基于NF-κB信号通路的针刺治疗下腰痛机制研究进展
Research Progress on the Mechanism of Acupuncture in Treating Low Back Pain Based on the NF-κB Signaling Pathway
DOI: 10.12677/tcm.2026.153158, PDF,    科研立项经费支持
作者: 王俊淇, 周海燕*：成都中医药大学针灸推拿学院，四川 成都；李睿琪：西南医科大学临床医学院，四川 泸州
关键词: 下腰痛；NF-κB信号通路；针刺；Low Back Pain； NF-κB Signaling Pathway； Acupuncture
摘要: 核因子κB (The nuclear factor kappa-B, NF-κB)信号通路是下腰痛(Low back pain, LBP)慢性炎症与椎间盘退变的关键驱动环节。该通路激活后，通过上调促炎因子、疼痛介质及基质降解酶，加剧神经炎症、组织破坏和痛觉敏化。大量研究表明，针刺的治疗效应与其精准调控NF-κB通路密切相关。针刺可通过抑制IKK/IκB磷酸化、阻断NF-κB核转位，从源头上遏制下游炎症级联反应；同时可能通过激活胆碱能抗炎通路等机制，多靶点发挥抗炎、镇痛及组织保护作用。本研究系统阐述针刺通过干预NF-κB通路改善下腰痛的分子机制，为深化其科学内涵及推动靶向治疗研究提供理论依据。
Abstract: The Nuclear Factor Kappa-B (NF-κB) signaling pathway serves as a central driver of chronic inflammation and intervertebral disc degeneration in low back pain (LBP). Upon activation, this pathway upregulates pro-inflammatory factors, pain mediators, and matrix-degrading enzymes, thereby exacerbating neuroinflammation, tissue destruction, and pain sensitization. Numerous studies have demonstrated that the therapeutic effects of acupuncture are closely associated with its precise modulation of the NF-κB pathway. Acupuncture exerts its effects by inhibiting IKK/IκB phosphorylation and blocking NF-κB nuclear translocation, thereby curbing the downstream inflammatory cascade at its source. Additionally, through mechanisms such as activating the cholinergic anti-inflammatory pathway, acupuncture multi-targetedly delivers anti-inflammatory, analgesic, and tissue-protective actions. This review systematically elaborates on the molecular mechanisms through which acupuncture ameliorates low back pain by intervening in the NF-κB pathway, providing a theoretical basis for deepening its scientific understanding and promoting research into targeted therapies.
文章引用：王俊淇, 李睿琪, 周海燕. 基于NF-κB信号通路的针刺治疗下腰痛机制研究进展[J]. 中医学, 2026, 15(3): 219-226. https://doi.org/10.12677/tcm.2026.153158

参考文献

[1] Ferreira, M.L., de Luca, K., Haile, L.M. and GBD 2021 Low Back Pain Collaborators (2023) Global, Regional, and National Burden of Low Back Pain, 1990-2020, Its Attributable Risk Factors, and Projections to 2050: A Systematic Analysis of the Global Burden of Disease Study 2021. The Lancet Rheumatology, 5, e316-e329.
[2] Zhou, T., Salman, D. and McGregor, A.H. (2024) Recent Clinical Practice Guidelines for the Management of Low Back Pain: A Global Comparison. BMC Musculoskeletal Disorders, 25, Article No. 344. [Google Scholar] [CrossRef] [PubMed]
[3] Wang, Z., Li, X., Yu, P., Zhu, Y., Dai, F., Ma, Z., et al. (2024) Role of Autophagy and Pyroptosis in Intervertebral Disc Degeneration. Journal of Inflammation Research, 17, 91-100. [Google Scholar] [CrossRef] [PubMed]
[4] Cashin, A.G., Wand, B.M., O’Connell, N.E., Lee, H., Rizzo, R.R., Bagg, M.K., et al. (2023) Pharmacological Treatments for Low Back Pain in Adults: An Overview of Cochrane Reviews. Cochrane Database of Systematic Reviews, 2023, CD013815. [Google Scholar] [CrossRef] [PubMed]
[5] Domper Arnal, M., Hijos-Mallada, G. and Lanas, A. (2021) Gastrointestinal and Cardiovascular Adverse Events Associated with NSAIDs. Expert Opinion on Drug Safety, 21, 373-384. [Google Scholar] [CrossRef] [PubMed]
[6] Gisev, N., Buizen, L., Hopkins, R.E., Schaffer, A.L., Daniels, B., Bharat, C., et al. (2023) Five-Year Trajectories of Prescription Opioid Use. JAMA Network Open, 6, e2328159. [Google Scholar] [CrossRef] [PubMed]
[7] Cho, Y.J., Song, Y.K., Cha, Y.Y., Shin, B.C., et al. (2013) Acupuncture for Chronic Low Back Pain: A Multicenter, Randomized, Patient-Assessor Blind, Sham-Controlled Clinical Trial. Spine (Phila Pa 1976), 38, 549-57.
[8] Bahrami-Taghanaki, H., Liu, Y., Azizi, H., Khoursand-Vakilzadeh, A., Esmaily, H., Bahrami, A., et al. (2014) A Randomized Controlled Trial of Acupuncture for Chronic Low Back Pain. The Journal of Alternative and Complementary Medicine, 20, A40. [Google Scholar] [CrossRef] 
[9] Barth, J., Muff, S., Kern, A., Zieger, A., Keiser, S., Zoller, M., et al. (2021) Effect of Briefing on Acupuncture Treatment Outcome Expectations, Pain, and Adverse Side Effects among Patients with Chronic Low Back Pain. JAMA Network Open, 4, e2121418. [Google Scholar] [CrossRef] [PubMed]
[10] Liu, H., Li, Y.P., Hou, M.J., et al. (2023) Effect of Trigger Point Acupuncture on Pain and Functional Activity in Patients with Chronic Non-Specific Low Back Pain: A Randomised Controlled Trial. Acupuncture in Medicine, 41, 130-141. [Google Scholar] [CrossRef] [PubMed]
[11] Mitchell, S., Vargas, J. and Hoffmann, A. (2016) Signaling via the NF-κB System. Wiley Interdisciplinary Reviews: Systems Biology and Medicine, 8, 227-241.
[12] Kracht, M., Müller-Ladner, U. and Schmitz, M.L. (2020) Mutual Regulation of Metabolic Processes and Proinflammatory NF-κB Signaling. Journal of Allergy and Clinical Immunology, 146, 694-705. [Google Scholar] [CrossRef] [PubMed]
[13] Zhang, Q., Lenardo, M.J. and Baltimore, D. (2017) 30 Years of NF-κB: A Blossoming of Relevance to Human Pathobiology. Cell, 168, 37-57. [Google Scholar] [CrossRef] [PubMed]
[14] Hayden, M.S. and Ghosh, S. (2014) Regulation of NF-κB by TNF Family Cytokines. Seminars in Immunology, 26, 253-266. [Google Scholar] [CrossRef] [PubMed]
[15] Zhang, G.Z., Liu, M.Q., Chen, H.W., Wu, Z.L., et al. (2021) NF‐κB Signalling Pathways in Nucleus Pulposus Cell Function and Intervertebral Disc Degeneration. Cell Proliferation, 54, e13057. [Google Scholar] [CrossRef] [PubMed]
[16] Ke, W., Xu, H., Zhang, C., Liao, Z., Liang, H., Tong, B., et al. (2025) An Overview of Mechanical Microenvironment and Mechanotransduction in Intervertebral Disc Degeneration. Experimental & Molecular Medicine, 57, 2157-2168. [Google Scholar] [CrossRef] 
[17] Yao, Q., Wu, X., Tao, C., Gong, W., Chen, M., Qu, M., et al. (2023) Osteoarthritis: Pathogenic Signaling Pathways and Therapeutic Targets. Signal Transduction and Targeted Therapy, 8, Article No. 56. [Google Scholar] [CrossRef] [PubMed]
[18] Wang, H., Zhang, W., Cai, Y., Guo, Q., Pan, L., Chu, G., et al. (2023) Moderate Mechanical Stimulation Antagonizes Inflammation of Annulus Fibrosus Cells through Yap-Mediated Suppression of NF-κB Signaling. Journal of Orthopaedic Research, 41, 2667-2684. [Google Scholar] [CrossRef] [PubMed]
[19] Li, B., Hu, Y., Chen, Y., Liu, K., Rong, K., Hua, Q., et al. (2024) Homoplantaginin Alleviates Intervertebral Disc Degeneration by Blocking the NF-κB/MAPK Pathways via Binding to TAK1. Biochemical Pharmacology, 226, Article 116389. [Google Scholar] [CrossRef] [PubMed]
[20] Tu, H. and Li, Y.L. (2023) Inflammation Balance in Skeletal Muscle Damage and Repair. Frontiers in Immunology, 14, Article 1133355. [Google Scholar] [CrossRef] [PubMed]
[21] Zhou, X.L., Tang, N., Wu, T., Zhang, Y., et al. (2020) Mechanism of Catgut Embedding at Back-Shu Points for Nonalcoholic Steatohepatitis Based on IKK/IKB/NF-κB Signaling Pathway. Chinese Acupuncture & Moxibustion, 40, 59-66.
[22] Qin, W.Y., Luo, Y. and Yu, C. (2013) Influence of Electroacupuncture Intervention on Hippocampal IL-1 Beta Content and I Kappa B Kinase Beta Expression in Focal Cerebral Ischemia/Reperfusion Rats. Acupuncture Research, 38, 271-276.
[23] 陈艺敏, 杨正瑜, 陈群, 等. 针刺脾俞对衰老大鼠腰骨骼肌萎缩Akt/NF-κB信号通路的影响[J]. 中国骨质疏松杂志, 2024, 30(4): 482-487.
[24] Zhang, K., Zhao, X., Yang, T., Zhang, Y., Yan, Y., Xu, Z., et al. (2021) Initiation of Acupoint Molecular Mechanisms for Manual Acupuncture Analgesia—Nuclear Factor κB Signaling Pathway. Chinese Journal of Integrative Medicine, 27, 933-939. [Google Scholar] [CrossRef] [PubMed]
[25] Wu, G., Chen, J., Huang, Y., Pan, C., Chen, W., Zhang, S., et al. (2019) Electroacupuncture Delays Cartilage Degeneration by Modulating Nuclear Factor-κB Signaling Pathway. Chinese Journal of Integrative Medicine, 25, 677-683. [Google Scholar] [CrossRef] [PubMed]
[26] Karamanos, N.K., Piperigkou, Z., Passi, A., Götte, M., Rousselle, P. and Vlodavsky, I. (2021) Extracellular Matrix-Based Cancer Targeting. Trends in Molecular Medicine, 27, 1000-1013. [Google Scholar] [CrossRef] [PubMed]
[27] Morgan, M. and Liu, Z.G. (2011) Crosstalk of Reactive Oxygen species and NF-κB Signaling. Cell Research, 21, 103-115.
[28] Lennicke, C. and Cochemé, H.M. (2021) Redox Metabolism: ROS as Specific Molecular Regulators of Cell Signaling and Function. Molecular Cell, 81, 3691-3707. [Google Scholar] [CrossRef] [PubMed]
[29] Thoma, A. and Lightfoot, A.P. (2018) NF-kB and Inflammatory Cytokine Signalling: Role in Skeletal Muscle Atrophy. In: Advances in Experimental Medicine and Biology, Springer, 267-279. [Google Scholar] [CrossRef] [PubMed]
[30] Bellezza, I., Giambanco, I., Minelli, A. and Donato, R. (2018) Nrf2-Keap1 Signaling in Oxidative and Reductive Stress. Biochimica et Biophysica Acta—Molecular Cell Research, 1865, 721-733. [Google Scholar] [CrossRef] [PubMed]
[31] Li, N., Guo, Y., Gong, Y., Zhang, Y., Fan, W., Yao, K., et al. (2021) The Anti-Inflammatory Actions and Mechanisms of Acupuncture from Acupoint to Target Organs via Neuro-Immune Regulation. Journal of Inflammation Research, 14, 7191-7224. [Google Scholar] [CrossRef] [PubMed]
[32] Lou, H., Yao, J., Zhang, Y., Wu, X., Sun, L., Wang, Y., et al. (2024) Potential Effect of Acupuncture on Mitochondrial Biogenesis, Energy Metabolism and Oxidation Stress in MCAO Rat via PGC-1α/Nrf1/TFAM Pathway. Journal of Stroke and Cerebrovascular Diseases, 33, Article 107636. [Google Scholar] [CrossRef] [PubMed]
[33] Li, J., Wu, X., Yan, S., Shen, J., Tong, T., Aslam, M.S., et al. (2025) Understanding the Antidepressant Mechanisms of Acupuncture: Targeting Hippocampal Neuroinflammation, Oxidative Stress, Neuroplasticity, and Apoptosis in CUMS Rats. Molecular Neurobiology, 62, 4221-4236. [Google Scholar] [CrossRef] [PubMed]
[34] Li, X., Sun, Y., Tjahjono, A.W., Wei, Y., Li, X., Zheng, Q., et al. (2025) Acupuncture Attenuates Myocardial Ischemia/reperfusion Injury-Induced Ferroptosis via the Nrf2/HO-1 Pathway. Chinese Medicine, 20, Article No. 61. [Google Scholar] [CrossRef] [PubMed]
[35] 薛维婳, 罗芳芳, 林楚镇, 等. 针刺“阳陵泉”“足三里”调控PINK1/Parkin介导的线粒体自噬对膝骨关节炎大鼠软骨细胞的保护机制[J].广州中医药大学学报, 2025, 42(6): 1446-1453.
[36] Peng, Y., Chen, X., Rao, Z., Wu, W., Zuo, H., Chen, K., et al. (2023) Multifunctional Annulus Fibrosus Matrix Prevents Disc-Related Pain via Inhibiting Neuroinflammation and Sensitization. Acta Biomaterialia, 170, 288-302. [Google Scholar] [CrossRef] [PubMed]
[37] Mengis, T., Bernhard, L., Nüesch, A., Heggli, I., Herger, N., Devan, J., et al. (2024) The Expression of Toll-Like Receptors in Cartilage Endplate Cells: A Role of Toll-Like Receptor 2 in Pro-Inflammatory and Pro-Catabolic Gene Expression. Cells, 13, Article 1402. [Google Scholar] [CrossRef] [PubMed]
[38] Chao-Yang, G., Peng, C. and Hai-Hong, Z. (2021) Roles of NLRP3 Inflammasome in Intervertebral Disc Degeneration. Osteoarthritis and Cartilage, 29, 793-801. [Google Scholar] [CrossRef] [PubMed]
[39] Gong, Y., Qiu, J., Jiang, T., Li, Z., Zhang, W., Zheng, X., et al. (2022) Maltol Ameliorates Intervertebral Disc Degeneration through Inhibiting PI3K/AKT/NF-κB Pathway and Regulating NLRP3 Inflammasome-Mediated Pyroptosis. Inflammopharmacology, 31, 369-384. [Google Scholar] [CrossRef] [PubMed]
[40] Xu, W., Xiao, Y., Zhao, M., Zhu, J., Wang, Y., Wang, W., et al. (2023) Effective Treatment of Knee Osteoarthritis Using a Nano-Enabled Drug Acupuncture Technology in Mice. Advanced Science, 10, Article 2302586. [Google Scholar] [CrossRef] [PubMed]
[41] Xia, Y., Xue, M., Sun, Y., Wang, Y., Huang, Z. and Huang, C. (2024) Electroacupuncture Inhibits TLR4/NF-κB Signaling in the Dorsal Root Ganglion of Rats with Spared Nerve Injury. Acupuncture in Medicine, 42, 275-284. [Google Scholar] [CrossRef] [PubMed]
[42] Zhao, Y.X., Yao, M.J., Liu, Q., Xin, J.J., Gao, J.H. and Yu, X.C. (2020) Electroacupuncture Treatment Attenuates Paclitaxel-Induced Neuropathic Pain in Rats via Inhibiting Spinal Glia and the TLR4/NF-κB Pathway. Journal of Pain Research, 13, 239-250. [Google Scholar] [CrossRef] [PubMed]
[43] 胡情, 张天生, 苏嘉琪, 等. 针刺对穴“后溪-环跳”对腰椎间盘突出症大鼠HMGB1/TLR4/NF-κB信号通路的影响[J]. 针灸临床杂志, 2023, 39(8): 64-70.
[44] Sadowska, A., Kameda, T., Krupkova, O. and Wuertz-Kozak, K. (2018) Osmosensing, Osmosignalling and Inflammation: How Intervertebral Disc Cells Respond to Altered Osmolarity. European Cells and Materials, 36, 231-250. [Google Scholar] [CrossRef] [PubMed]
[45] Aydin, H.E., Yigit, S., Kaya, I., Tural, E., Tuncer, S. and Nursal, A.F. (2022) VEGF and eNOS Variants May Influence Intervertebral Disc Degeneration. Nucleosides, Nucleotides & Nucleic Acids, 41, 982-993. [Google Scholar] [CrossRef] [PubMed]
[46] Zhu, R.L., Zhi, Y.K., Yi, L., et al. (2019) Sinomenine Regulates CD14/TLR4, JAK2/STAT3 Pathway and Calcium Signal via Alpha7nAChR to Inhibit Inflammation in LPS-Stimulated Macrophages. Immunopharmacology and Immunotoxicology, 41, 172-177.
[47] Zhi, Y.K., Li, J., Yi, L., et al. (2022) Sinomenine Inhibits Macrophage M1 Polarization by Downregulating α7nAChR via a Feedback Pathway of α7nAChR/ERK/Egr-1. Phytomedicine, 100, Article 154050.
[48] 季彬彬, 陈林碧, 庄秀秀, 等. 电针对脑缺血再灌注大鼠脑缺血耐受和炎性痛大鼠镇痛效应的穴位特异性研究[J]. 针刺研究, 2020, 45(10): 823-828+834.
[49] Shi, G.X., Tu, J.F., Wang, T.Q., et al. (2020) Effect of Electro-Acupuncture (EA) and Manual Acupuncture (MA) on Markers of Inflammation in Knee Osteoarthritis. Journal of Pain Research, 13, 2171-2179. [Google Scholar] [CrossRef] [PubMed]
[50] He, Q.X., Pan, S.T., Chen, Y.R., et al. (2019) Lower Frequency Electroacupuncture Is Better in Promoting Recovery of Limb Locomotion in Rats with Sciatic Nerve Injury by Reducing Local Inflammatory Reaction. Acupuncture Research, 44, 571-576.
[51] Wu, L., Tan, Z., Su, L., Dong, F., Xu, G. and Zhang, F. (2024) Transcutaneous Electrical Acupoint Stimulation Alleviates Cerebral Ischemic Injury through the TLR4/MyD88/NF-κB Pathway. Frontiers in Cellular Neuroscience, 17, Article 1343842. [Google Scholar] [CrossRef] [PubMed]