系统视角下针灸干预慢性炎症的神经免疫调节研究OA
Neuroimmune Regulation of Chronic Inflammation:A Systems Perspective on Acupuncture
慢性炎症是当代许多疾病的核心病理特征,包括自身免疫性疾病、慢性疼痛综合征、神经精神疾病以及病毒感染后遗症.越来越多的证据表明,炎症调节失衡源于免疫、神经和内分泌系统之间相互作用的紊乱,而非孤立的分子异常.本综述综合梳理针灸通过神经免疫调节通路调控炎症的临床与机制性证据,特别关注细胞因子平衡及系统层面的机制.对针灸诱导的细胞因子、自主神经活动、神经内分泌信号及免疫细胞表型调节相关的实验研究、随机对照试验、荟萃分析和机制性研究进行叙述性综述.本综述发现,在不同的疾病背景下,针灸与促炎细胞因子(包括IL-6、TNF-α和IL-1β)的减少,以及抗炎介质(如IL-10和TGF-β)的增加相关联.机制研究表明,这些效应是通过迷走-胆碱能抗炎反射的协同参与、下丘脑-垂体-肾上腺轴动态的正常化、免疫细胞重编程以及结缔组织机械传导介导的.针灸似乎并非产生全面的免疫抑制,而是以一种情境依赖的方式重新校准免疫反应性.从神经免疫系统的视角来看,针灸作为一种具有生物活性的免疫调节干预手段,能够在多个调控领域恢复炎症稳态.这一观点为其临床效果提供了连贯的生物学解释,并支持将其整合到当代慢性炎症性疾病的治疗方法中.
Chronic inflammation is a central pathological feature of many contemporary diseases,including autoimmune disorders,chronic pain syndromes,neuropsychiatric conditions,and postviral sequelae.Increasing evidence indicates that inflammatory dysregulation arises from disturbed interactions among immune,neural,and endocrine systems rather than from isolated molecular abnormalities.The objective of this study is to synthesize clinical and mechanistic evidence on acupuncture's role in modulating inflammation through neuroimmune regulatory pathways,with particular emphasis on cytokine balance and systems-level mechanisms.A narrative review of experimental studies,randomized controlled trials,meta-analyses,and mechanistic investigations examining acupuncture-induced modulation of cytokines,autonomic activity,neuroendocrine signaling,and immune cell phenotypes.Across diverse disease contexts,acupuncture is associated with reductions in proinflammatory cytokines,including IL-6,TNF-α,a nd IL-1β,alongside increases in anti-inflammatory mediators such as IL-10 and TGF-β.Mechanistic studies demonstrate that these effects are mediated through coordinated engagement of the vagal-cholinergic anti-inflammatory reflex,normalization of hypothalamic-pituitary-adrenal axis dynamics,immune cell reprogram-ming,and connective tissue mechanotransduction.Rather than producing global immunosuppression,acupuncture appears to recalibrate immune responsiveness in a context-dependent manner.Viewed through a neuroimmune systems framework,acupuncture functions as a biologically active immunomodulatory intervention capable of restoring inflammatory homeostasis across multiple regulatory domains.This perspective provides a coherent biological rationale for its clinical effects and supports its integration into contemporary approaches to chronic inflammatory disease.
巩昌镇
美国中医学院/美国中医协会 明尼苏达州罗丝维尔市 55113 美国
针灸神经免疫调节慢性炎症细胞因子迷走-胆碱能抗炎反射系统医学
acupunctureneuroimmune regulationchronic inflammationcytokinesvagal-cholinergic anti-inflammatory reflexsystems medicine
《中医学报(英文)》 2026 (1)
24-32,中插23-中插32,19
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