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理解血管平滑肌细胞功能与针刺治疗脑缺血性中风疗效之间的关系:一项临床前Meta分析与系统评价

Understanding the Relationship Between Vascular Smooth Muscle Cell Function and the Efficacy of Acupuncture in Treating Cerebral Ischemic Stroke: A Preclinical Meta-Analysis and Systematic Review.

作者信息

Cao Jiang-Peng, Du Yuan-Hao, Jia Lan-Yu, Yin Xiu-Mei, Yang Li-Hong, Chen Lin-Ling, Jiang Tao, Zhang Man, Qiu Tian

机构信息

Department of Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China.

National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People's Republic of China.

出版信息

J Pain Res. 2024 May 10;17:1693-1707. doi: 10.2147/JPR.S449499. eCollection 2024.

DOI:10.2147/JPR.S449499
PMID:38746535
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11093122/
Abstract

BACKGROUND

Cerebral blood flow and vascular structures serve as the fundamental components of brain metabolism and circulation. Acupuncture, an alternative and complementary medical approach, has demonstrated efficacy in treating cerebral ischemic stroke (CIS). Nevertheless, the mechanisms underlying the impact of acupuncture on vascular smooth muscle cell (VSMC) function remain uncertain. The objective of this systematic review and meta-analysis is to assess the alterations in VSMC function following acupuncture stimulation in CIS models.

METHODS

The databases PubMed, Web of Science, SCOPUS, and EMBASE were queried until November 2022 using a predetermined search strategy. The FORMAT BY SYRCLE guidelines were adhered to, and the risk of bias of the included studies was evaluated using the Risk of Bias tool developed by the Systematic Review Centre for Laboratory Animal Experimentation. The random-effects model was employed to estimate the standardized mean difference (SMD).

RESULTS

Eighteen articles are included in this review. Acupuncture showed significant positive effects on the region cerebral blood flow (SMD=8.15 [95% CI, 4.52 to 11.78]) and neurological deficiency (SMD=-3.75 [95% CI, -5.54 to -1.97]). Descriptive analysis showed a probable mechanism of acupuncture stimulation in CIS rats related to VSMC function. Limitations and publication bias were presented in the studies.

CONCLUSION

In this systematic review and meta-analysis, our findings indicate that acupuncture stimulation has the potential to improve regional cerebral blood flow and alleviate neurological deficits, possibly by regulating VSMC function. However, it is important to exercise caution when interpreting these results due to the limitations of animal experimental design and methodological quality.

摘要

背景

脑血流量和血管结构是脑代谢和循环的基本组成部分。针灸作为一种替代和补充医学方法,已证明对治疗脑缺血性中风(CIS)有效。然而,针灸对血管平滑肌细胞(VSMC)功能影响的潜在机制仍不明确。本系统评价和荟萃分析的目的是评估CIS模型中针刺刺激后VSMC功能的变化。

方法

使用预定的检索策略,对PubMed、Web of Science、SCOPUS和EMBASE数据库进行检索,直至2022年11月。遵循SYRCLE指南的格式,并使用实验室动物实验系统评价中心开发的偏倚风险工具评估纳入研究的偏倚风险。采用随机效应模型估计标准化平均差(SMD)。

结果

本综述纳入18篇文章。针灸对局部脑血流量(SMD=8.15 [95%CI,4.52至11.78])和神经功能缺损(SMD=-3.75 [95%CI,-5.54至-1.97])显示出显著的积极影响。描述性分析显示了CIS大鼠针刺刺激与VSMC功能相关的可能机制。研究中存在局限性和发表偏倚。

结论

在本系统评价和荟萃分析中,我们的研究结果表明,针刺刺激有可能改善局部脑血流量并减轻神经功能缺损,可能是通过调节VSMC功能实现的。然而,由于动物实验设计和方法学质量的局限性,在解释这些结果时应谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b84a/11093122/68fbbd5a2e99/JPR-17-1693-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b84a/11093122/d5d1e5a14708/JPR-17-1693-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b84a/11093122/5efc3af0a43c/JPR-17-1693-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b84a/11093122/1f9fdd443622/JPR-17-1693-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b84a/11093122/68fbbd5a2e99/JPR-17-1693-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b84a/11093122/d5d1e5a14708/JPR-17-1693-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b84a/11093122/5efc3af0a43c/JPR-17-1693-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b84a/11093122/1f9fdd443622/JPR-17-1693-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b84a/11093122/68fbbd5a2e99/JPR-17-1693-g0004.jpg

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