基于免疫炎症反应探讨针刺治疗慢性疼痛的研究进展与思考
Current Research Status and Considerations on Acupuncture Treatment for Chronic Pain Based on Immune-Inflammatory Responses
DOI: 10.12677/tcm.2024.139359, PDF,   
作者: 管蔚娜:黑龙江中医药大学研究生院,黑龙江 哈尔滨;李晓宁*:黑龙江中医药大学附属第二医院针灸科,黑龙江 哈尔滨
关键词: 慢性疼痛免疫炎症反应针刺Chronic Pain Immunoinflammatory Response Acupuncture
摘要: 慢性疼痛与免疫炎症反应之间存在复杂相互关系。慢性疼痛不仅仅是一个单纯的感觉体验,它涉及身体的多个系统,包括免疫系统。炎症是免疫系统对损伤或感染的反应,是身体修复过程中的一部分。在治疗免疫炎症反应引起的慢性疼痛通常涉及使用非甾体抗炎药、糖皮质激素、免疫抑制剂等药物来减少炎症,以及使用抗抑郁药和抗癫痫等药物来管理疼痛。然而,此类药物效果有限且副作用大。而针灸作为一种深植于传统中医的治疗方法,在应对慢性疼痛方面展现出了其独有的优势。这一疗法不仅具备多重作用机制、低副作用的风险、持久的治疗效果,还能提供全面的疗效。本文的目的是综述针灸治疗慢性疼痛的最新研究动态,特别是它基于免疫炎性反应的机制,旨在为针灸在慢性疼痛管理领域的应用开辟新的视角。
Abstract: There exists a complex interrelationship between chronic pain and immune-inflammatory responses. Chronic pain is not merely a simple sensory experience; it involves multiple systems within the body, including the immune system. Inflammation is a response of the immune system to injury or infection and is a part of the body’s repair process. Numerous studies have demonstrated the unique advantages of acupuncture in addressing chronic pain. This therapy is not only characterized by its multifaceted mechanisms of action, low risk of side effects, and long-term treatment effectiveness, but also provides comprehensive therapeutic benefits. This article aims to review the latest research developments in the treatment of chronic pain with acupuncture, especially focusing on mechanisms based on immune-inflammatory responses, to pave new pathways for the application of acupuncture in the management of chronic pain.
文章引用:管蔚娜, 李晓宁. 基于免疫炎症反应探讨针刺治疗慢性疼痛的研究进展与思考[J]. 中医学, 2024, 13(9): 2412-2418. https://doi.org/10.12677/tcm.2024.139359

参考文献

[1] Zheng, Y.J., et al. (2020) A Survey of Chronic Pain in China. Libyan Journal of Medicine, 15, Article ID: 1730550. [Google Scholar] [CrossRef] [PubMed]
[2] Ji, R., Chamessian, A. and Zhang, Y. (2016) Pain Regulation by Non-Neuronal Cells and Inflammation. Science, 354, 572-577. [Google Scholar] [CrossRef] [PubMed]
[3] Gold, M.S. and Gebhart, G.F. (2010) Nociceptor Sensitization in Pain Pathogenesis. Nature Medicine, 16, 1248-1257. [Google Scholar] [CrossRef] [PubMed]
[4] Duan, Y., Chen, S., Li, Q. and Zang, Y. (2022) Neuroimmune Mechanisms Underlying Neuropathic Pain: The Potential Role of TNF-α-Necroptosis Pathway. International Journal of Molecular Sciences, 23, Article No. 7191. [Google Scholar] [CrossRef] [PubMed]
[5] Mailhot, B., Christin, M., Tessandier, N., Sotoudeh, C., Bretheau, F., Turmel, R., et al. (2020) Neuronal Interleukin-1 Receptors Mediate Pain in Chronic Inflammatory Diseases. Journal of Experimental Medicine, 217, e20191430. [Google Scholar] [CrossRef] [PubMed]
[6] Zhou, Y., Liu, Z., Liu, Z., Chen, S., Li, M., Shahveranov, A., et al. (2016) Interleukin-6: An Emerging Regulator of Pathological Pain. Journal of Neuroinflammation, 13, Article No. 141. [Google Scholar] [CrossRef] [PubMed]
[7] Udit, S., Blake, K. and Chiu, I.M. (2022) Somatosensory and Autonomic Neuronal Regulation of the Immune Response. Nature Reviews Neuroscience, 23, 157-171. [Google Scholar] [CrossRef] [PubMed]
[8] Fiore, N.T., Debs, S.R., Hayes, J.P., Duffy, S.S. and Moalem-Taylor, G. (2023) Pain-Resolving Immune Mechanisms in Neuropathic Pain. Nature Reviews Neurology, 19, 199-220. [Google Scholar] [CrossRef] [PubMed]
[9] Su, P.P., Zhang, L., He, L., Zhao, N. and Guan, Z. (2022) The Role of Neuro-Immune Interactions in Chronic Pain: Implications for Clinical Practice. Journal of Pain Research, 15, 2223-2248. [Google Scholar] [CrossRef] [PubMed]
[10] Taché, Y. and Bonaz, B. (2007) Corticotropin-Releasing Factor Receptors and Stress-Related Alterations of Gut Motor Function. Journal of Clinical Investigation, 117, 33-40. [Google Scholar] [CrossRef] [PubMed]
[11] Slota, C., Shi, A., Chen, G., Bevans, M. and Weng, N. (2015) Norepinephrine Preferentially Modulates Memory CD8 T Cell Function Inducing Inflammatory Cytokine Production and Reducing Proliferation in Response to Activation. Brain, Behavior, and Immunity, 46, 168-179. [Google Scholar] [CrossRef] [PubMed]
[12] Ma, R.S.Y., Kayani, K., Oshodi, D.W., Whyte Oshodi, A., Nachiappan, N., Gnanarajah, S., et al. (2019) Voltage Gated Sodium Channels as Therapeutic Targets for Chronic Pain. Journal of Pain Research, 12, 2709-2722. [Google Scholar] [CrossRef] [PubMed]
[13] Guo, Q., Jin, Y., Chen, X., Ye, X., Shen, X., Lin, M., et al. (2024) Nf-κb in Biology and Targeted Therapy: New Insights and Translational Implications. Signal Transduction and Targeted Therapy, 9, Article No. 53. [Google Scholar] [CrossRef] [PubMed]
[14] Alam, M.B., Chowdhury, N.S., Sohrab, M.H., Rana, M.S., Hasan, C.M. and Lee, S. (2020) Cerevisterol Alleviates Inflammation via Suppression of MAPK/NF-κB/AP-1 and Activation of the Nrf2/HO-1 Signaling Cascade. Biomolecules, 10, Article No. 199. [Google Scholar] [CrossRef] [PubMed]
[15] Woolf, C.J. and Salter, M.W. (2000) Neuronal Plasticity: Increasing the Gain in Pain. Science, 288, 1765-1768. [Google Scholar] [CrossRef] [PubMed]
[16] Puja, G., Sonkodi, B. and Bardoni, R. (2021) Mechanisms of Peripheral and Central Pain Sensitization: Focus on Ocular Pain. Frontiers in Pharmacology, 12, Article ID: 764396. [Google Scholar] [CrossRef] [PubMed]
[17] Leung, L. and Cahill, C.M. (2010) TNF-α and Neuropathic Pain—A Review. Journal of Neuroinflammation, 7, Article No. 27. [Google Scholar] [CrossRef] [PubMed]
[18] Wang, M., Liu, W., Ge, J. and Liu, S. (2023) The Immunomodulatory Mechanisms for Acupuncture Practice. Frontiers in Immunology, 14, Article ID: 1147718. [Google Scholar] [CrossRef] [PubMed]
[19] Yu, W. and Kim, S. (2023) The Effect of Acupuncture on Pain and Swelling of Arthritis Animal Models: A Systematic Review and Meta-Analysis. Frontiers in Genetics, 14, Article ID: 1153980. [Google Scholar] [CrossRef] [PubMed]
[20] Lee, S. and Kim, S. (2022) The Effect of Acupuncture on Modulating Inflammatory Cytokines in Rodent Animal Models of Respiratory Disease: A Systematic Review and Meta-analysis. Frontiers in Immunology, 13, Article ID: 878463. [Google Scholar] [CrossRef] [PubMed]
[21] Li, N., Wang, H., Liu, H., Zhu, L., Lyu, Z., Qiu, J., et al. (2023) The Effects and Mechanisms of Acupuncture for Post-Stroke Cognitive Impairment: Progress and Prospects. Frontiers in Neuroscience, 17, Article ID: 1211044. [Google Scholar] [CrossRef] [PubMed]
[22] McDonald, J.L., Cripps, A.W., Smith, P.K., Smith, C.A., Xue, C.C. and Golianu, B. (2013) The Anti-Inflammatory Effects of Acupuncture and Their Relevance to Allergic Rhinitis: A Narrative Review and Proposed Model. Evidence-Based Complementary and Alternative Medicine, 2013, Article ID: 591796. [Google Scholar] [CrossRef] [PubMed]
[23] Park, H., Yoo, D., Kwon, S., Yoo, T., Park, H., Hahm, D., et al. (2012) Acupuncture Stimulation at HT7 Alleviates Depression-Induced Behavioral Changes via Regulation of the Serotonin System in the Prefrontal Cortex of Maternally-Separated Rat Pups. The Journal of Physiological Sciences, 62, 351-357. [Google Scholar] [CrossRef] [PubMed]
[24] Shi, Y. and Wu, W. (2023) Multimodal Non-Invasive Non-Pharmacological Therapies for Chronic Pain: Mechanisms and Progress. BMC Medicine, 21, Article No. 372. [Google Scholar] [CrossRef] [PubMed]
[25] Karatay, S., Okur, S.C., Uzkeser, H., Yildirim, K. and Akcay, F. (2017) Effects of Acupuncture Treatment on Fibromyalgia Symptoms, Serotonin, and Substance P Levels: A Randomized Sham and Placebo-Controlled Clinical Trial. Pain Medicine, 19, 615-628. [Google Scholar] [CrossRef] [PubMed]
[26] Lai, H., Lin, Y. and Hsieh, C. (2019) Acupuncture-Analgesia-Mediated Alleviation of Central Sensitization. Evidence-Based Complementary and Alternative Medicine, 2019, Article ID: 6173412. [Google Scholar] [CrossRef] [PubMed]
[27] Ma, X., Chen, W., Yang, N., Wang, L., Hao, X., Tan, C., et al. (2022) Potential Mechanisms of Acupuncture for Neuropathic Pain Based on Somatosensory System. Frontiers in Neuroscience, 16, Article ID: 940343. [Google Scholar] [CrossRef] [PubMed]