Yang Na-Na, Xie Xiao-Xia, Yan Wen-Li, Liu Yi-Duo, Wang He-Xuan, Yang Liu-Xin, Liu Cun-Zhi
International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine.
Int J Med Sci. 2025 May 20;22(11):2620-2636. doi: 10.7150/ijms.107643. eCollection 2025.
The expanding knowledge on the involvement of the autonomic nervous system in regulating digestive tract homeostasis is shedding new light on the therapeutic potential of acupuncture. This review aims to evaluate the effectiveness and autonomic nervous system associated mechanisms of acupuncture in gastrointestinal dysmotility in both laboratory and clinical settings, guiding future studies. Mechanistically, studies with animal models and human subjects demonstrated that acupuncture, as a non-invasive somatosensory stimulation, can help improve gastrointestinal dysmotility via directly modulating the activation of autonomic nervous system. Additionally, acupuncture has been found to suppress inflammatory response and alter the secretion of gastrointestinal hormones via different somatic autonomic reflex pathways. Importantly, the therapeutic effects of acupuncture are affected by, and even rely on, the selected acupoints, the frequency and intensity of stimulation, type of gastrointestinal disorders, and the treatment frequency. Meanwhile, clinical studies indicated that acupuncture shows promise in alleviating gastrointestinal dysmotility from the esophagus to the colon, including conditions like gastroparesis, functional dyspepsia, postoperative ileus, irritable bowel syndrome, and chronic functional constipation. We argued against a narrow classification of abdominal and hindlimb acupoints as solely activating sympathetic or vagal nerve to decrease or increase gastrointestinal motility, respectively. Lastly, incorporating new technologies will assist to reveal central autonomic network changes in response to acupuncture stimulation.
自主神经系统参与调节消化道内环境稳定的知识不断扩展，为针灸的治疗潜力带来了新的启示。本综述旨在评估实验室和临床环境中针灸治疗胃肠动力障碍的有效性及其与自主神经系统相关的机制，为未来的研究提供指导。从机制上讲，对动物模型和人体受试者的研究表明，针灸作为一种非侵入性的体感刺激，可以通过直接调节自主神经系统的激活来帮助改善胃肠动力障碍。此外，已发现针灸可通过不同的躯体自主反射途径抑制炎症反应并改变胃肠激素的分泌。重要的是，针灸的治疗效果受到所选穴位、刺激频率和强度、胃肠疾病类型以及治疗频率的影响，甚至依赖于这些因素。同时，临床研究表明，针灸在缓解从食管到结肠的胃肠动力障碍方面显示出前景，包括胃轻瘫、功能性消化不良、术后肠梗阻、肠易激综合征和慢性功能性便秘等病症。我们反对将腹部和后肢穴位简单地分类为分别仅激活交感神经或迷走神经以降低或增加胃肠动力。最后，结合新技术将有助于揭示针刺刺激后中枢自主神经网络的变化。
