针刺干预心肌纤维化机制实验研究现状

Experimental Research Status of Acupuncture on the Mechanism of Myocardial Fibrosis

心肌纤维化是众多心脏疾病进展的病理基础,以心脏成纤维细胞增殖、心肌间质蛋白合成和降解失衡为主要病理特征,心肌组织顺应性和收缩舒张功能减退为其主要病理表现。心肌纤维化可导致心脏结构或功能改变,如心室扩大、室壁变薄、心室僵硬、射血分数降低、心律失常等,甚至出现心脏骤停,严重威胁患者生命安全。针刺治疗可以通过干预心脏成纤维细胞增殖、分化,胶原蛋白合成、代谢防治心肌纤维化。现代研究发现针刺可以通过不同方式干预心肌纤维化的发生:(1)通过干预交感神经系统、肾素-血管紧张素-醛固酮系统调控体内神经内分泌因子诱导的心肌纤维化。(2)通过干预TGF-β_(1)、Wnt、MAPK等信号通路多靶点调控心肌纤维化。(3)通过干预微小RNA、炎症细胞因子的表达,进而调控其介导的心肌纤维化。

Myocardial fibrosis is the pathological basis of the progression of many cardiac diseases.The main pathological features are cardiac fibroblast proliferation,imbalance of myocardial interstitial protein synthesis and degradation,and the main pathological features are cardiac tissue compliance and systolic and diastolic dysfunction.Myocardial fibrosis can lead to changes in cardiac structure or function,such as ventricular enlargement,thinning of ventricular wall,ventricular stiffness,reduced ejection fraction,arrhythmia,etc.,and even cardiac arrest,which seriously threatens the safety of patients.Acupuncture therapy can prevent and cure myocardial fibrosis by intervening the proliferation and differentiation of cardiac fibroblasts and the synthesis and metabolism of collagen protein.According to modern studies,acupuncture can intervene the occurrence of myocardial fibrosis in different ways:(1)By regulating the myocardial fibrosis induced by neuroendocrine factors in vivo by interfering the sympathetic nervous system and the renin-angiotensin-aldosterone system.(2)By intervening TGF-β_(1),Wnt,MAPK and other signaling pathways,myocardial fibrosis is regulated by multi-target.(3)By interfering with the expression of microRNA and inflammatory cytokines,it can regulate the myocardial fibrosis mediated by them.