电针足三里穴治疗糖尿病周围神经痛的作用机制探索

The action mechanism of electroacupuncture at the Zusanli point on treating diabetic peripheral neuralgia

糖尿病周围神经痛(Diabetic Peripheral Neuralgia,DPN)是糖尿病的主要并发症。DPN在临床上缺乏行之有效的治疗方法,是一个紧迫需要解决的问题。针对DPN的研究,在动物模型实验已经确定了包括糖代谢、脂代谢和炎性反应等多个路径的变化与其致病机制相关,越来越多的证据证明炎性反应的严重程度和神经病理性呈现正相关。最新研究表明,电针足三里穴可有效镇痛及抗炎,在治疗DPN方面凸显优势。文章将全面总结DPN的患病机制,阐述电针足三里穴治疗DPN的作用机制,并分别从动物机制研究和临床研究进行系统和深入的探索。其中,动物机制研究将从以下四个方面进行阐述:纠正炎性因子失衡途径、改善糖代谢异常途径、改善脂代谢异常途径、纠正其他代谢途径。而临床机制研究将从以下三个方面进行诠释:减轻DPN引发的疼痛,提高痛阈;提高DPN神经传导速度;改善DPN其他症状。根据目前已知的研究结果,电针足三里穴可用于治疗DPN。然而,之后也需要进行多中心大样本的随机对照试验研究,以更好地评估电针足三里穴治疗DPN的有效性和不良反应,继续深入研究将有助于明确DPN的患病机制,为未来提供优质、高效且不良反应低的治疗方案。

Diabetes peripheral neuralgia(DPN)is a major complication of diabetes.There is a lack of effective therapeutic therapy for DPN in clinical practice,and it is an urgent problem for solution.In the study of DPN,animal model experiments have determined that changes in multiple pathways involved in glucose metabolism,lipid metabolism and inflammatory response pathway are related to the pathogenesis of DPN.More and more evidence has proved that the severity of inflammatory response is positively correlatedD with neuropathy.The latest research shows that electroacupuncture at Zusanli point(ST36)is effective on analgesia and anti-inflammatory,and has prominent advantages in the treatment of DPN.In this paper,the pathogenesis of DPN is summarized comprehensively,the therapeutic mechanism of electroacupuncture at the Zusanli point in the treatment of DPN is described,and systematic and in-depth exploration is conducted from the aspects of animal experiments and clinical trials.Among them,the study of animal mechanism is demonstrated from the following four aspects:correcting inflammatory factor imbalance pathway,ameliorating glucose metabolism disorder pathway,ameliorating lipid metabolism disorder pathway,and correcting the other metabolic pathways.The clinical mechanisms studies are interpreted from the following three aspects:alleviating pain caused by PDN and raising pain threshold,increasing the nerve conduction velocity of DPN patients,relieving the other symptoms of DPN.According to the current known research results,it is convinced that electroacupuncture at the Zusanli point can be used to treat DPN.However,multi-center,large-sample,and randomized controlled trial studies are also needed to further evaluate the effectiveness and adverse reactions of electroacupuncture at the Zusanli point in the treatment of DPN.Further in-depth studies will help to clarify the pathogenesis of DPN and provide high-quality,efficient,and fewer adverse reactions therapeutic strategy in the future.