电针治疗脊髓损伤

Electroacupuncture for Spinal Cord Injuries

摘要: 脊髓损伤(SCI)在世界范围内发病率与死亡率均高，且给患者造成了巨大心理和经济负担。电针在脊髓损伤治疗中通过多种机制抑制炎症、促进神经修复并改善功能恢复。它可抑制NLRP3炎症小体的活化，降低IL-18、IL-1β等炎症因子的表达，减少HMGB1介导的小胶质细胞凋亡，并通过Hippo通路抑制YAP蛋白过度增加，从而缓解神经炎症。同时，电针能提高VEGF、bFGF和Ang-1等血管生成因子水平，促进局部血管再生，改善缺血缺氧环境。通过AKT/CREB和AKT/GSK-3β/CREB通路，电针可促进内源性神经干细胞增殖，减少神经元死亡，并调节Bcl-2/Bax蛋白平衡抑制细胞凋亡。此外，电针改善SCI后的肠道功能，增加粪便含水量，恢复小肠推进率，调节胃铋素和胃动素分泌，保护肠屏障。它还能维持血脑脊髓屏障(BSCB)完整性，阻止炎症扩散，优化损伤微环境，最终促进神经功能恢复，展现出重要的临床应用价值。

Abstract: Spinal cord injury (SCI) has a high morbidity and mortality worldwide, and imposes a significant psychological and economic burden on patients. Electroacupuncture inhibits inflammation, promotes nerve repair, and improves functional recovery through a variety of mechanisms in the treatment of spinal cord injury. It can inhibit the activation of NLRP3 inflammasome, reduce the expression of inflammatory factors such as IL-18 and IL-1β, reduce HMGB1-mediated apoptosis of microglia, and inhibit the excessive increase of YAP protein through the Hippo pathway, thereby alleviating neuroinflammation. At the same time, electroacupuncture can increase the levels of angiogenesis factors such as VEGF, bFGF and Ang-1, promote local angiogenesis, and improve the ischemia and hypoxia environment. Through the AKT/CREB and AKT/GSK-3β/CREB pathways, electroacupuncture can promote endogenous neural stem cell proliferation, reduce neuronal death, and regulate Bcl-2/Bax protein balance to inhibit apoptosis. In addition, electroacupuncture improves intestinal function after SCI, increases stool water content, restores small intestinal propulsion, regulates gastric bismuth and motilin secretion, and protects the intestinal barrier. It can also maintain the integrity of the blood-brain-spinal cord barrier (BSCB), prevent the spread of inflammation, optimize the injury microenvironment, and ultimately promote the recovery of neurological function, showing important clinical application value.