Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China; Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Department of Acupuncture, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China.
Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China; Department of Acupuncture, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China.
Ageing Res Rev. 2024 Nov;101:102536. doi: 10.1016/j.arr.2024.102536. Epub 2024 Oct 9.
Ischemic stroke(IS), a severe acute cerebrovascular disease, not only imposes a heavy economic burden on society but also presents numerous challenges in treatment. During the acute phase, while thrombolysis and thrombectomy serve as primary treatments, these approaches are restricted by a narrow therapeutic window. During rehabilitation, commonly used neuroprotective agents struggle with their low drug delivery efficiency and inadequate preclinical testing, and the long-term pharmacological and toxicity effects of nanomedicines remain undefined. Meanwhile, acupuncture as a therapeutic approach is widely acknowledged for its effectiveness in treating IS and has been recommended by the World Health Organization (WHO) as an alternative and complementary therapy, even though its exact mechanisms remain unclear. This review aims to summarize the known mechanisms of acupuncture and electroacupuncture (EA) in the treatment of IS. Research shows that acupuncture treatment mainly protects the neurovascular unit through five mechanisms: 1) reducing neuronal apoptosis and promoting neuronal repair and proliferation; 2) maintaining the integrity of the blood-brain barrier (BBB); 3) inhibiting the overactivation and polarization imbalance of microglia; 4) regulating the movement of vascular smooth muscle (VSM) cells; 5) promoting the proliferation of oligodendrocyte precursors. Through an in-depth analysis, this review reveals the multi-level, multi-dimensional impact of acupuncture treatment on the neurovascular unit (NVU) following IS, providing stronger evidence and a theoretical basis for its clinical application.
缺血性脑卒中（IS）是一种严重的急性脑血管病，不仅给社会带来了沉重的经济负担，而且在治疗方面也面临诸多挑战。在急性阶段，虽然溶栓和取栓是主要的治疗方法，但这些方法受到治疗窗口狭窄的限制。在康复阶段，常用的神经保护剂存在药物递送效率低和临床前测试不足的问题，而纳米医学的长期药理学和毒性效应仍不明确。与此同时，针刺作为一种治疗方法，其治疗 IS 的有效性已得到广泛认可，并被世界卫生组织（WHO）推荐为一种替代和补充疗法，尽管其确切机制仍不清楚。本综述旨在总结针刺和电针对 IS 的治疗作用的已知机制。研究表明，针刺治疗主要通过以下五种机制保护神经血管单元：1）减少神经元凋亡，促进神经元修复和增殖；2）维持血脑屏障（BBB）的完整性；3）抑制小胶质细胞的过度激活和极化失衡；4）调节血管平滑肌（VSM）细胞的运动；5）促进少突胶质前体细胞的增殖。通过深入分析，本综述揭示了针刺治疗对 IS 后神经血管单元（NVU）的多层次、多维度影响，为其临床应用提供了更强的证据和理论基础。
