针刺促进慢性创面愈合相关临床研究

Clinical Research on Acupuncture Promoting Chronic Wound

慢性创面愈合是困扰临床的一个重要难题,其难愈合性及易感染性严重降低患者的生活质量。皮肤微源性电场是引导皮肤表皮细胞定向迁移、促进愈合的主要生物学信号,电场发生异常或衰竭是导致创面难愈的重要方面。该文通过探究中医针刺手段调控微电场对慢性创面愈合相关细胞的影响,发现针刺治疗能够调控p38丝裂原活化蛋白激酶(p38 MAPK)和MAPK/ERK信号通路的表达水平,干预肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)等炎性因子,调控巨噬细胞等免疫细胞及炎症进程,增加血管内皮生长因子(VEGF)数量,促进血管生成和胶原蛋白合成,能够有效改善皮肤慢性创面状态,促进慢性创面愈合。未来应进一步深入研究针刺促进创面愈合的内源性机制,更加关注针刺疗效与针刺穴位及针刺方式的量效关系、针刺调控菌群及神经-内分泌-免疫与创面愈合关系。

Chronic wound healing is an important difficulty in clinical practice,and its refractory and susceptibility to infection seriously reduces the quality of life of patients.The micro-electric field of the skin is the most important biological signal to guide the directional migration of skin epidermal cells and promote healing.In this paper,we explored the effect of acupuncture on the regulation of microelectric field on cells related to chronic wound healing,and found that acupuncture treatment can regulate the expression levels of p38 mitogenactivated protein kinase(p38 MAPK)and MAPK/ERK signaling pathways,intervene in inflammatory factors such as tumor necrosis factor(TNF-α),interleukin-1β(IL-1β)and interleulcin-6(IL-6),increase the number of immune cells such as macrophages,and regulate the inflammatory process,increasing the amount of vascular endothelial growth factor(VEGF)to promote angiogenesis and collagen synthesis can effectively improve the condition of chronic wounds and promote the healing of chronic wounds.In the future,further research should be carried out on the endogenous mechanism of acupuncture in promoting wound healing,and more attention should be paid to the dose-response relationship between acupuncture efficacy and acupuncture acupuncture points and acupuncture methods,the regulation of microbiota by acupuncture,and the relationship between acupuncture and neuro-endocrine-immune and wound healing.