针刺治疗功能性消化不良作用机制研究进展
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摘要
针刺治疗功能性消化不良疗效确切,其作用机制可能与胃动力异常、中枢神经系统功能障碍、脑肠肽分泌紊乱、血浆分子代谢物含量变化和基因表达异常有关。本文从电生理学、影像学、分子生物学、代谢及基因组学方面探讨针刺作用机制,为临床治疗功能性消化不良提供依据。
Acupuncture is effective in the treatment of functional dyspepsia, and its mechanism may be related to abnormal gastric motility, central nervous system dysfunction, brain intestinal peptide secretion disorder, plasma molecular metabolite content changes and abnormal gene expression. This article summarized the mechanism of acupuncture treatment for functional dyspepsia in recent years from the aspects of electrophysiology, imaging, molecular biology, metabolism and genomics, and provided basis for clinical treatment of functional dyspepsia.
Acupuncture is effective in the treatment of functional dyspepsia, and its mechanism may be related to abnormal gastric motility, central nervous system dysfunction, brain intestinal peptide secretion disorder, plasma molecular metabolite content changes and abnormal gene expression. This article summarized the mechanism of acupuncture treatment for functional dyspepsia in recent years from the aspects of electrophysiology, imaging, molecular biology, metabolism and genomics, and provided basis for clinical treatment of functional dyspepsia.
引文
[1]MAHADEVA S,FORD A C.Clinical and epidemiological differences in functional dyspepsia between the East and the West[J].Neurogastroenterol Motil,2016,28(2):167-174.
[2]RST H,VCH C,CHL W,et al.Acupuncture and related therapies used as add-on or alternative to prokinetics for functional dyspepsia:overview of systematic reviews and network Meta-analysis[J].Sci Rep,2017,7(1):10320.
[3]洪枫.电针公孙、内关穴治疗功能性消化不良疗效观察[J].上海针灸杂志,2016,35(1):38-40.
[4]杨敏,张红星,邹燃.针刺对功能性消化不良症状及胃动力的影响[J].中国康复,2009,24(2):100-102.
[5]唐胜修,梁列新.功能性消化不良针刺分型治疗胃动素和胃电参数的相关性[J].辽宁中医药大学学报,2008,10(1):85-86.
[6]XU F,TAN Y,HUANG Z,et al.Ameliorating effect of transcutaneous electroacupuncture on impaired gastric accommodation in patients with postprandial distress syndrome-predominant functional dyspepsia:A pilot study[J].Evidence-based Complementary and Alternative Medicine,2015,2015:168-252.
[7]胡伟,张蔚,杨健,等.针刺足三里对功能性消化不良患者脑功能成像与胃泌素的影响[J].武汉大学学报:医学版,2014,35(5):740-743.
[8]陈媛.胃俞募配穴治疗功能性消化不良的边缘系统整合机制研究[D].成都:成都中医药大学,2012.
[9]LIU M,LIU C,WU J,et al.Low-frequency fluctuation amplitude analysis of resting-state fMRI for functional brain response differences between acupuncture and moxibustion at Zusanli(ST 36)in patient with functional dyspepsia[J].Journal of Acupuncture&Tuina Science,2017,15(4):230-236.
[10]LI Z,ZENG F,YANG Y,et al.Different cerebral responses to puncturing at ST36 among patients with functional dyspepsia and healthy subjects.[J].Forschende Komplementarmedizin,2014,21(2):99-104.
[11]FANG J,WANG D,ZHAO Q,et al.Brain-gut axis modulation of acupuncture in functional dyspepsia:a preliminary resting-state fcMRI study[J].Evid Based Complement Alternat Med,2015,2015:860463.
[12]曾芳.循经取穴治疗功能性消化不良的临床疗效评价及中枢响应特征研究[D].成都:成都中医药大学,2010.
[13]ZENG F,LAN L,TANG Y,et al.Cerebral responses to puncturing at different acupoints for treating meal-related functional dyspepsia[J].Neurogastroenterol Motil,2015,27(4):559-568.
[14]于涛,赵利娜,陈其奎.脑肠肽与功能性消化不良[J].现代消化及介入诊疗,2012,17(4):241-245.
[15]张卫,陈一.针刺对功能性消化不良患者心理因素及血清Ghrelin水平的影响[J].上海针灸杂志,2018,37(1):37-41.
[16]杨洋,艾芬,马朝阳,等.辨证针刺治疗功能性消化不良的临床观察[J].中国中西医结合杂志,2015,35(4):411-414.
[17]李学军,龙小娜,刘礼梅,等.不同针刺强度对功能性消化不良患者临床疗效及胃排空的影响[J].中医药临床杂志,2014,26(9):896-899.
[18]任秦有,张超,黄裕新,等.针刺功能性消化不良患者足三里穴对其胃排空及相关激素水平影响的临床研究[J].山西医科大学学报,2010,41(9):819-821.
[19]ZHANG C X,GUO L K.Dalitong granule,combined with electroacupuncture in the treatment of functional dyspepsia:Arandomized controlled trial[J].Chinese Journal of Integrative Medicine,2015,21(10):743-750.
[20]周利,程艳萍.电针对功能性消化不良大鼠胃促生长素及其受体mRNA表达的影响[J].中国中西医结合杂志,2016,36(3):322-326.
[21]周利,程艳萍.电针对功能性消化不良大鼠下丘脑和海马胃促生长素及受体mRNA表达的影响[J].上海针灸杂志,2015,34(7):673-677.
[22]周利,程艳萍.电针对功能性消化不良大鼠的胃排空和血浆Ghrelin的调节作用[J].湖北中医杂志,2014,36(3):19-21.
[23]杨云,徐派的,辛玉,等.电针对功能性消化不良大鼠胃排空功能及NT的影响[J].湖北中医杂志,2015,37(9):1-3.
[24]羊燕群,候陈凤,彭丹,等.针刺足三里对FD胃排空及血清Motilin和Ghrelin的影响[J].中华中医药学刊,2013,31(4):881-883.
[25]吴巧凤,周思远,刘娟,等.基于代谢组学的电针与伊托必利治疗功能性消化不良的比较研究[J].成都中医药大学学报,2010,33(1):1-5.
[26]周思远.针刺胃俞募穴治疗功能性消化不良的1H-NMR代谢组学研究[D].成都:成都中医药大学,2011.
[27]李晓亮.基于UPLC-MS技术的针刺合募配穴治疗功能性消化不良的代谢组学研究[D].成都:成都中医药大学,2016.
[28]YANG Q,XIE Y D,ZHANG M,et al.Effect of electroacupuncture stimulation at Zusanli acupoint(ST36)on gastric motility:possible through PKC and MAPK signal transduction pathways[J].BMC Complementary&Alternative Medicine,2014,14(1):137.
[29]刘沐苍.针刺足三里穴治疗功能性消化不良大鼠实验研究[D].大连:大连医科大学,2016.
[2]RST H,VCH C,CHL W,et al.Acupuncture and related therapies used as add-on or alternative to prokinetics for functional dyspepsia:overview of systematic reviews and network Meta-analysis[J].Sci Rep,2017,7(1):10320.
[3]洪枫.电针公孙、内关穴治疗功能性消化不良疗效观察[J].上海针灸杂志,2016,35(1):38-40.
[4]杨敏,张红星,邹燃.针刺对功能性消化不良症状及胃动力的影响[J].中国康复,2009,24(2):100-102.
[5]唐胜修,梁列新.功能性消化不良针刺分型治疗胃动素和胃电参数的相关性[J].辽宁中医药大学学报,2008,10(1):85-86.
[6]XU F,TAN Y,HUANG Z,et al.Ameliorating effect of transcutaneous electroacupuncture on impaired gastric accommodation in patients with postprandial distress syndrome-predominant functional dyspepsia:A pilot study[J].Evidence-based Complementary and Alternative Medicine,2015,2015:168-252.
[7]胡伟,张蔚,杨健,等.针刺足三里对功能性消化不良患者脑功能成像与胃泌素的影响[J].武汉大学学报:医学版,2014,35(5):740-743.
[8]陈媛.胃俞募配穴治疗功能性消化不良的边缘系统整合机制研究[D].成都:成都中医药大学,2012.
[9]LIU M,LIU C,WU J,et al.Low-frequency fluctuation amplitude analysis of resting-state fMRI for functional brain response differences between acupuncture and moxibustion at Zusanli(ST 36)in patient with functional dyspepsia[J].Journal of Acupuncture&Tuina Science,2017,15(4):230-236.
[10]LI Z,ZENG F,YANG Y,et al.Different cerebral responses to puncturing at ST36 among patients with functional dyspepsia and healthy subjects.[J].Forschende Komplementarmedizin,2014,21(2):99-104.
[11]FANG J,WANG D,ZHAO Q,et al.Brain-gut axis modulation of acupuncture in functional dyspepsia:a preliminary resting-state fcMRI study[J].Evid Based Complement Alternat Med,2015,2015:860463.
[12]曾芳.循经取穴治疗功能性消化不良的临床疗效评价及中枢响应特征研究[D].成都:成都中医药大学,2010.
[13]ZENG F,LAN L,TANG Y,et al.Cerebral responses to puncturing at different acupoints for treating meal-related functional dyspepsia[J].Neurogastroenterol Motil,2015,27(4):559-568.
[14]于涛,赵利娜,陈其奎.脑肠肽与功能性消化不良[J].现代消化及介入诊疗,2012,17(4):241-245.
[15]张卫,陈一.针刺对功能性消化不良患者心理因素及血清Ghrelin水平的影响[J].上海针灸杂志,2018,37(1):37-41.
[16]杨洋,艾芬,马朝阳,等.辨证针刺治疗功能性消化不良的临床观察[J].中国中西医结合杂志,2015,35(4):411-414.
[17]李学军,龙小娜,刘礼梅,等.不同针刺强度对功能性消化不良患者临床疗效及胃排空的影响[J].中医药临床杂志,2014,26(9):896-899.
[18]任秦有,张超,黄裕新,等.针刺功能性消化不良患者足三里穴对其胃排空及相关激素水平影响的临床研究[J].山西医科大学学报,2010,41(9):819-821.
[19]ZHANG C X,GUO L K.Dalitong granule,combined with electroacupuncture in the treatment of functional dyspepsia:Arandomized controlled trial[J].Chinese Journal of Integrative Medicine,2015,21(10):743-750.
[20]周利,程艳萍.电针对功能性消化不良大鼠胃促生长素及其受体mRNA表达的影响[J].中国中西医结合杂志,2016,36(3):322-326.
[21]周利,程艳萍.电针对功能性消化不良大鼠下丘脑和海马胃促生长素及受体mRNA表达的影响[J].上海针灸杂志,2015,34(7):673-677.
[22]周利,程艳萍.电针对功能性消化不良大鼠的胃排空和血浆Ghrelin的调节作用[J].湖北中医杂志,2014,36(3):19-21.
[23]杨云,徐派的,辛玉,等.电针对功能性消化不良大鼠胃排空功能及NT的影响[J].湖北中医杂志,2015,37(9):1-3.
[24]羊燕群,候陈凤,彭丹,等.针刺足三里对FD胃排空及血清Motilin和Ghrelin的影响[J].中华中医药学刊,2013,31(4):881-883.
[25]吴巧凤,周思远,刘娟,等.基于代谢组学的电针与伊托必利治疗功能性消化不良的比较研究[J].成都中医药大学学报,2010,33(1):1-5.
[26]周思远.针刺胃俞募穴治疗功能性消化不良的1H-NMR代谢组学研究[D].成都:成都中医药大学,2011.
[27]李晓亮.基于UPLC-MS技术的针刺合募配穴治疗功能性消化不良的代谢组学研究[D].成都:成都中医药大学,2016.
[28]YANG Q,XIE Y D,ZHANG M,et al.Effect of electroacupuncture stimulation at Zusanli acupoint(ST36)on gastric motility:possible through PKC and MAPK signal transduction pathways[J].BMC Complementary&Alternative Medicine,2014,14(1):137.
[29]刘沐苍.针刺足三里穴治疗功能性消化不良大鼠实验研究[D].大连:大连医科大学,2016.