近十年针刺治疗慢性萎缩性胃炎作用机制研究进展

Research progress of acupuncture in the treatment of chronic atrophic gastritis

慢性萎缩性胃炎(chronic atrophic gastritis,CAG)是消化系统常见的癌前病变之一,与胃癌的发生密切相关。如何有效减轻胃黏膜损伤、促进胃黏膜保护屏障的修复以及阻断CAG的癌变趋势是当前研究的热点与难点。近年来,针刺已被发现可通过多靶点、多途径对CAG进行干预和治疗。本文总结了近10年针刺治疗CAG的相关文献,归纳发现针刺可以通过三个方面、多条途径发挥对CAG的治疗作用。首先,针刺可以通过调节黏膜损伤因子,如调节炎性介质、抑杀幽门螺杆菌等,以减轻胃黏膜的炎症损伤。其次,针刺可以通过调节一氧化氮、胃黏膜保护因子、胃肠激素、神经肽物质等保护胃黏膜屏障。此外,针刺能通过调控胃壁细胞的凋亡,改变CAG的癌变趋势。笔者在现有研究的基础上,提出新的研究方向,如应在今后的研究中,通过更多的动物实验,将众多的单一靶点、单一途径进行整合研究,进一步揭示针刺治疗CAG的机制,为针刺治疗CAG的临床应用提供理论支持。

Chronic atrophic gastritis(CAG)is one of the common precancerous lesions in digestive system,which is closely related to the occurrence of gastric cancer.How to effectively reduce the damage of gastric mucosa,promote the protective barrier of gastric mucosa and block the carcinogenic trend of CAG is a hot and difficult topic in current research.In recent years,acupuncture,as a safe adjuvant alternative medicine therapy without side effects,has been found to be able to intervene and treat CAG through multi-target and multi-pathway.In this paper,the literature related to acupuncture treatment of CAG in recent 10 years was summarized,and it was found that acupuncture can play a role in the treatment of CAG through three aspects and multiple ways.First of all,acupuncture can reduce gastric mucosal inflammation by regulating mucosal damage factors such as regulating inflammatory mediators and suppressing Helicobacter pylori.Secondly,acupuncture can protect the gastric mucosal barrier by regulating NO,gastric mucosal protective factor,gastrointestinal hormone and neuropeptide substances.It was also found in the study that acupuncture could change the carcinogenic trend of CAG by regulating the proliferation and apoptosis of gastric parietal cells.At the same time,on the basis of existing studies,new research directions are proposed.For example,more animal experiments should be conducted in the future to integrate numerous single targets and approaches,so as to further reveal the mechanism of acupuncture therapy for CAG and provide theoretical support for the clinical application.