIRI should deal with its complexity in various aspects:(1)in CIRI form In the aspect of formation mechanism,it can inhibit inflammatory reaction,block calcium overload and alleviate overdose.Oxidative reaction,promoting nerve and blood vessel regeneration,etc.2.Different needling methods of ac.upuncture,eye needle,electric needle,skull needle,scalp needle,etc.The method has been used for treatment,and objective results have been achieved.3.From different acupoints.For treatment,commonly used acupoints are Fengfu,Shuigou,Baihui,Zusanli and Dada.Vertebral and human middle acupoints have achieved good therapeutic effects;4.Other acupoints,such as needles.The duration of needling,the stimulation of acupunciture and exercise,acupuncture and prescription,and electro-acupunetureare strong.The combination of degree and other methods fully embodies the comprehensive function of acupuncture and moxibustion.However,while making progress at present,there are also some shortcomings:(1)Most of the experimental models are rats,which makes it difficult to confirm.Whether giving people the same acupuncture method will achieve the same effect;(2)In cerebral ischemia-reperfusion,thecontrolof isehemietimeisrathercdifficult.The problem of how to treat it in an effective time still needs to he explored.(3)Apply the experiment effectively in clinic,so that the experiment and clinic can he closely combined.It is also worth practicing.