针刺治疗缺血性脑卒中免疫调节机制的研究进展
Research Progress on the Immunomodulatory Mechanism of Acupuncture in Ischemic Stroke
DOI: 10.12677/tcm.2026.1510595, PDF,   
作者: 李鸿祥：黑龙江中医药大学研究生院，黑龙江 哈尔滨；尹洪娜*：黑龙江中医药大学附属第二医院针灸七科，黑龙江 哈尔滨
关键词: 针刺；缺血性脑卒中；免疫稳态；神经–免疫调控；信号通路；Acupuncture； Ischemic Stroke； Immune Homeostasis； Neuro-Immune Regulation； Signaling Pathways
摘要: 缺血性脑卒中是全球范围内导致死亡和长期残疾的主要原因之一。免疫稳态失衡是驱动IS后神经炎症级联反应和继发性脑损伤的核心病理机制。针刺作为传统非药物疗法，在IS治疗中展现出显著的免疫调节潜力，但其系统性的分子机制尚未完全阐明。本文基于神经–免疫–内分泌网络理论，系统梳理针刺调节IS后免疫稳态的双重机制：中枢免疫调节——通过调控小胶质细胞M1/M2极化平衡、星形胶质细胞反应性、少突胶质细胞存活及血脑屏障完整性；外周免疫调节——通过调节脾脏、肠道等免疫器官的T细胞亚群分化(Th1/Th2、Th17/Treg平衡)及细胞因子网络。进一步总结针刺调控NF-κB、JAK/STAT、PI3K/Akt、NLRP3及IL-33/ST2等关键信号通路的分子机制，并探讨操作参数(穴位选择、刺激频率、干预时机)对疗效的影响。最后，分析当前研究在标准化方案、转化医学及多组学整合方面的不足，提出基于单细胞测序、空间转录组学和神经免疫互作网络的未来研究方向，以期为针刺治疗IS的精准化提供理论支撑。
Abstract: Ischemic stroke (IS) is one of the leading causes of mortality and long-term disability worldwide. Immune homeostasis imbalance represents a core pathological mechanism driving post-IS neuroinflammatory cascades and secondary brain injury. As a traditional non-pharmacological therapy, acupuncture demonstrates significant immunomodulatory potential in IS treatment, yet its systematic molecular mechanisms remain incompletely elucidated. Based on the neuro-immune-endocrine network theories, this review systematically summarizes the dual mechanisms of acupuncture in regulating post-IS immune homeostasis: 1) Central immunomodulation—controlling microglial M1/M2 polarization balance, astrocyte reactivity, oligodendrocyte survival, and blood-brain barrier integrity; 2) Peripheral immunomodulation—regulating T-cell subset differentiation (Th1/Th2, Th17/Treg balance) and cytokine networks in immune organs such as the spleen and intestine. We further delineate the molecular mechanisms underlying acupuncture-mediated modulation of key signaling pathways including NF-κB, JAK/STAT, PI3K/Akt, NLRP3, and IL-33/ST2, and discuss the impact of operational parameters (acupoint selection, stimulation frequency, intervention timing) on therapeutic efficacy. Finally, we analyze current limitations in standardized protocols, translational medicine, and multi-omics integration, proposing future directions based on single-cell sequencing, spatial transcriptomics, and neuro-immune interaction networks to provide theoretical support for precision acupuncture in IS treatment.
文章引用：李鸿祥, 尹洪娜. 针刺治疗缺血性脑卒中免疫调节机制的研究进展[J]. 中医学, 2026, 15(10): 600-608. https://doi.org/10.12677/tcm.2026.1510595

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