针刺中脘调节胃运动的神经通路研究进展

Research progress on nerve pathways of acupuncture at Zhongwan to regulate gastric motility

中脘穴是调节胃动力的常用穴,针刺疗效显著,临床应用广泛。本文通过整理近15年参与针刺中脘调节胃运动的神经核团及相关通路相关研究发现:(1)针刺中脘双向调节胃运动的效应与针刺时间长短密切相关,其内在机制可能与神经反射调节、神经—内分泌调节存在时效性差异有关。(2)杏仁核、海马是针刺中脘调节情绪和胃运动的共同响应核团。(3)针刺中脘可经辣椒素受体-Aδ与C纤维—脊髓、脊髓—交感神经、海马谷氨酸-N-甲基-D-天冬氨酸受体亚基NR1、CeA(γ-氨基丁酸)-室旁核、室旁核(胃动素)—迷走神经有核复合体—迷走神经等神经机制调节胃运动;也可经DVC-NMDAR亚基NR1—外周NO等神经—内分泌途径调节胃运动。研究结果表明针刺中脘对胃运动的调节是多方面、多维度、多靶点的综合调控。今后的研究应规范实验针刺操作,优化实验方案,结合脑科学技术综合、整体、动态探究针刺效应机制,进一步揭示针灸疗法中近治作用的内在机理。

Zhongwan point is a commonly used acupoint for regulating gastric motility,with significant acupuncture effect and widespread clinical application.This article summarized the research on the neural nuclei and related pathways involved in acupuncture regulating gastric motility in the past 15 years.It was found that:(1)The effect of acupuncture on the bidirectional regulation of gastric motility was closely related to the duration of acupuncture,and its internal mechanism may be related to the temporal differences in neural reflex regulation and neuroendocrine regulation.(2)The amygdala and hippocampus were the common response nuclei of acupuncture regulating emotion and gastric movement.(3)Acupuncture of Zhongwan Ke via TRPV1-AδRegulating gastric motility through neural mechanisms such as C-fiber spinal cord,spinal cord sympathetic nerve,hippocampal Glu-NMDA receptor NR1 subunit,CeA(GABA)PVN,PVN(motilin)DVC vagus nerve,etc;gastric motility could also be regulated through neuroendocrine pathways such as DVC-NMDA receptor NR1 subunit peripheral NO.The research results indicate that the regulation of gastric motility by acupuncture at Zhongwan acupoint is a comprehensive regulation with multiple aspects,dimensions,and targets.Future research should standardize the operation of experimental acupuncture,optimize the experimental scheme,combine brain science and technology to explore the mechanism of acupuncture effect comprehensively,holistically and dynamically,and further reveal the internal mechanism of the proximity effect of acupuncture and moxibustion therapy.