针灸治疗克罗恩病的机制研究进展及思考

Progression and reflection on the mechanism study of acupuncture and moxibustion in treatment of Crohn’s disease

克罗恩病(CD)是一种常见的慢性非特异性胃肠道炎性疾病,多项研究表明,针灸能够有效改善CD患者的症状,临床疗效确切。本文查阅近年来针灸治疗CD的相关机制研究资料,归纳分析发现针灸对于CD的治疗效应机制主要集中在肠内局部调节和肠外神经调节两个层面。肠内主要包括对肠道菌群、肠上皮细胞功能和对肠道局部免疫细胞的调节作用;肠外主要包括对脑功能效应的调控和对“脑-肠轴”相关神经递质的调节作用。本文还针对当前临床研究与动物实验中干预方式和穴位选择之间的差异进行了分析,并对未来围绕“脑-肠轴”系统阐释针灸治疗CD的神经-免疫机制提出了建议和展望,以期对针灸治疗CD的效应机制研究提供一定的帮助,为优化临床针灸治疗CD方案提供科学依据。

Crohn’s disease(CD)is a common chronic non-specific gastrointestinal inflammatory disease.Studies showed that acupuncture-moxibustion(A&M)can effectively relieve the symptoms of CD and its clinical efficacy has been confirmed in patients.In this paper,by reviewing the relevant articles for the mechanism studies on CD treated with A&M in recent years,it is discovered that the effect mechanism of A&M on CD includes two aspects,i.e.the local regulation inside the intestines and the neuromodulation outside intestines.The former one refers to the regulation of intestinal microflora,intestinal epithelial cell function and the regulation of intestinal local immune cells.The latter points to the modulation of brain function effect and the modulation of“brain-gut axis”related neurotransmitters.This paper also introduces the differences in intervention modes and acupoint selection between clinical trial and animal experiment,the suggestions on elucidating the nerve-immunity mechanism for CD treatment with A&M in view of“brain-gut axis”system,and its prospects.It is anticipated that this review may be conductive to the effect mechanism research of A&M for CD so that the evidences may be provided for optimizing the clinical regimen of A&M in treatment of this disease.