Xu Sen-Lei, Zhang Hong-Ru, Gu Yi-Huang
The Second Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210023, China.
Zhen Ci Yan Jiu. 2018 Nov 25;43(11):738-43. doi: 10.13702/j.1000-0607.170309.
Moxibustion is one of the commonly used therapy of traditional Chinese medicine by applying burning dried mugwort on particular acupoints of the body surface. In the present paper，we reviewed progress of researches about the mechanisms of moxibustion treatment undering imporvement of blood circulation in recent 15 years. Research results displayed that moxibustion can dilate blood vessels to increase blood flow and improve microcirculation, not only in the local superficial vessels of body, but also in the deep tissues as the brain, stomach and mesentery, kidney, heart, etc., as well as in the distal blood vessels. The vasodilator action of moxibustion stimulation is related to nerve regulation, endothelium derived relaxing factors and vasodilator mediator, etc. through 1) interaction of acetylcholine (Ach)/muscarinic receptor (MR) and noradrenaline (NE)/α- or β-receptor; 2) nitric oxide synthase (NOS)/NO/arachidonic acid/prostacyclin (PGI)/endothelium-derived hyperpolarizing factor (EDHF) pathway; 3) EDHF/TRPV 4/KCa channel, cytochrome P 450 oxidase/epoxyeicosatrienoicacid (EET); 4) EET/TRPV 4/big conductance calcium-activated potassium channel (BKCa); 5) sulfuretted hydrogen (HS)/ATP-sensitive potassium channel (K) or voltage-gated potassium channels (Kv 7); 6) NO/substance P (SP) or CGRP and adrenergic β 2 receptor(R)/TRPV 1/adenosin A 1 R and A 2 R/NK 1 R pathway; 7) PGI/adenylyl cyclase (cAMP)/PKA and vasoactive intestinal peptide (VIP), etc. in the vascular endothelium and smooth muscle. These research results may help us understand the effects and mechanisms of moxibustion in the treatment of different clinical conditions by improving microcirculation.
艾灸是中医常用疗法之一，通过将燃烧的干燥艾草施用于体表特定穴位。在本文中，我们综述了近15年来艾灸治疗改善血液循环机制的研究进展。研究结果表明，艾灸不仅能扩张体表局部浅表血管，还能扩张脑、胃、肠系膜、肾、心脏等深部组织以及远端血管，增加血流量，改善微循环。艾灸刺激的血管舒张作用与神经调节、内皮源性舒张因子和血管舒张介质等有关，其作用途径包括：1）乙酰胆碱（Ach）/毒蕈碱受体（MR）与去甲肾上腺素（NE）/α或β受体的相互作用；2）一氧化氮合酶（NOS）/一氧化氮（NO）/花生四烯酸/前列环素（PGI）/内皮源性超极化因子（EDHF）途径；3）EDHF/瞬时受体电位香草酸亚型4（TRPV 4）/钙激活钾通道（KCa）、细胞色素P 450氧化酶/环氧二十碳三烯酸（EET）；4）EET/TRPV 4/大电导钙激活钾通道（BKCa）；5）硫化氢（HS）/三磷酸腺苷敏感钾通道（K）或电压门控钾通道（Kv 7）；6）NO/物质P（SP）或降钙素基因相关肽（CGRP）与肾上腺素能β 2受体（R）/TRPV 1/腺苷A 1受体和A 2受体/NK 1受体途径；7）血管内皮和平滑肌中的PGI/腺苷酸环化酶（cAMP）/蛋白激酶A（PKA）和血管活性肠肽（VIP）等。这些研究结果可能有助于我们理解艾灸通过改善微循环治疗不同临床病症的作用及机制。
