阿片类药物成瘾的运动干预及其作用机制研究进展

Research Progress on Exercise Intervention and Mechanisms of Opioid Addiction

阿片类药物使用过程中的高度成瘾性,已成为当前严峻的公共卫生问题之一,严重危害人类健康与社会安全。阿片类药物通过激活γ-氨基丁酸(γ-aminobutyric acid,GABA)能中间神经元上的μ阿片受体(μ-opioid receptor,MOR),减弱GABA对多巴胺(dopamine,DA)释放的抑制,以及通过抑制DA能神经元突触前膜的DT转运蛋白功能使突触间隙DA作用效能增强,同时作为外源性药物干扰并抑制机体内源性阿片肽(endogenous opioid peptide,EOP)正常生成,破坏DA和EOP系统的稳态,停药后产生生理、心理症状,损害健康。运动(有氧运动、抗阻运动和高强度间歇训练等)作为一种健康的非药理学干预方式,通过调节药物成瘾后的DA和EOP系统紊乱、增加催产素与脑源性神经营养因子水平、增强神经免疫系统机能等途径改善阿片类药物成瘾戒断症状,其作用已得到初步证实,但不同运动种类、周期、强度对药物依赖者脱瘾的效果及机制仍需深入研究。此外,运动方案的制定需做到个性化和科学化,同时应配合运动监控,在获得运动收益的同时防范运动风险。

The high degree of addiction in the use of opioids has become one of the most serious public health problems,which seriously endangers human health and social security.After opioids are ingested by users,the inhibition ofγ-aminobutyric acid(GABA)on dopamine(DA)release is weakened by activating theμ-opioid receptor(MOR)on GABAergic interneurons,and the efficacy of DA in the synaptic cleft is enhanced by inhibiting the function of dopamine transporter in the presynaptic membrane of DAergic neurons.At the same time,due to the interference of exogenous drugs,the normal production of endogenous opioid peptide(EOP)is inhibited,which destroys the homeostasis of DA and EOP systems,and produces many physiological and psychological symptoms after drug withdrawal,damaging physical and mental health.Exercise includes aerobic exercise,resistance exercise and high-intensity interval training can be used as a healthy non-pharmacological intervention to improve the withdrawal symptoms of opioid addiction by regulating the disorder of DA and EOP systems after drug addiction,increasing the levels of oxytocin and brain-derived neurotrophic factor,and enhancing the function of the neuroimmune system.The effect has been preliminarily confirmed,but the effects and mechanisms of different types,different cycles,and different intensities of exercise on the withdrawal of drug addicts still need to be further studied.In addition,the formulation of exercise program should be personalized and scientific,and should cooperate with exercise monitoring,so as to prevent the occurrence of exercise risks while obtaining exercise benefits.