| 引用本文:吴焕淦1,2，翁志军1,2，刘慧荣1,2，张建斌3，余曙光4，常小荣5，马晓芃1,2，沈雪勇6，王晓梅1,2，吴璐一1，黄艳1,2.基于免疫相关性疾病的艾灸镇痛与抗炎免疫研究[J].世界中医药,2016,(12):. |
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| 基于免疫相关性疾病的艾灸镇痛与抗炎免疫研究 |
| Analgesic and Anti-Inflammatory Effects of Moxibustion on Immune-Related Disease |
| 投稿时间：2016-12-07 |
| DOI：10.3969/j.issn.1673-7202.2016.12.001 |
| 中文关键词: 艾灸 抗炎免疫与镇痛 皮肤启动 中枢响应 靶器官调节 |
| English Keywords:Moxibustion Analgesia and anti-inflammation Peripheral startup Central nerves system response Target organ regulation |
| 基金项目:国家重点基础研究发展计划（“973”计划）项目（编号：2009CB522900；2015CB554501）；国家自然科学基金项目(编号：81303033；81674074)；上海市重点学科资助项目（编号：S30304-A3） |
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| 中文摘要: |
| 艾灸治疗痛症从古有之，抗炎免疫是现代针灸临床研究的热点。艾灸镇痛及其抗炎免疫作用已被中医针灸临床实践所证实，对其效应机制的研究多从温热刺激穴位（区）启动着手，研究发现皮肤穴位（区）中嘌呤受体（P2受体）和瞬时感受器电位香草酸受体（TRP）在艾灸效应的启动环节发挥了重要作用，参与机体疼痛、炎性反应的发生和发展，这种调节效应发生在“神经-内分泌-免疫”网络的各个环节，对诸多介导的疼痛的镇痛/致痛因子、炎性细胞因子具有调节作用，“艾灸嘌呤”这一概念可以概括目前研究发现的艾灸镇痛与抗炎效应，实验研究已发现艾灸能够对腹痛大鼠脊髓背角广动力神经元的异常兴奋性具有调节作用；临床中通过脑功能成像(fMRI)技术研究发现，艾灸和针刺在调控缓解期CD腹痛患者异常的脑灰质密度以及静息状态下异常的脑功能活动方面，镇痛效应的发挥存在着“共同响应脑区”和“差异响应脑区”；温热刺激能够在丘脑内侧和腹内侧核绕开对低阈值的下行易化系统的激活而实现对高阈值激活的下行抑制系统选择性激活，这种艾灸的内源性的调节作用可能在CD痛觉及炎性反应的治疗中发挥了重要的作用，今后将围绕“艾灸嘌呤”这一机制方向来展开更为深入的艾灸镇痛与抗炎研究。艾灸抗炎免疫研究发现，艾灸能通过HPA轴提高肾上腺素皮质激素的水平调节炎性细胞因子的合成，艾灸镇痛与抗炎免疫效应大多数情况下是同时存在，艾灸通过外周穴位（区）和中枢响应，激活抗炎通路，调节免疫应答，在实现抗炎作用的同时实现了镇痛效应。文章围绕“穴位（区）启动-中枢响应-靶器官效应”对艾灸镇痛与抗炎免疫机制进行回顾研究。 |
| English Summary: |
| Pain treatment with moxibustion has been used since ancient times. And anti-inflammation and immunity is a modern clinical research spot in acupuncture and moxibustion. Analgesic and anti-inflammatory effects of moxibustion have been improved by clinical practice. Research on its mechanism mostly focuses on warm-stimulated acupoints(area). It has been found that purinoceptor (P2 receptor) in skin acupoints(area) and transient receptor potential vanilloid (TRPV) play important roles in the startup procedure of moxibustion effect. They take effect in the occurrence and developing process of body pain and inflammation. This kind of regulating effect happens in each link of neuro-endocrine-immune network, which influences many analgesia/pain factor as well as inflammatory cytokines. The concept of moxibustion purine contains the analgesic and anti-inflammatory effects of moxibustion found by research. It has been proved that moxibustion has regulating effects on abnormal excitability of wide dynamic range neurons in spinal dorsal horn of rats with abdominal pain. Clinical research with fMRI has found that the regulating activities of moxibustion and acupuncture happen in both common and different brain areas, when they are regulating abnormal cerebral gray matter density and resting state brain activity of Crone’s disease patients during relieving period. Warm stimulation of moxibustion selectively activates high-threshold-activated descending inhibitory system without activating low-threshold descending facilitatory system in the medial thalamus and the ventromedial nucleus. This endogenous regulating effects of moxibustion can play an important role in the treatment of pain and inflammation. Further research, focusing on moxibustion purine, will explain the mechanism of analgesic and anti-inflammatory effects of moxibustion. Research of moxibustion anti-inflammation have found that it regulates the synthesis of inflammatory cytokines by increasing the level of adrenergic cortical hormone (ACH) on the hypothalamic-pituitary-adrenal axis (HPA axis). In most situations, analgesic and anti-inflammatory effects of moxibustion occur at the same time. Moxibustion stimulates peripheral acupoints (area) and central nerves, regulate immune response and manage pain as well. This study is to give a review of research on mechanism of analgesic and anti-inflammatory effects of moxibustion, focusing on peripheral acupoint (area) startup-central nerve system response-target organ effect. |
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