兰州大学第二医院,甘肃省兰州市城关区萃英门82号,730000
wangzplzu@163.com
收稿:2021-05-04,
修回:2021-07-20,
纸质出版:2022-01-17
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张小华,肖要,王志平.针刺三阴交治疗急性肾绞痛效果的机制研究概述[J].中医杂志,2022,63(02):184-189.
张小华,肖要,王志平.针刺三阴交治疗急性肾绞痛效果的机制研究概述[J].中医杂志,2022,63(02):184-189. DOI: 10.13288/j.11-2166/r.2022.02.017.
三阴交是目前疼痛领域研究最为广泛的腧穴之一,也是在输尿管结石、急性肾绞痛治疗中使用频率最高的穴位之一。针刺三阴交后,穴位内肥大细胞活化并释放相应神经递质,再通过胫神经、坐骨神经传递信号可能是镇痛效应的起始环节。神经信号通过脊髓、脑水平进一步地传递可激活内源性阿片肽系统,如促进阿片肽、脑啡肽、强啡肽释放,促进脑内阿片肽受体激活来发挥镇痛作用,还可以通过抑制环氧化酶2活性、增加皮质醇浓度从而减少前列腺素E2、5羟色胺、白细胞介素1、肿瘤坏死因子α释放来减轻炎症刺激,还可能通过调节大脑皮层、丘脑、岛叶、边缘系统等来调节焦虑、紧张的情绪。此外,还可能通过改善尿路平滑肌活动,促进结石排出进而从根本上缓解急性肾绞痛。然而,针刺三阴交镇痛效应相关的分子生物学机制仍有待进一步完善。
TRAVAGLINI F , BARTOLETTI R , GACCI M , et al . Pathophysiology of reno-ureteral colic [J]. Urol Int , 2004 , 72 ( Suppl 1 ): 20 - 23 .
PATHAN SA , MITRA B , CAMERON PA . A systematic review and meta-analysis comparing the efficacy of nonsteroidal anti-inflammatory drugs, opioids, and paracetamol in the treatment of acute renal colic [J]. Eur Urol , 2018 , 73 ( 4 ): 583 - 595 .
STEINBERG PL , CHANG SL . Pain relief for acute urolithiasis: the case for non-steroidal anti-inflammatory drugs [J]. Drugs , 2016 , 76 ( 10 ): 993 - 997 .
MOTOV S , DRAPKIN J , BUTT M , et al . Analgesic administration for patients with renal colic in the emergency department before and after implementation of an opioid reduction initiative [J]. West J Emerg Med , 2018 , 19 ( 6 ): 1028 - 1035 .
HOSIER GW , MCGREGOR T , BEIKO D , et al . Increased risk of new persistent opioid use in pediatric and young adult patients with kidney stones [J]. Can Urol Assoc J , 2020 , 14 ( 8 ): 237 - 244 .
张明强 , 秦国政 , 王定国 , 等 . 针灸治疗泌尿系结石的文献计量学研究 [J]. 云南中医学院学报 , 2018 , 41 ( 3 ): 87 - 91,97 .
BELTAIEF K , GRISSA MH , MSOLLI MA , et al . Acupuncture versus titrated morphine in acute renal colic: a randomized controlled trial [J]. J Pain Res , 2018 , 11 : 335 - 341 . doi: 10.2147/JPR.S136299 http://dx.doi.org/10.2147/JPR.S136299 .
梁绮婷 , 赵冬 , 蔡泽锋 . 浮针治疗急性结石性肾绞痛疗效分析 [J]. 针灸临床杂志 , 2019 , 35 ( 1 ): 37 - 40 .
张明强 , 秦国政 , 王定国 , 等 . 针灸治疗泌尿系结石的用穴规律研究 [J]. 中国中医急症 , 2019 , 28 ( 7 ): 1184 - 1187 .
陈少宗 . 现代针灸学视域下的腧穴-靶器官相关规律解析 [J]. 针刺研究 , 2019 , 44 ( 8 ): 620 - 624 .
郭珊珊 , 傅心昊 , 秦照梅 , 等 . 基于数据挖掘的神经节段效应对取穴规律的影响 [J]. 成都中医药大学学报 , 2019 , 42 ( 4 ): 65 - 69 .
HWANG YC , LEE IS , RYU Y , et al . Exploring traditional acupuncture point selection patterns for pain control: data mining of randomised controlled clinical trials [J]. Acupunct Med , 2020 , 964528420926173 . doi: 10.1177/0964528420926173 http://dx.doi.org/10.1177/0964528420926173 .
MA YX , MA LX , LIU XL , et al . A comparative study on the immediate effects of electroacupuncture at Sanyinjiao (SP6), Xuanzhong (GB39) and a non-meridian point, on menstrual pain and uterine arterial blood flow, in primary dysmenorrhea patients [J]. Pain Med , 2010 , 11 ( 10 ): 1564 - 1575 .
LIN W , JIA D , FU C , et al . Electro-acupuncture on ST36 and SP6 acupoints ameliorates lung injury via sciatic nerve in a rat model of limb ischemia-reperfusion [J]. J Inflamm Res , 2020 , 13 : 465 - 470 . doi: 10.2147/JIR.S264093 http://dx.doi.org/10.2147/JIR.S264093 .
CHEN T , ZHANG WW , CHU YX , et al . Acupuncture for pain management: molecular mechanisms of action [J]. Am J Chin Med , 2020 , 48 ( 4 ): 793 - 811 .
LI Y , YANG M , WU F , et al . Mechanism of electroacupuncture on inflammatory pain: neural-immune-endocrine interactions [J]. J Tradit Chin Med , 2019 , 39 ( 5 ): 740 - 749 .
HUANG M , WANG X , XING B , et al . Critical roles of TRPV2 channels, histamine H1 and adenosine A1 receptors in the initiation of acupoint signals for acupuncture analgesia [J]. Sci Rep , 2018 , 8 ( 1 ): 6523 . doi: 10.1038/s41598-018-24654-y http://dx.doi.org/10.1038/s41598-018-24654-y .
WU Y , QI J , WU C , et al . Emerging roles of the TRPV4 channel in bladder physiology and dysfunction [J]. J Physiol , 2021 , 599 ( 1 ): 39 - 47 .
ZHANG D , YAN X , ZHANG X , et al . Synchrotron radiation phase-contrast x-ray ct imaging of acupuncture points [J]. Anal Bioanal Chem , 2011 , 401 ( 3 ): 803 - 808 .
LIU C , LIU Q , ZHANG D , et al . Insight into the biological effects of acupuncture points by X-ray absorption fine structure [J]. Anal Bioanal Chem , 2018 , 410 ( 20 ): 4959 - 4965 .
ZHAO ZQ . Neural mechanism underlying acupuncture analgesia [J]. Prog Neurobiol , 2008 , 85 ( 4 ): 355 - 375 .
CHEN XH , GELLER EB , ADLER MW . Electrical sti-mulation at traditional acupuncture sites in periphery produces brain opioid-receptor-mediated antinociception in rats [J]. J Pharmacol Exp Ther , 1996 , 277 ( 2 ): 654 - 660 .
HAIGHT ES , FORMAN TE , CORDONNIER SA , et al . Microglial modulation as a target for chronic pain: from the bench to the bedside and back [J]. Anesth Analg , 2019 , 128 ( 4 ): 737 - 746 .
MACHELSKA H , CELIK MO . Opioid receptors in immune and glial cells-implications for pain control [J]. Front Immunol , 2020 , 11 : 300 . doi: 10.3389/fimmu. 2020.00300 http://dx.doi.org/10.3389/fimmu.2020.00300 .
GIM GT , LEE JH , PARK E , et al . Electroacupuncture attenuates mechanical and warm allodynia through suppression of spinal glial activation in a rat model of neuropathic pain [J]. Brain Res Bull , 2011 , 86 ( 5/6 ): 403 - 411 .
LAU WK , LAU YM , ZHANG HQ , et al . Electroacupuncture versus celecoxib for neuropathic pain in rat SNL model [J]. Neuroscience , 2010 , 170 ( 2 ): 655 - 661 .
LEE JH , CHOI YH , CHOI BT . The anti-inflammatory effects of 2 Hz electroacupuncture with different intensities on acute carrageenan-induced inflammation in the rat paw [J]. Int J Mol Med , 2005 , 16 ( 1 ): 99 - 102 .
ZHU H , NAN S , SUO C , et al . Electro-acupuncture affects the activity of the hypothalamic-pituitary-ovary axis in female rats [J]. Front Physiol , 2019 ( 10 ): 466 . doi: 10.3389/fphys.2019.00466 http://dx.doi.org/10.3389/fphys.2019.00466 .
CAROLINE CR , DANIELA TB , FRANCISCO JC , et al . Acupuncture reduces peripheral and brainstem cytokines in rats subjected to lipopolysaccharide-induced inflammation [J]. Acupunct Med , 2020 , 964528420 938379 . doi: 10.1177/0964528420938379 http://dx.doi.org/10.1177/0964528420938379 .
YU JB , DONG SA , GONG LR , et al . Effect of electroacupuncture at Zusanli (ST36) and Sanyinjiao (SP6) acupoints on adrenocortical function in etomidate anesthesia patients [J]. Med Sci Monit , 2014 , 20 : 406 - 412 . doi: 10.12659/MSM.890111 http://dx.doi.org/10.12659/MSM.890111 .
SILVA MD DA , GUGINSKI G , WERNER MF , et al . Involvement of interleukin-10 in the anti-inflammatory effect of Sanyinjiao (SP6) acupuncture in a mouse model of peritonitis [J]. Evid Based Complement Alternat Med , 2011 , 2011 : 217946 . doi: 10.1093/ecam/neq036 http://dx.doi.org/10.1093/ecam/neq036 .
FENG XM , MI WL , XIA F , et al . Involvement of spinal orexin a in the electroacupuncture analgesia in a rat model of post-laparotomy pain [J]. BMC Complement Altern Med , 2012 , ( 12 ): 225 . doi: 10.1186/1472-6882-12-225 http://dx.doi.org/10.1186/1472-6882-12-225 .
MAZZARDO-MARTINS L , SALM DC , WINKELMANN-DUARTE EC , et al . Electroacupuncture induces antihyperalgesic effect through endothelin-B receptor in the chronic phase of a mouse model of complex regional pain syndrome type I [J]. Pflugers Arch , 2018 , 470 ( 12 ): 1815 - 1827 .
ZHANG XH , LIU XG , YE QX , et al . Acupuncture versus Lornoxicam in the treatment of acute renal colic: a randomized controlled trial [J]. J Pain Res , 2021 , 14 : 3637 - 3648 . doi: 10.2147/JPR.S339006 http://dx.doi.org/10.2147/JPR.S339006 .
SILVA MD DA , BOBINSKI F , SATO KL , et al . IL-10 cytokine released from M2 macrophages is crucial for analgesic and anti-inflammatory effects of acupuncture in a model of inflammatory muscle pain [J]. Mol Neurobiol , 2015 , 51 ( 1 ): 19 - 31 .
DOMINGUEZ-GUTIERREZ PR , KWENDA EP , KHAN SR , et al . Immunotherapy for stone disease [J]. Curr Opin Urol , 2020 , 30 ( 2 ): 183 - 189 .
KHAN SR , CANALES BK , DOMINGUEZ-GUTIERREZ PR . Randall's plaque and calcium oxalate stone formation: role for immunity and inflammation [J]. Nat Rev Nephrol , 2021 , 17 ( 6 ): 417 - 433 .
彭慕云 , 谭长连 . 疼痛的脑功能成像研究进展 [J]. 中国疼痛医学杂志 , 2012 , 18 ( 1 ): 50 - 52 .
LUO Z , YU M , SMITH SD , et al . The effect of intravenous lidocaine on brain activation during non-noxious and acute noxious stimulation of the forepaw: a functional magnetic resonance imaging study in the rat [J]. Anesth Analg , 2009 , 108 ( 1 ): 334 - 344 .
HUANG W , PACH D , NAPADOW V , et al . Characterizing acupuncture stimuli using brain imaging with fmri: a systematic review and meta-analysis of the literature [J]. PLoS One , 2012 , 7 ( 4 ): e32960 . doi: 10.1371/journal.pone.0032960 http://dx.doi.org/10.1371/journal.pone.0032960 .
JIN L , SUN J , XU Z , et al . Intersubject synchronisation analysis of brain activity associated with the instant effects of acupuncture: an fmri study [J]. Acupunct Med , 2018 , 36 ( 1 ): 14 - 20 .
DINIZ DH , BLAY SL , SCHOR N . Anxiety and depression symptoms in recurrent painful renal lithiasis colic [J]. Braz J Med Biol Res , 2007 , 40 ( 7 ): 949 - 955 .
王程圆 , 王琨 , 李雅楠 , 等 . 心理护理干预对妊娠期肾绞痛患者负性情绪及护理满意度的影响 [J]. 保健医学研究与实践 , 2021 , 18 ( 1 ): 76 - 80 .
WU YY , JIANG YL , HE XF , et al . Effects of electroacupuncture with dominant frequency at SP 6 and ST 36 based on meridian theory on pain-depression dyad in rats [J]. Evid Based Complement Alternat Med , 2015 , 2015 : 732845 . doi: 10.1155/2015/732845 http://dx.doi.org/10.1155/2015/732845 .
KIM HN , KIM YR , JANG JY , et al . Effects of electroacupuncture on N-methyl-D-aspartate receptor-related signaling pathway in the spinal cord of normal rats [J]. Evid Based Complement Alternat Med , 2012 , 2012 : 492471 . doi: 10.1155/2012/492471 http://dx.doi.org/10.1155/2012/492471 .
KIM HN , KIM YR , JANG JY , et al . Electroacupuncture inhibits phosphorylation of spinal phosphatidylinositol 3-kinase/Akt in a carrageenan-induced inflammatory rat model [J]. Brain Res Bull , 2012 , 87 ( 2/3 ): 199 - 204 .
SHAH TT , GAO C , PETERS M , et al . Factors associated with spontaneous stone passage in a contemporary cohort of patients presenting with acute ureteric colic: results from the multi-centre cohort study evaluating the role of inflammatory markers in patients presenting with acute ureteric colic (MIMIC) study [J]. BJU Int , 2019 , 124 ( 3 ): 504 - 513 .
JANKOVIC SM , STOJADINOVIC D , STOJADINOVIC M , et al . Angiotensin receptor blocker losartan inhibits spontaneous motility of isolated human ureter [J]. Eur J Drug Metab Pharmacokinet , 2016 , 41 ( 6 ): 835 - 838 .
JENDEBERG J , GEIJER H , ALSHAMARI M , et al . Size matters: the width and location of a ureteral stone accurately predict the chance of spontaneous passage [J]. Eur Radiol , 2017 , 27 ( 11 ): 4775 - 4785 .
王定国 , 张明强 , 郭太品 , 等 . 基于文献挖掘的针灸治疗输尿管结石用穴规律探讨 [J]. 中国中医急症 , 2019 , 28 ( 8 ): 1331 - 1334,1357 .
YI WM , CHEN Q , LIU CH , et al . Acupuncture for preventing complications after radical hysterectomy: a randomized controlled clinical trial [J]. Evid Based Complement Alternat Med , 2014 , 2014 : 802134 . doi: 10.1155/2014/802134 http://dx.doi.org/10.1155/2014/802134 .
程莉莉 , 吴聪英 , 睢明河 . 电针不同穴位对急性尿潴留后家兔膀胱内压和膀胱组织三磷酸腺苷含量的影响 [J]. 针刺研究 , 2012 , 37 ( 4 ): 291 - 295 .
何婷 , 杨硕 , 莫倩 . 针刺不同腧穴对急性尿潴留大鼠膀胱功能的影响 [J]. 世界科学技术-中医药现代化 , 2019 , 21 ( 4 ): 715 - 720 .
YANG LK , WANG Y , MO Q , et al . A comparative study of electroacupuncture at Zhongliao (BL33) and other acupoints for overactive bladder symptoms [J]. Front Med , 2017 , 11 ( 1 ): 129 - 136 .
朱毅 , 黄杰 , 程洁 , 等 . 电针对t10水平脊髓全横断尿潴留大鼠逼尿肌及尿道外括约肌肌电活动的影响 [J]. 中国康复医学杂志 , 2013 , 28 ( 2 ): 124 - 128 .
CHUNG IM , KIM YS , SUNG YH , et al . Effects of acupuncture on abdominal leak point pressure and c-Fos expression in the brain of rats with stress urinary incontinence [J]. Neurosci Lett , 2008 , 439 ( 1 ): 18 - 23 .
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