针刺治疗帕金森抑郁的作用机制及取穴思路探析

Mechanism of acupuncture on the treatment of Parkinson’s depression and its ideas of point selection

针刺治疗帕金森抑郁的作用机制主要有:平衡肠道菌群、刺激多巴胺分泌,减少多巴胺凋亡、调节5-羟色胺代谢水平、提高去甲肾上腺素(NE)水平、刺激神经营养因子、调控神经内分泌系统、缓解炎症反应、改善睡眠障碍。针灸取穴思路遵从就近取穴原则,多根据神经生理解剖理论选用头部腧穴,常用效穴如百会、四神聪、印堂、神庭;根据脑肠轴理论,多选天枢、足三里、上巨虚、胃经腧穴,调理胃肠以健脑;根据神经节段支配理论,多选用具有"单元穴"属性的天枢和具有"集元穴"属性的上巨虚,调节肠神经系统。

The mechanism of acupuncture on the treatment of Parkinson’s depression mainly involves balancing the intestinal flora,stimulating the dopamine secretion,reducing the dopamine apoptosis,regulating the serotonin metabolism level,raising the norepinephrine (NE) level,stimulating neurotrophic factors,regulating the neuroendocrine system,alleviating inflammatory reactions and improving sleep disorders.The principle of nearby point selection is followed in this respect.For instance,the head points are mostly selected according to the theory of neurophysiological anatomy,with Baihui (GV20),Sishencong (EX-HN1),Yintang (EX-HN3),and Shenting (GV24) as its commonly used effective points;according to the brain-gut axis theory,Tianshu (S25),Zusanli (S36),Shangjuxu (S37) and points along the stomach channel are selected to regulate the stomach and intestines and strengthen the brain;according to the ganglion segment innervation theory,Tianshu (S25) and Shangjuxu (S37) are often selected to regulate the enteric nervous system.