首页|针刺治疗原发性高血压病作用机制的研究进展

针刺治疗原发性高血压病作用机制的研究进展

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随着针刺降压优势的逐渐显现,针刺降压机制成为研究热点.本文检索并梳理近10年来针刺治疗原发性高血压(essential hypertension,EH)的相关文献研究,总结针刺治疗EH的机制包括通过改善炎症反应、氧化应激,调控基因表达、生物因子分泌等影响以神经—内分泌—免疫三大系统为中心的多个系统,提高对靶器官的保护,降低血压.具体来说,针刺可通过调节中枢神经系统来直接影响血压,尤其是作用于下丘脑、延髓等区域;通过干预肾素—血管紧张素—醛固酮系统调控激素和酶的活性,进而影响血管收缩,改善血管内皮功能;在通过免疫系统发挥作用同时,针刺还能提高心血管的控制能力,减轻肾小球动脉硬化及间质纤维化,抑制神经细胞凋亡,从而综合降低血压.目前对于针刺降压机制研究成果颇丰,但仍存在些许不足之处,笔者认为今后研究需深入挖掘三大系统之间相关联的靶基因、靶蛋白,对针刺联合药物治疗靶器官损害相关研究量化其参数、明确药量等,以期为指导临床治疗提供更可信的实验数据和科学依据.
Research progress of acupuncture mechanism in treating essential hypertension
With the advantages of acupuncture in reducing blood pressure,the mechanism of acu-puncture in lowering blood pressure has become a research focus. In this paper,we reviewed relevant literature on the treatment of essential hypertension ( EH ) with acupuncture over the past decade,summarized the mechanism by which acupuncture improves EH through modulation of inflammatory response and oxidative stress. Acupuncture regulates gene expression and secretion of biological factors,thereby impacting multiple systems centered around the neuro-endocrine-immune system to enhance target organ protection and reduce blood pressure. Specifically,acupuncture exerts direct effects on blood pressure regulation by modulating the central nervous system,particularly the hypothalamus and medulla oblongata. It was interfered with the RAAS system to regulate hormone and enzyme activity,thus influencing vascular contraction and improving endothelial function. Apart from its immunomodulatory effects,acupuncture also enhances cardiovascular control while reducing glomerular arteriosclerosis,interstitial fibrosis,and nerve cell apoptosis for comprehensive blood pressure reduction. Although there have been numerous research findings on the mechanisms underlying acupuncture's antihypertensive effects,certain limitations still exist. This paper revealed that future studies should explore target genes and proteins associated with these three systems closely;quantify parameters related to combined drug-acupuncture treatments for target organ damage;clarify drug dosages;ultimately providing more credible experimental data as well as scientific evidence to guide clinical treatment.

essential hypertensionacupuncturemechanism of actioncentral nervous systemRASS systemthe immune systemvascular functiontarget organ damage

范林鹃、王美霞、赵欣佳、焦琮舒、陈璐、申鹏飞、石江伟

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300073 天津中医药大学第一附属医院针灸科 国家中医针灸临床医学研究中心

原发性高血压病 针刺 作用机制 中枢神经系统 RASS系统 免疫系统 血管功能 靶器官损害

国家自然科学基金面上项目

81373751

2024

环球中医药
中华国际医学交流基金会

环球中医药

CSTPCD
影响因子:1.553
ISSN:1674-1749
年,卷(期):2024.17(7)
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