

浏览全部资源
扫码关注微信
1.江汉大学医学部,湖北省武汉市经济开发区三角湖路8号,430056
2.武汉市中医医院
Received:16 February 2026,
Revised:2026-05-18,
Accepted:14 May 2026,
Online First:15 July 2026,
Published:17 July 2026
移动端阅览
梁诗韵,王文炎.基于穴位敏化探讨针刺得气的科学内涵与外延[J].中医杂志,2026,67(14):1474-1480.
LIANG Shiyun,WANG Wenyan.Exploring the Scientific Connotation and Extension of Deqi (得气) in Acupuncture:Based on Acupoint Sensitization[J].Journal of Traditional Chinese Medicine,2026,67(14):1474-1480.
梁诗韵,王文炎.基于穴位敏化探讨针刺得气的科学内涵与外延[J].中医杂志,2026,67(14):1474-1480. DOI: 10.13288/j.11-2166/r.2026.14.002.
LIANG Shiyun,WANG Wenyan.Exploring the Scientific Connotation and Extension of Deqi (得气) in Acupuncture:Based on Acupoint Sensitization[J].Journal of Traditional Chinese Medicine,2026,67(14):1474-1480. DOI: 10.13288/j.11-2166/r.2026.14.002.
穴位敏化和得气是影响针灸疗效的关键因素。穴位敏化是得气的重要条件。在梳理穴位敏化和得气相关研究进展的基础上,提出得气的生物学基础主要包括机械传导与微环境改变的生物力学基础、分子事件与信号通路激活的能量代谢基础、感受器激活与中枢整合的神经生理学基础,以及神经-内分泌-免疫网络双向调控的生物效应基础;得气的外延是得气后机体自我调节、重塑而形成的一种持续、相对稳定的生物学稳态,主要包括神经反射阈值重置与神经功能重塑、内分泌稳态的重建、免疫稳态的再平衡、基因表达时序性的改变等。系统研究得气的科学内涵与外延,既有助于深入阐释针灸的作用机制,又可为临床优化治疗方案提供理论依据与实践指导。
Acupoint sensitization and
deqi
(得气) are key factors influencing the therapeutic efficacy of acupuncture. Acupoint sensitization serves as an important prerequisite for achieving
deqi
. Based on a review of recent research progress on acupoint sensitization and
deqi
, this study proposes that the biological basis of
deqi
primarily encompasses the biomechanical basis of mechanotransduction and microenvironmental changes, the energy metabolic basis of molecular events and signaling pathway activation, the neurophysiological basis of receptor activation and central integration, and the biological effect basis of bidirectional regulation within the neuro-endocrine-immune network. The extension of
deqi
refers to a sustained and relatively stable biological homeostasis after
deqi
through self-regulation and remodeling of the organism, which mainly manifests as neural reflex threshold resetting and neural functional remodeling, re-establishment of endocrine homeostasis, rebalancing of immune homeostasis, and temporal changes in gene expression. Systematic investigation into the scientific connotation and extension of
deqi
not only contributes to a deeper elucidation of the mechanisms underlying acupuncture's therapeutic actions, but also provides theoretical foundations and practical guidance for the optimization of clinical therapeutic regimens.
王春琛 , 石广霞 , 李旭 , 等 . 针刺得气的研究及展望 [J]. 世界中医药 , 2023 , 18 ( 8 ): 1198 - 1201, 1205 .
Tan H , Tumilty S , Chapple C , et al . Understanding acupoint sensitization: a narrative review on phenomena, potential mechanism, and clinical application [J]. Evid Based Complement Alternat Med , 2019 : 6064358 . DOI: 10.1155/2019/6064358 http://dx.doi.org/10.1155/2019/6064358 .
于宏君 , 蒋海琳 , 王富春 . 试论腧穴的生物学特性:敏化性 [J]. 中国中医基础医学杂志 , 2016 , 22 ( 12 ): 1643 - 1645 .
陈日新 , 康明非 . 腧穴热敏化及其临床意义 [J]. 中医杂志 , 2006 , 47 ( 12 ): 905 - 906 .
宋婷婷 , 王军 . 从“气至而有效”谈提高针刺疗效的关键因素 [J]. 中国针灸 , 2019 , 39 ( 2 ): 197 - 200 .
王富春 , 贾春生 , 马铁明 , 等 . 刺法灸法学 [M]. 上海 : 上海科学技术出版社 , 2013 : 24 .
徐赟赟 , 孙若晗 , 韩德雄 , 等 . 浅谈针感、得气、气至的相互关系 [J]. 中医杂志 , 2020 , 61 ( 4 ): 294 - 297 .
朱兵 . 穴位敏化现象及其生物学意义 [J]. 中国针灸 , 2019 , 39 ( 2 ): 115 - 121 .
李霞 , 吕涛 , 奚晗清 , 等 . 内脏疾病背根神经节交感-感觉偶联参与穴位敏化并放大针刺效应 [J]. 中国疼痛医学杂志 , 2024 , 30 ( 9 ): 645 - 652 .
潘威 , 林力楠 , 余笑帅 , 等 . 体表敏化点探查的模式总结及应用分析 [J]. 北京中医药大学学报 , 2024 , 47 ( 11 ): 1623 - 1628 .
晏明熙 . 针刺敏化穴治疗慢性颈痛的随机对照临床研究 [D]. 成都 : 成都中医药大学 , 2021 : 1 .
Wu J , Zhao Z . Acupuncture in circadian rhythm sleep-wake disorders and its potential neurochemical mechanisms [J]. Front Neurosci , 2024 , 18 : 1346635 . DOI: 10.3389/fnins.2024.1346635 http://dx.doi.org/10.3389/fnins.2024.1346635 .
Zhang M , Guo H , Ma Y , et al . Acupoint sensitization is associated with increased excitability and hyperpolarization-activated current (ih) in C- but not aδ-type neurons [J]. Neuroscience , 2019 , 404 : 499 - 509 . DOI: 10. 1016/j.neuroscience.2019.02.028 http://dx.doi.org/10.1016/j.neuroscience.2019.02.028 .
孔小洁 , 许金森 . 不同时辰针刺足三里对胃肠功能的影响 [J]. 中医研究 , 2019 , 32 ( 4 ): 56 - 59 .
崔彩霞 , 刘宏宇 , 越娜 , 等 . 神经敏化在慢性神经病理性疼痛发病机制中的研究进展 [J]. 内蒙古医学杂志 , 2023 , 55 ( 7 ): 834 - 836 .
伍晓鸣 , 毛翔 , 周熙 , 等 . 用肌骨超声技术探索针刺足三里穴“得气”相关的局部组织特征 [J]. 针刺研究 , 2017 , 42 ( 5 ): 444 - 448 .
周杰 , 毛慧娟 , 沈雪勇 , 等 . 针刺得气对正常人足三里穴伏安特性的影响 [J]. 上海针灸杂志 , 2011 , 30 ( 7 ): 433 - 435 .
张小红 , 蔡定均 , 王宇 , 等 . 针刺作用及机械力刺激对成纤维细胞的影响 [J]. 中国中医基础医学杂志 , 2017 , 23 ( 3 ): 380 - 383 .
Langevin H M , Bouffard N A , Churchill D L , et al . Connective tissue fibroblast response to acupuncture: dose-dependent effect of bidirectional needle rotation [J]. J Altern Complement Med , 2007 , 13 ( 3 ): 355 - 360 .
Tian D S , Xiong J , Pan Q , et al . De qi, a threshold of the stimulus intensity, elicits the specific response of acupoints and intrinsic change of human brain to acupuncture [J]. Evid Based Complement Alternat Med , 2014 : 914878 . DOI: 10.1155/2014/914878 http://dx.doi.org/10.1155/2014/914878 .
何伟 , 吴美玲 , 景向红 , 等 . 穴位的本态:穴位组织细胞化学的动态变化 [J]. 中国针灸 , 2015 , 35 ( 11 ): 1181 - 1186 .
Luo M , Dong X , Song X , et al . Study on the dynamic compound structure composed of mast cells, blood vessels, and nerves in rat acupoint [J]. Evid Based Complement Alternat Med , 2013 : 160651 . DOI: 10.1155/2013/160651 http://dx.doi.org/10.1155/2013/160651 .
邓雅方 , 胡颖 , 许金森 , 等 . 急性心肌缺血模型大鼠内关、心俞穴穴区肥大细胞的分布及特征 [J]. 云南中医学院学报 , 2021 , 44 ( 4 ): 22 - 25 .
Wang L N , Wang X Z , Li Y J , et al . Activation of subcutaneous mast cells in acupuncture points triggers analgesia [J]. Cells , 2022 , 11 ( 5 ): 809 .
He J R , Yu S G , Tang Y , et al . Purinergic signaling as a basis of acupuncture-induced analgesia [J]. Purinergic Signal , 2020 , 16 ( 3 ): 297 - 304 .
Lv Z Y , Yang Y Q , Yin L M . Role of purinergic signaling in acupuncture therapeutics [J]. Am J Chin Med , 2021 , 49 ( 3 ): 645 - 659 .
Goldman N , Chen M , Fujita T , et al . Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture [J]. Nat Neurosci , 2010 , 13 ( 7 ): 883 - 888 .
Chen Z , Yao K , Wang X , et al . Acupuncture promotes muscle cells ATP metabolism in ST36 acupoint local exerting effect by activating TRPV1/CaMKII/AMPK/PGC1α signaling pathway [J]. Chin Med , 2025 , 20 ( 1 ): 112 .
Lee C H , Chen C C . Roles of ASICs in nociception and proprioception [M]//Shyu B C, Tominaga M. Adv Exp Med Biol . Singapore : Springer , 2018 : 37 - 47 .
Roux P P , Blenis J . ERK and p38 MAPK-activated protein kinases: a family of protein kinases with diverse biological functions [J]. Microbiol Mol Biol Rev , 2004 , 68 ( 2 ): 320 - 344 .
Guo Q , Jin Y , Chen X , et al . NF-κB in biology and targeted therapy: new insights and translational implications [J]. Signal Transduct Target Ther , 2024 , 9 ( 1 ): 53 .
李亮 , 荣培晶 , 罗曼 , 等 . 内脏伤害性传入易化体表穴区功能的中枢机制 [J]. 中国针灸 , 2015 , 35 ( 11 ): 1187 - 1191 .
陆凤燕 , 陈安莉 , 张雯晰 , 等 . 针刺穴区不同组织结构对得气针感及穴区肌电的影响初探 [J]. 针刺研究 , 2021 , 46 ( 2 ): 136 - 144 .
Wilkinson K A . Molecular determinants of mechanosensation in the muscle spindle [J]. Curr Opin Neurobiol , 2022 , 74 : 102542 . DOI: 10.1016/j.conb.2022. 102542 http://dx.doi.org/10.1016/j.conb.2022.102542 .
曹静雅 , 瞿玉竹 , 陈丽 , 等 . 基于fNIRS技术的不同针刺补泻手法中枢响应特征研究 [J]. 中华中医药杂志 , 2024 , 39 ( 5 ): 2417 - 2422 .
王祥 , 余常 , 吴巧凤 , 等 . 针刺得气中枢响应的神经影像学研究概况 [J]. 中医杂志 , 2016 , 57 ( 6 ): 529 - 532 .
Liu S , Wang Z , Su Y , et al . A neuroanatomical basis for electroacupuncture to drive the vagal-adrenal axis [J]. Nature , 2021 , 598 ( 7882 ): 641 - 645 .
肖新新 , 王昊 , 黄宗跃 , 等 . 健康女性足三里针刺“得气”的自主神经效应观察 [J]. 针灸临床杂志 , 2023 , 39 ( 3 ): 41 - 46 .
Bai L , Tian J , Zhong C , et al . Acupuncture modulates temporal neural responses in wide brain networks: evidence from fMRI study [J]. Mol Pain , 2010 , 6 : 73 . DOI: 10.1186/1744-8069-6-73 http://dx.doi.org/10.1186/1744-8069-6-73 .
赵雪 , 郭义 , 郭永明 , 等 . 针刺穴位效应启动的初始动力学调控机制 [J]. 世界中医药 , 2020 , 15 ( 7 ): 997 - 1002 .
柳钶 , 姜劲峰 , 卢圣锋 . 针灸调节自主神经研究的效应特点及其途径分析 [J]. 针刺研究 , 2021 , 46 ( 4 ): 335 - 341 .
Zheng J Y , Zhu J , Wang Y , et al . Effects of acupuncture on hypothalamic-pituitary-adrenal axis: current status and future perspectives [J]. J Integr Med , 2024 , 22 ( 4 ): 445 - 458 .
李美晨 , 王毓婷 , 李柯谊 , 等 . 靳三针调神针法治疗卒中后焦虑的疗效观察及对下丘脑-垂体-肾上腺轴的影响 [J]. 针刺研究 , 2024 , 49 ( 1 ): 57 - 63 .
Wei Y , Dong M , Zhong L , et al . Regulation of hypothalamic-pituitary-adrenal axis activity and immunologic function contributed to the anti-inflammatory effect of acupuncture in the OVA-induced murine asthma model [J]. Neurosci Lett , 2017 , 636 : 177 - 183 . DOI: 10. 1016/j.neulet.2016.11.001 http://dx.doi.org/10.1016/j.neulet.2016.11.001 .
Xu X , Huang X , Xiao L , et al . Mechanism of electro-acupuncture in alleviating intestinal injury in septic mice via polyamine-related M2-macrophage polarization [J]. Front Immunol , 2024 , 15 : 1373876 . DOI: 10.3389/fimmu.2024.1373876 http://dx.doi.org/10.3389/fimmu.2024.1373876 .
陈丽 . 电针调控肥胖小鼠脂肪m1/m2巨噬细胞化的机制研究 [D]. 成都 : 成都中医药大学 , 2019 : 1 - 2 .
Wang N , Zhao L , Zhang D , et al . Research progress on the immunomodulatory mechanism of acupuncture in tumor immune microenvironment [J]. Front Immunol , 2023 , 14 : 1092402 . DOI: 10.3389/fimmu.2023. 1092402 http://dx.doi.org/10.3389/fimmu.2023.1092402 .
Choi Y J , Lee J E , Moon W K , et al . Does the effect of acupuncture depend on needling sensation and manipulation? [J]. Complement Ther Med , 2013 , 21 ( 3 ): 207 - 214 .
Liu Z , Huang J , Yan D , et al . Effect of "needle sensation" and the real-time changes in autonomic nervous system activity during acupuncture analgesia [J]. Front Neurosci , 2024 , 18 : 1349059 . DOI: 10.3389/fnins.2024.1349059 http://dx.doi.org/10.3389/fnins.2024.1349059 .
Chan A K S , Vujnovich A , Bradnam-Roberts L . The effect of acupuncture on alpha-motoneuron excitability [J]. Acupunct Electrother Res , 2004 , 29 ( 1/2 ): 53 - 72 .
Eshkevari L , Mulroney S E , Egan R , et al . Effects of acupuncture, RU-486 on the hypothalamic-pituitary-adrenal axis in chronically stressed adult male rats [J]. Endocrinology , 2015 , 156 ( 10 ): 3649 - 3660 .
Wu F , Zhu J , Wan Y , et al . Electroacupuncture ameliorates hypothalamic-pituitary-adrenal axis dysfunction induced by surgical trauma in mice through the hypothalamic oxytocin system [J]. Neurochem Res , 2023 , 48 ( 11 ): 3391 - 3401 .
Ye Z , Zhu L , Li X J , et al . PC6 electroacupuncture reduces stress-induced autonomic and neuroendocrine responses in rats [J]. Heliyon , 2023 , 9 ( 4 ): e15291 .
Lu W , Matulonis U A , Doherty-Gilman A , et al . Acupuncture for chemotherapy-induced neutropenia in patients with gynecologic malignancies: a pilot randomized, sham-controlled clinical trial [J]. J Altern Complement Med , 2009 , 15 ( 7 ): 745 - 753 .
Nian J , Sun X , Zhao W , et al . Efficacy and safety of acupuncture for chemotherapy-induced leukopenia: a systematic review and meta-analysis [J]. Medicine , 2022 , 101 ( 42 ): e30995 .
Lindberg V , Baak J . The majority of norwegian patients with treatment-resistant chronic pain regained normal national health standards within 12 months after de-qi acupuncture: a prospective observational propensity score matched study [J]. Front Pain Res , 2025 , 6 : 1521466 . DOI: 10.3389/fpain.2025.1521466 http://dx.doi.org/10.3389/fpain.2025.1521466 .
崔霞 . 电针刺激下即刻早期基因和前脑啡肽基因在中枢神经系统中的表达及定位研究 [J]. 生理科学进展 , 1995 , 26 ( 3 ): 230 - 232 .
郭保君 , 余思奕 , 申治富 , 等 . 针刺跷脉对失眠大鼠视交叉上核内生物钟基因Period 1及Period 2的影响 [J]. 针刺研究 , 2017 , 42 ( 6 ): 507 - 509 .
舒娅 , 杨华元 , 奚倩慧 , 等 . 仿真针刺对自发性高血压大鼠心肌生物钟基因Bmal1、clock、Per2表达的影响 [J]. 上海中医药大学学报 , 2021 , 35 ( 4 ): 89 - 93 .
Mohammadnejad A , Li S , Duan H , et al . Network based analysis of microarray gene expression profiles in response to electroacupuncture [J]. J Tradit Complement Med , 2020 , 10 ( 5 ): 471 - 477 .
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010102007558号