针刺缓解膝骨关节炎疼痛机制的研究进展

Research progress on the mechanism of acupuncture relieving knee osteoarthritis associated pain

膝骨关节炎(knee osteoarthritis,KOA)是一种常见的退行性疾病,特别是老年人群患病率极高,且常伴随疼痛、运动障碍和生活质量降低等临床表现。尽管药物可以缓解KOA的疼痛症状,但长期使用不可避免会产生不良反应。针刺是一种有效的非药物治疗方法,可缓解KOA疼痛并提高病人生活质量。国内外关于针刺治疗KOA疼痛机制的综述较少,本文从疼痛传导通路着手,聚焦针刺发挥镇痛的作用机制,包括针刺作用于外周组织器官和中枢神经系统,通过调节痛觉传导物质、免疫炎症因子、促进内源性镇痛物质释放缓解关节疼痛,改善关节功能。本文通过简述KOA疼痛的产生以及针刺缓解KOA疼痛的机制,以期为促进针刺治疗KOA疼痛的临床实践提供理论依据与治疗思路。

Knee osteoarthritis(KOA)is a common degenerative disease,extremely prevalent among older population,and is often associated with pain,movement disorders,and reduced quality of life.Although drugs can relieve the painful symptoms of KOA,long-term use inevitably produces adverse reactions.Acupuncture is an effective non-drug treatment that relives KOA pain and improves patients'quality of life.In the world,there are few reviews on the mechanism of acupuncture in the treatment of KOA pain.This paper profits from the pain conduction pathway and focuses on the analgesic mechanism of acupuncture,including the action of acupuncture on peripheral tissues and organs and the central nervous system to relieve joint pain and improve joint function,through regulating the nociceptive conduction and immune inflammatory factors,as well as promoting the release of endogenous analgesic substances.The origin of KOA pain and the mechanism of acupuncture to relieve KOA pain are briefly discussed in order to provide theoretical basis and therapeutic ideas for promoting the clinical practice of acupuncture treatment of KOA pain.