针灸预处理防治心肌缺血再灌注损伤研究进展

Research Progress of Acupuncture Preconditioning in the Prevention and Treatment of Myocardial Ischemia-reperfusion Injury

近年来,心血管疾病的发病率及致死率不断增长,其病因多为心脏冠状动脉发生阻塞,导致心肌供血不足,临床治疗均采取手段恢复心肌供血,而梗死区血流恢复再灌注会导致严重的再灌注损伤,严重危害着人们的生命健康。因此,目前对心血管疾病的研究重点之一就是解决心肌缺血再灌注损伤问题。大量实验研究表明,针灸预处理对心肌缺血再灌注损伤有积极的保护作用。该文对近年来心肌缺血再灌注损伤的针灸预处理方式进行了梳理,具体疗法以电针治疗为主,向温和灸、麦粒灸等多种手段干预发展,选穴方面内关穴是选用频率最高的腧穴,且内关穴治疗再灌注损伤具有特异性,也有学者对预处理的介入时间进行了对比。此外,研究指出针灸预处理的作用机制主要涉及调控细胞自噬、抑制细胞凋亡、抑制氧化应激、减轻炎性损害、调节腺苷受体以及神经调控。

In recent years,the incidence and mortality of cardiovascular diseases have been increasing,most of which are caused by coronary circulation obstructionof the heart,resulting in insufficient myocardial blood supply.Clinical treatments are all adopted to restore myocardial blood supply,while blood reperfusion in infarcted areas will lead to serious reperfusion injury,which seriouslyendangers people's life and health.Therefore,one of the current research focuses on cardiovascular diseases is to solve the problem of myocardial ischemia reperfusion injury.A large number of experimental studies have shown that acupuncture pretreatment can play a positive protective effect on myocardial ischemia-reperfusion injury.In this paper,the pretreatment methods of acupuncture and moxibustion for myocardial ischemia-reperfusion injury in recent years were reviewed.The specific therapies were mainly electroacupuncture and developed to mildmoxibustion and grain moxibustion,etc.Neiguan(PC6)was the most frequently selected acupoint,and neiguan point had specificity in the treatment of MIRI,some scholars also compared the intervention time of pretreatment.Inaddition,studiesindicate that the mechanisms of acupuncture preconditioningmainly involve regulating autophagy,inhibiting apoptosis,inhibiting oxidative stress,alleviating inflammatory damage,regulating adenosine receptors and nerve regulation.