非侵入性电刺激治疗视网膜色素变性的研究进展

Research Progress on Non-invasive Electrical Stimulation Therapy for Retinitis Pig⁃mentosa

视网膜色素变性(RP)是一种遗传性疾病,伴有视网膜神经元和(或)视神经的退行性病变,具有极高的致盲率,预后不良,目前尚无确切有效的治疗方法。近年来基础及临床研究表明,电刺激对RP具有确切的治疗作用。本文对非侵入性电刺激在RP中的研究进展进行综述,从中、西医角度总结了RP的病理生理特点,发现电刺激治疗RP的可能作用机制为外源性电刺激可以增强残存神经元及中枢的电活动,从而促进神经元存活;可以抑制小胶质细胞的炎症作用,同时上调神经营养因子的表达;可以减轻神经炎症并改善视网膜血流。同时,本文总结了目前电刺激治疗包括经角膜电刺激以及电针治疗在RP患者中的临床应用。非侵入性电刺激作为一种新的治疗手段,具有独特优势,虽然无法纠正基因水平的改变从根本上治疗该疾病,但在减轻RP患者临床症状,延缓该病的发生、发展方面有着重要的作用,在未来临床RP的治疗中具有较好的前景。

Retinitis pigmentosa(RP)is a genetic disease,accompanied by degenerative changes of retinal neurons and/or optic nerves,with a high rate of blindness and poor prognosis.At present,there is no effective treatment.In recent years,basic and clinical studies have shown that electrical stimulation has a definite protective effect on RP.This paper reviewed the research progress of non-invasive electrical stimulation in RP,summarized the pathophysiological characteristics of RP from the perspectives of both Western Medicine and Traditional Chinese Medicine,and the possible mechanisms of electrical stimulation in the treatment of RP:exogenous electrical stimulation can enhance the electrical activity of residual neurons and the central nervous system,thereby promoting neuronal survival;electrical stimulation can inhibit the inflammatory effect of microglia and upregulate the expression of neurotrophic factors;also electrical stimulation can alleviate neuroinflammation and improve retinal blood flow.Meanwhile,this paper summarized the current clinical applications of electrical stimulation therapy,including transcorneal electrical stimulation and electroacupuncture,in RP patients.Non-invasive electrical stimulation,as a new treatment method,has unique advantages.Although it cannot correct changes in gene levels to fundamentally treat the disease,it plays an important role in alleviating clinical symptoms in RP patients and delaying the occurrence and development of RP,which may show good prospects in the future clinical treatment of RP.