针刺联合生酮饮食治疗难治性癫痫机制的研究
A Study on the Mechanism of Acupuncture Combined with Ketogenic Diet in Treating Refractory Epilepsy
DOI: 10.12677/tcm.2026.151054, PDF,    科研立项经费支持
作者: 张 奇：黑龙江中医药大学附属第一院治未病中心，黑龙江 哈尔滨；王裕文*：黑龙江中医药大学附属第一院针灸二科，黑龙江 哈尔滨
关键词: 难治性癫痫；生酮饮食；针刺；中西医结合疗法；Refractory Epilepsy； Ketogenic Diet； Acupuncture； Integrated Chinese and Western Medicine Therapy
摘要: 本文探讨了针刺联合生酮饮食治疗难治性癫痫的作用机制，该联合疗法通过多种途径发挥协同抗癫痫作用。生酮饮食通过代谢重构，将大脑能量来源从葡萄糖转为酮体，提升ATP生成效率，激活KATP通道，降低神经元兴奋性；针刺则通过上调GABA合成关键酶GAD67表达、增强GABAA受体功能，增强抑制性神经传递。二者共同抑制海马区NF-κB通路及NLRP3炎症小体激活，减轻神经炎症；通过调节肠道菌群与脑肠轴，影响短链脂肪酸和迷走神经信号，进一步抑制癫痫发作；并促进5-羟色胺释放、BDNF表达及mTOR通路调控，增强神经修复与突触可塑性。尽管该联合疗法展现出良好的应用前景，但目前仍缺乏高质量临床研究支持，存在不良反应与治疗方案标准化不足等问题。因此建议将其视为辅助治疗策略，未来需加强机制研究与临床验证，推动其精准化与个体化应用。
Abstract: This paper explores the mechanism of action of acupuncture combined with a ketogenic diet in treating refractory epilepsy, whereby this combined therapy exerts synergistic antiepileptic effects through multiple pathways. The ketogenic diet achieves metabolic reorganisation, shifting the brain’s energy source from glucose to ketone bodies. This enhances ATP production efficiency, activates potassium-ATPase channels (KATP), and reduces neuronal excitability. Concurrently, acupuncture modulates inhibitory neurotransmission by upregulating GAD67 expression—a key enzyme in GABA synthesis, and enhancing GABAA receptor function. Together, they inhibit the NF-κB pathway and NLRP3 inflammasome activation in the hippocampus, thereby reducing neuroinflammation. By modulating the gut microbiota and the gut-brain axis, they influence short-chain fatty acids and vagal nerve signalling, further suppressing epileptic seizures. Additionally, they promote serotonin release, enhance BDNF expression, and regulate the mTOR pathway, thereby strengthening neural repair and synaptic plasticity. Although this combined therapy demonstrates promising clinical potential, it currently lacks robust high-quality clinical research support and faces challenges such as adverse reactions and insufficient standardisation of treatment protocols. It is therefore recommended to consider this approach as an adjunctive therapeutic strategy. Future efforts should focus on strengthening mechanistic research and clinical validation to advance its precision and individualised application.
文章引用：张奇, 王裕文. 针刺联合生酮饮食治疗难治性癫痫机制的研究[J]. 中医学, 2026, 15(1): 386-394. https://doi.org/10.12677/tcm.2026.151054

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