天枢、上巨虚作为基础腧穴治疗胃肠疾病的研究进展

Tianshu(ST 25)and Shangjuxu(ST 37)as Basic Acupoints in the Treatment of Gastrointestinal Diseases:A Review

分析总结天枢、上巨虚作为基础腧穴治疗胃肠疾病的临床与基础研究进展,探索合募配穴的临床价值,从而为合募配穴的临床应用提供依据。基于现有文献,天枢与上巨虚作为基础腧穴应用广泛,二者共同作为基础腧穴主要应用于功能性肠病与炎症性肠病的治疗,而在慢性胃炎、功能性消化不良等其他常见消化疾病中应用较少。临床常用的治疗方法为针刺、艾灸、中药穴位贴敷。基于动物实验的疗效机制表明,天枢、上巨虚及其他配穴干预,可调节大鼠兴奋性、抑制性神经递质并改善大鼠体内炎症介质水平,改善功能性便秘症状;抑制中枢敏化,从而缓解大鼠肠易激症状;抑制胃内压和胃运动以减轻功能性腹泻症状;通过降低大鼠延髓孤束核内神经元和星形胶质细胞的阳性免疫产物的高表达水平,并抑制Toll样受体4(TLR4)/髓样分化因子88(MyD88)/核因子κB(NF-κB)信号通路并减少炎症介质的释放以保护溃疡性结肠炎大鼠结肠黏膜组织。在不同胃肠疾病治疗中,天枢、上巨虚所配伍的腧穴有所差异,因此应基于现有证据与临床经验选择最佳腧穴配伍,从而提升临床疗效。

This study aims to summarize the progress in the clinical and basic research on Tianshu(ST 25)and Shangjuxu(ST 37)as basic acupoints in the treatment of gastrointestinal diseases,so as to explore the clinical value and provide evidence for the clinical application of the combination of sea point and alarm point.According to the available studies,Tianshu(ST 25)and Shangjuxu(ST 37)are widely used as basic acupoints in the treatment of functional bowel disease and inflammatory bowel disease,while they are less used in the treatment of other common digestive diseases such as chronic gastritis and functional dyspepsia.The commonly treatment methods include acupuncture,moxibustion,and acupoint application with Chinese herbal medicines.The results of animal experiments have demonstrated that intervention at Tianshu(ST 25),Shangjuxu(ST 37)and other acupoints regulate the excitatory and inhibitory neurotransmitters,recover the levels of inflammatory cytokines,and alleviate the symptoms of functional constipation in rats.In addition,the intervention can inhibit central sensitization to alleviate irritable bowel symptoms in rats,and reduce gastric pressure and gastric motility to mitigate functional diarrhea symptoms.Furthermore,it can protect the colonic mucosa of rats with ulcerative colitis by down-regulating the high expression levels of positive immune products of neurons and astrocytes in the solitary nucleus of medulla oblongata and inhibiting Toll-like receptor 4(TLR4)/myeloid differentiation primary response protein 88(MyD88)/nuclear factor-kappa beta(NF-κB)signaling pathway to reduce the release of inflammatory cytokines.The acupoints compatible with Tianshu(ST 25)and Shangjuxu(ST 37)vary in the treatment of different gastrointestinal diseases.Therefore,the optimal acupoints for compatibility should be selected based on the existing evidence and clinical experience to improve the clinical efficacy.