从交感神经系统探讨针刺治疗肥胖症的机制及疗效优化方案

Mechanism and protocol optimization of acupuncture in treatment of obesity based on sympathetic nerve system

脂肪组织的生理功能依赖交感神经系统(SNS)的调控,而肥胖等疾病会引起SNS信号通路的异常。针刺是改善脂肪组织内SNS功能的有效方法,本文基于脂肪组织内SNS的生理病理意义梳理了针刺直接或间接调节脂肪组织SNS功能的分子通路。随着电针调控自主神经的机制不断被阐明,调整针刺作用模式(包括选取不同神经节段的穴位及调整电针刺激参数等)可能导致脂肪组织内SNS传出支释放的去甲肾上腺素及神经肽Y等神经递质的含量比不同,从而产生不同的减肥疗效。在此基础之上,建立不同针刺作用模式与SNS神经末梢释放神经递质之间的特异联系可以丰富穴位内在的神经编码,从而优化肥胖症的选穴治疗方案。

The physiological function of adipose tissue is dominated by the sympathetic nerve system(SNS),but obesity and other diseases may cause the abnormality of the SNS signaling pathway.Acupuncture has been proved to be an effective the-rapy to improve the function of SNS in adipose tissue.Based on the physiological and pathological significance of SNS,this paper reviewed the molecular pathways in which acupuncture directly or indirectly regulated the function of SNS in adipose tissue.As the mechanism of electroacupuncture in regulating autonomic nerves was continuously illuminated,the adjustment of acupuncture mode,such as selection of acupoints in different nerve segments and adjustment of stimulation parameters of electroacupuncture,presumedly induced different content ratios of neurotransmitters released by SNS efferent axons,including noradrenaline and neuropeptide Y,thereby producing different effects on weight loss.Therefore,the specific connections between various acupuncture modes and neurotransmitters released by SNS enriched the intrinsic nerve coding of acupoints,thus optimizing the acupoint selection protocol for the treatment of obesity.