Research Center of Experimental Acupuncture Science, School of Acupuncture-Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Tianjin Key Laboratory of Modern Chinese Medicine Theory of Innovation and Application, School of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
CNS Neurosci Ther. 2024 Oct;30(10):e14920. doi: 10.1111/cns.14920.
Cardio-cerebrovascular disease (CCVD) is a serious threat to huma strategy to prevent the occurrence and development of disease by giving electroacupuncture intervention before the disease occurs. EAP has been shown in many preclinical studies to relieve ischemic symptoms and improve damage from ischemia-reperfusion, with no comprehensive review of its mechanisms in cardiovascular disease yet. In this paper, we first systematically discussed the meridian and acupoint selection law of EAP for CCVD and focused on the progress of the mechanism of action of EAP for the prevention and treatment of CCVD. As a result, in preclinical studies, AMI and MCAO models are commonly used to simulate ischemic injury in CCVD, while MIRI and CI/RI models are used to simulate reperfusion injury caused by blood flow recovery after focal tissue ischemia. According to the meridian matching rules of EAP for CCVD, PC6 in the pericardial meridian is the most commonly used acupoint in cardiovascular diseases, while GV20 in the Du meridian is the most commonly used acupoint in cerebrovascular diseases. In terms of intervention parameters, EAP intervention generally lasts for 30 min, with acupuncture depths mostly between 1.5 and 5 mm, stimulation intensities mostly at 1 mA, and commonly used frequencies being low frequencies. In terms of molecular mechanisms, the key pathways of EAP in preventing and treating cardiovascular and cerebrovascular diseases are partially similar. EAP can play a protective role in cardiovascular and cerebrovascular diseases by promoting autophagy, regulating Ca overload, and promoting vascular regeneration through anti-inflammatory reactions, antioxidant stress, and anti-apoptosis. Of course, both pathways involved have their corresponding specificities. When using EAP to prevent and treat cardiovascular diseases, it involves the metabolic pathway of glutamate, while when using EAP to prevent and treat cerebrovascular diseases, it involves the homeostasis of the blood-brain barrier and the release of neurotransmitters and nutritional factors. I hope these data can provide experimental basis and reference for the clinical promotion and application of EAP in CCVD treatment.
心脑血管疾病（CCVD）是人类健康的严重威胁。因此，人们提出了治未病的策略，即在疾病发生之前给予电针干预，以预防疾病的发生和发展。许多临床前研究表明，EAP 可缓解缺血症状，改善缺血再灌注损伤，但尚未对其在心血管疾病中的作用机制进行全面综述。本文首先系统地讨论了 EAP 防治 CCVD 的经络和穴位选择规律，并重点介绍了 EAP 防治 CCVD 的作用机制的研究进展。结果表明，在临床前研究中，AMI 和 MCAO 模型常用于模拟 CCVD 中的缺血性损伤，而 MIRI 和 CI/RI 模型用于模拟局灶组织缺血后血流恢复引起的再灌注损伤。根据 EAP 防治 CCVD 的经络匹配规律，心包经的 PC6 穴是心血管疾病中最常用的穴位，而督脉的 GV20 穴是脑血管疾病中最常用的穴位。在干预参数方面，EAP 干预一般持续 30min，针刺深度多为 1.5~5mm，刺激强度多为 1mA，常用频率为低频。在分子机制方面，EAP 防治心脑血管疾病的关键途径部分相似。EAP 通过促进自噬、调节 Ca 超载、通过抗炎反应、抗氧化应激和抗细胞凋亡促进血管再生，在心脑血管疾病中发挥保护作用。当然，涉及的两条途径都有其特异性。当使用 EAP 预防和治疗心血管疾病时，它涉及到谷氨酸的代谢途径，而当使用 EAP 预防和治疗脑血管疾病时，它涉及到血脑屏障的内稳态以及神经递质和营养因子的释放。希望这些数据能为 EAP 在 CCVD 治疗中的临床推广应用提供实验依据和参考。
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