Zhang Jiyao, Zhu Luwen, Li Hongyu, Tang Qiang
Graduate School, Heilongjiang University of Chinese Medicine, 24 Heping Road, Xiangfang District, Harbin 150040, Heilongjiang, China.
Brain Function and Neurorehabilitation Laboratory, Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, 411 Guogeli Street, Nangang District, Harbin 150001, Heilongjiang, China.
Evid Based Complement Alternat Med. 2020 May 18;2020:9786482. doi: 10.1155/2020/9786482. eCollection 2020.
In recent years, the efficacy of electroacupuncture (EA) pretreatment generating ischemic tolerance mimicking ischemic pretreatment (IP) has been continuously confirmed, which was first found in the brain and then in the heart. Furthermore, researchers have observed the intensive cardioprotection impact of EA pretreatment on patients undergoing percutaneous coronary intervention (PCI) and heart valve replacement, indicating that EA pretreatment tends to be a valuable and advantageous avenue for preventing acute myocardial ischemia/reperfusion (I/R) injury or treatment of ischemic heart disease (IHD). In reality, the heart protection mechanism of EA pretreatment is robust and pleiotropic, of which the regulatory molecular pathways are involved in multichannel, multilevel, and multitarget, including energy metabolism, inflammatory response, calcium overload, oxidative stress, autophagy, and apoptosis. Through a growing number of clinical tests and basic experiments with animal models, researchers progressively explored the optimal acupoints and parameters, where EA pretreatment induced acute and delayed ischemic tolerance for myocardial protection. Thereby, this article aims to collect the relevant evidence on EA pretreatment against myocardial ischemia/reperfusion injury (MIRI) and summarize the mechanism of cardioprotection of EA pretreatment to provide ideas and methods for further clinical applications.
近年来，电针（EA）预处理产生模拟缺血预处理（IP）的缺血耐受的功效不断得到证实，这一现象最初在大脑中被发现，随后在心脏中也被发现。此外，研究人员观察到EA预处理对接受经皮冠状动脉介入治疗（PCI）和心脏瓣膜置换术的患者具有强烈的心脏保护作用，这表明EA预处理有望成为预防急性心肌缺血/再灌注（I/R）损伤或治疗缺血性心脏病（IHD）的一种有价值且具优势的途径。实际上，EA预处理的心脏保护机制强大且具有多效性，其调控分子途径涉及多通道、多层次和多靶点，包括能量代谢、炎症反应、钙超载、氧化应激、自噬和凋亡。通过越来越多的临床试验和动物模型基础实验，研究人员逐步探索出了最佳穴位和参数，EA预处理可诱导急性和延迟性缺血耐受以保护心肌。因此，本文旨在收集EA预处理抗心肌缺血/再灌注损伤（MIRI）的相关证据，并总结EA预处理的心脏保护机制，为进一步的临床应用提供思路和方法。
