基于针灸脑科学的神经调控技术研究进展
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摘要
中医针灸是中国古代科学的瑰宝,研究证实,针灸通过体表刺激将信息传输到人体,在脑内整合处理,进而输出指令,调控神经-内分泌-免疫系统,调节整体功能,达到改善机体状态、治疗疾病的目的。目前,神经调控技术风头正劲。美国国立卫生研究院(NIH)2016年开展一项名为"刺激周围神经治疗疾病"的计划,该计划类似于电针疗法。本文就传统中医学和现代医学对针灸与脑相关的研究进行梳理和特征总结,从神经调控角度阐释针灸的效应机制。理解针刺调节中枢及外周运行机制,将对针灸神经调控技术的人工智能化研发具有重大启迪意义。
Chinese acupuncture is a treasure of the ancient Chinese science. Evidences show that acupuncture can transmit signals through stimulating body surface to the brain where the signals are integrated and sent to the whole body, so as to regulate organs' function through the neuro-endocrine-immune system, improve human body harmony and treat diseases. Nowadays, neuromodulation technique represents a trend. In the U.S. the program of stimulating peripheral activity to relieve conditions(SPARC), which is similar to electro-acupuncture, has been conducted at the National Institutes of Health(NIH) since 2016. In this article, we briefly summarize the current situation of acupuncture and brain-related studies in both traditional Chinese medicine and modern medicine, and try to explore the therapeutic mechanisms of acupuncture from the perspective of neuromodulation. Understanding the operational mechanisms of acupuncture from the central and peripheral nerve systems will be of great significance to the AI development on account of acupuncture neuromodulation in the future.
Chinese acupuncture is a treasure of the ancient Chinese science. Evidences show that acupuncture can transmit signals through stimulating body surface to the brain where the signals are integrated and sent to the whole body, so as to regulate organs' function through the neuro-endocrine-immune system, improve human body harmony and treat diseases. Nowadays, neuromodulation technique represents a trend. In the U.S. the program of stimulating peripheral activity to relieve conditions(SPARC), which is similar to electro-acupuncture, has been conducted at the National Institutes of Health(NIH) since 2016. In this article, we briefly summarize the current situation of acupuncture and brain-related studies in both traditional Chinese medicine and modern medicine, and try to explore the therapeutic mechanisms of acupuncture from the perspective of neuromodulation. Understanding the operational mechanisms of acupuncture from the central and peripheral nerve systems will be of great significance to the AI development on account of acupuncture neuromodulation in the future.
引文
[1]项燕.李瑞教授调神理论在针灸临床中的应用[J].中国针灸,2013,33(5):443-446.Xiang Yan.Professor Li Rui's mind regulation theory in the clinical application of acupuncture and moxibustion[J].Chinese Acupuncture&Moxibustion2013,33(5):443-446.
[2]方继良,周科华,王小玲,等.针刺太冲穴得气及疼痛激发相对抗的脑功能网络效应f MRI研究[J].中国中西医结合影像学杂志,2012,10(1):4-9.Fang Jiliang,Zhou Kehua,Wang Xiaoling,et al.Deqi and Sharp pain during acupuncture at Taichong eliciting the opposite functional brain network effects:An f MRI study[J].Chinese Imaging Journal of Integrated Traditional And Western Medicine,2012,10(1):4-9.
[3]Wickramasekera I.A conditioned response model of the placebo effect[J].Applied Psychophysiology and Biofeedback,1980,5(1):5-18.
[4]邹蓓蕾.针灸治疗精神行为类障碍类疾病的文献研究[J].中国民族民间医药,2009,18(11):29-30.Zou Beilei.Literature resaerch of acupuncture on psychiatric and mental disorders[J].Chinese Journal of Ethnomedicine and Ethnopharmacy,2009,18(11):29-30.
[5]张亚敏,孙华,陈素辉.针灸干预血管性痴呆的临床研究进展[J].针灸临床杂志,2012,28(8):65-68.Zhang Yamin,Sun Hua,Chen Suhui.The clinical research progression of intervention on vascular dementia(VD)with acupuncture-Moxibustion[J]Journal of Clinical Acupuncture and Moxibustion,2012,28(8):65-68.
[6]赵建新,田元祥,李国明.拟血管性痴呆小鼠海马CA_1区细胞定量分析及电针的影响[J].中国病理生理杂志,2003,19(6):5,24.Zhao Jianxin,Tian Yuanxiang,Li Guoming.The effect of acupuncture on cell quantiative analysis in CA1 hippocampus of vascular dementia mice[J]Chinese Journal of Pathophysiology,2003,19(6):5,24.
[7]施炳培,卜怀娣,秀志英,等.针灸治疗对脑性瘫痪及精神发育迟缓患儿生长激素水平的影响[J].中国临床康复,2004,8(30):6627,6631.Shi Bingpei,Pu Huaidi,Xiu Zhiying,et al.The effect of acupuncture on growth hormone in cerebral palsy and mentally retarded children[J].Chinese Journal of Clinical Rehabilitation,2004,8(30):6627,6631.
[8]刘运珠,刘布谷,罗有年,等.温针灸夹脊穴治疗抑郁症患者30例疗效观察及对其脑电α波的影响[J].中医杂志,2008,49(11):995-997.Liu Yunzhu,Liu Bugu,Luo Younian,et al.Therapeutic observation on the effect of warming-needle moxibustion for 30 cases of depression and its effec onαwave of EEG[J].Journal of Traditional Chinese Medicine,2008,49(11):995-997.
[9]朱晶,国海东,邵水金.针灸治疗阿尔茨海默病机制的研究进展[J].针刺研究,2012,37(5):422-427.Zhu Jing,Guo Haidong,Shao Shuijin.Progress of researches on mechanisms of acupuncture intervention of Alzheimer's disease[J].Acupuncture Research,2012,37(5):422-427.
[10]Fang J,Rong P,Hong Y,et al.Transcutaneous vagus nerve stimulation modulates default mode network in major depressive disorder[J].Biological Psy chiatry,2016,79(4):266-273.
[11]Yuan H,Silberstein S D.Vagus nerve and vagus nerve stimulation,a comprehensive review:Part II[J].Headache:The Journal of Head and Face Pain2016,56(2):259-266.
[12]Rong P,Liu A,Zhang J,et al.An alternative therapy for drug-resistant epilepsy:Transcutaneous auricular vagus nerve stimulation[J].Chinese Medica Journal,2013,127(2):300-304.
[13]Rong P,Liu J,Wang L,et al.Effect of transcutaneous auricular vagus nerve stimulation on major depressive disorder:A nonrandomized controlled pilo study[J].Journal of Affective Disorders,2016,195:172-179.
[14]Rosas T R,Yehia G,Pe?a G,et al.Dopamine mediates vagal modulation of the immune system by electroacupuncture[J].Nature Medicine,2014,20(3)291-295.
[15]Man S C,Hung B H B,Ng R M K,et al.A pilot controlled trial of a combination of dense cranial electroacupuncture stimulation and body acupuncture for post-stroke depression[J].BMC Complementary and Alternative medicine,2014,14(1):255.
[16]Zhang Z J,Ng R,Man S C,et al.Dense cranial electroacupuncture stimulation for major depressive disorder-a single-blind,randomized,controlled study[J].PLo S One,2012,7(1):e29651.
[17]Chung K F,Yeung W F,Zhang Z J,et al.Randomized non-invasive sham-controlled pilot trial of electroacupuncture for postpartum depression[J].Jour nal of Affective Disorders,2012,142(1):115-121.
[18]Bueno V F,Brunoni A R,Boggio P S,et al.Mood and cognitive effects of transcranial direct current stimulation in post-stroke depression[J].Neurocase2011,17(4):318-322.
[19]Zhang Z J,Wang X Y,Tan Q R,et al.Electroacupuncture for refractory obsessive-compulsive disorder:A pilot waitlist-controlled trial[J].The Journa of Nervous and Mental Disease,2009,197(8):619-622.
[20]Zhang Z J,Wang X M,Mc Alonan G M.Neural acupuncture unit:A new concept for interpreting effects and mechanisms of acupuncture[J].Evidencebased Complementary and Alternative Medicine,2012,2012(3):429412.
[21]Ben-Menachem E.Vagus-nerve stimulation for the treatment of epilepsy[J].The Lancet Neurology,2002,1(8):477-482.
[22]Groves D A,Brown V J.Vagal nerve stimulation:A review of its applications and potential mechanisms that mediate its clinical effects[J].Neuroscience&Biobehavioral Reviews,2005,29(3):493-500.
[23]Hord E D,Evans M S,Mueed S,et al.The effect of vagus nerve stimulation on migraines[J].The Journal of Pain,2003,4(9):530-534.
[24]Nichols J A,Nichols A R,Smirnakis S M,et al.Vagus nerve stimulation modulates cortical synchrony and excitability through the activation of muscarinic receptors[J].Neuroscience,2011,189:207-214.
[25]Fox D.The shock tactics set to shake up immunology[J].Nature,2017,545(7652):20.
[2]方继良,周科华,王小玲,等.针刺太冲穴得气及疼痛激发相对抗的脑功能网络效应f MRI研究[J].中国中西医结合影像学杂志,2012,10(1):4-9.Fang Jiliang,Zhou Kehua,Wang Xiaoling,et al.Deqi and Sharp pain during acupuncture at Taichong eliciting the opposite functional brain network effects:An f MRI study[J].Chinese Imaging Journal of Integrated Traditional And Western Medicine,2012,10(1):4-9.
[3]Wickramasekera I.A conditioned response model of the placebo effect[J].Applied Psychophysiology and Biofeedback,1980,5(1):5-18.
[4]邹蓓蕾.针灸治疗精神行为类障碍类疾病的文献研究[J].中国民族民间医药,2009,18(11):29-30.Zou Beilei.Literature resaerch of acupuncture on psychiatric and mental disorders[J].Chinese Journal of Ethnomedicine and Ethnopharmacy,2009,18(11):29-30.
[5]张亚敏,孙华,陈素辉.针灸干预血管性痴呆的临床研究进展[J].针灸临床杂志,2012,28(8):65-68.Zhang Yamin,Sun Hua,Chen Suhui.The clinical research progression of intervention on vascular dementia(VD)with acupuncture-Moxibustion[J]Journal of Clinical Acupuncture and Moxibustion,2012,28(8):65-68.
[6]赵建新,田元祥,李国明.拟血管性痴呆小鼠海马CA_1区细胞定量分析及电针的影响[J].中国病理生理杂志,2003,19(6):5,24.Zhao Jianxin,Tian Yuanxiang,Li Guoming.The effect of acupuncture on cell quantiative analysis in CA1 hippocampus of vascular dementia mice[J]Chinese Journal of Pathophysiology,2003,19(6):5,24.
[7]施炳培,卜怀娣,秀志英,等.针灸治疗对脑性瘫痪及精神发育迟缓患儿生长激素水平的影响[J].中国临床康复,2004,8(30):6627,6631.Shi Bingpei,Pu Huaidi,Xiu Zhiying,et al.The effect of acupuncture on growth hormone in cerebral palsy and mentally retarded children[J].Chinese Journal of Clinical Rehabilitation,2004,8(30):6627,6631.
[8]刘运珠,刘布谷,罗有年,等.温针灸夹脊穴治疗抑郁症患者30例疗效观察及对其脑电α波的影响[J].中医杂志,2008,49(11):995-997.Liu Yunzhu,Liu Bugu,Luo Younian,et al.Therapeutic observation on the effect of warming-needle moxibustion for 30 cases of depression and its effec onαwave of EEG[J].Journal of Traditional Chinese Medicine,2008,49(11):995-997.
[9]朱晶,国海东,邵水金.针灸治疗阿尔茨海默病机制的研究进展[J].针刺研究,2012,37(5):422-427.Zhu Jing,Guo Haidong,Shao Shuijin.Progress of researches on mechanisms of acupuncture intervention of Alzheimer's disease[J].Acupuncture Research,2012,37(5):422-427.
[10]Fang J,Rong P,Hong Y,et al.Transcutaneous vagus nerve stimulation modulates default mode network in major depressive disorder[J].Biological Psy chiatry,2016,79(4):266-273.
[11]Yuan H,Silberstein S D.Vagus nerve and vagus nerve stimulation,a comprehensive review:Part II[J].Headache:The Journal of Head and Face Pain2016,56(2):259-266.
[12]Rong P,Liu A,Zhang J,et al.An alternative therapy for drug-resistant epilepsy:Transcutaneous auricular vagus nerve stimulation[J].Chinese Medica Journal,2013,127(2):300-304.
[13]Rong P,Liu J,Wang L,et al.Effect of transcutaneous auricular vagus nerve stimulation on major depressive disorder:A nonrandomized controlled pilo study[J].Journal of Affective Disorders,2016,195:172-179.
[14]Rosas T R,Yehia G,Pe?a G,et al.Dopamine mediates vagal modulation of the immune system by electroacupuncture[J].Nature Medicine,2014,20(3)291-295.
[15]Man S C,Hung B H B,Ng R M K,et al.A pilot controlled trial of a combination of dense cranial electroacupuncture stimulation and body acupuncture for post-stroke depression[J].BMC Complementary and Alternative medicine,2014,14(1):255.
[16]Zhang Z J,Ng R,Man S C,et al.Dense cranial electroacupuncture stimulation for major depressive disorder-a single-blind,randomized,controlled study[J].PLo S One,2012,7(1):e29651.
[17]Chung K F,Yeung W F,Zhang Z J,et al.Randomized non-invasive sham-controlled pilot trial of electroacupuncture for postpartum depression[J].Jour nal of Affective Disorders,2012,142(1):115-121.
[18]Bueno V F,Brunoni A R,Boggio P S,et al.Mood and cognitive effects of transcranial direct current stimulation in post-stroke depression[J].Neurocase2011,17(4):318-322.
[19]Zhang Z J,Wang X Y,Tan Q R,et al.Electroacupuncture for refractory obsessive-compulsive disorder:A pilot waitlist-controlled trial[J].The Journa of Nervous and Mental Disease,2009,197(8):619-622.
[20]Zhang Z J,Wang X M,Mc Alonan G M.Neural acupuncture unit:A new concept for interpreting effects and mechanisms of acupuncture[J].Evidencebased Complementary and Alternative Medicine,2012,2012(3):429412.
[21]Ben-Menachem E.Vagus-nerve stimulation for the treatment of epilepsy[J].The Lancet Neurology,2002,1(8):477-482.
[22]Groves D A,Brown V J.Vagal nerve stimulation:A review of its applications and potential mechanisms that mediate its clinical effects[J].Neuroscience&Biobehavioral Reviews,2005,29(3):493-500.
[23]Hord E D,Evans M S,Mueed S,et al.The effect of vagus nerve stimulation on migraines[J].The Journal of Pain,2003,4(9):530-534.
[24]Nichols J A,Nichols A R,Smirnakis S M,et al.Vagus nerve stimulation modulates cortical synchrony and excitability through the activation of muscarinic receptors[J].Neuroscience,2011,189:207-214.
[25]Fox D.The shock tactics set to shake up immunology[J].Nature,2017,545(7652):20.