多靶点协同与系统整合:针刺改善脑卒中后认知障碍的机制研究OA

Post-stroke cognitive impairment(PSCI)is a common disabling complication after stroke.Acupuncture can effectively improve learning and memory function in patients with PSCI and enhance their quality of life in long term.Research on its effect mechanisms has evolved from phenomenological observa-tion to multidimensional exploration progressively.In this paper,recent studies on effect mechanisms of acupuncture for PSCI were collected,which revealed that acupuncture can alleviate PSCI through multi-target synergism.The therapeutic mechanism of acupuncture primarily involves reducing immune dam-age in the brain by suppressing neuroinflammation,and promoting synaptic and memory circuit recon-struction through enhancing neural plasticity,egulating autophagy and maintaining the stability of neu-rovascular units as the critical auxiliary pathways,which can synergistically remove the damage products and preserve the neuronal microenvironment.Furthermore,emerging research directions such as mod-ulating gut microbiota,influencing epigenetics,and improving brain metabolism expand the mechanis-tic understanding.However,existing studies predominantly isolate and describe individual mechanisms without integrating their intrinsic correlations,nor do they adequately elucidate the corresponding re-lationships between different acupuncture techniques and their therapeutic advantages.Therefore,this review integrates the fragmented mechanistic evidences,and emphasizes that future research need multi-omics approaches,so as to explore the synergistic relationships among mechanisms,and to strengthen the correlative research between the specificity of acupuncture regimens and clinical effect,in order to facilitate bench-to-bedside translation.