中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (13): 2116-2123.doi: 10.12307/2023.232

• 骨与关节综述 bone and joint review • 上一篇    下一篇

中医药调控细胞自噬治疗脊髓损伤的方法、技术及未来

王雅欣,林一璨,郭伊诺,张  博,马玉滢,贺小平   

  1. 河北中医学院,河北省心脑血管病中医药防治研究重点实验室,河北省石家庄市   050091
  • 收稿日期:2022-01-10 接受日期:2022-03-10 出版日期:2023-05-08 发布日期:2022-08-12
  • 通讯作者: 贺小平,硕士,河北中医学院,河北省心脑血管病中医药防治研究重点实验室,河北省石家庄市 050091
  • 作者简介:王雅欣,女,2002年生,河北省邢台市人,汉族,主要从事中医药治疗脊髓损伤研究。
  • 基金资助:
    河北省中医药管理局资助项目(2022105),项目负责人:贺小平;河北省卫生健康委员会(20221046),项目负责人: 贺小平;燕赵医学研究专项(YZYX2021006),项目负责人:贺小平

Methods, technologies and future of Chinese medicine modulation of cellular autophagy in the treatment of spinal cord injury

Wang Yaxin, Lin Yican, Guo Yinuo, Zhang Bo, Ma Yuying, He Xiaoping   

  1. Hebei Key Laboratory of Chinese Medicine Research on Cardio-cerebrovascular Disease, Hebei University of Chinese Medicine, Shijiazhuang 050091, Hebei Province, China
  • Received:2022-01-10 Accepted:2022-03-10 Online:2023-05-08 Published:2022-08-12
  • Contact: He Xiaoping, Master, Hebei Key Laboratory of Chinese Medicine Research on Cardio-cerebrovascular Disease, Hebei University of Chinese Medicine, Shijiazhuang 050091, Hebei Province, China
  • About author:Wang Yaxin, Hebei Key Laboratory of Chinese Medicine Research on Cardio-cerebrovascular Disease, Hebei University of Chinese Medicine, Shijiazhuang 050091, Hebei Province, China
  • Supported by:
    a grant from Hebei Provincial Administration of Traditional Chinese Medicine, No. 2022105 (to HXP); a grant from Hebei Provincial Health Commission, No. 20221046 (to HXP); Yanzhao Medical Research Project, No. YZYX2021006 (to HXP)

摘要:

文题释义:
脊髓损伤:主要分为原发性和继发性脊髓损伤,在中医领域属于“痿症”范畴,原发性脊髓损伤是由于击打、切割等造成的不可逆的物理损伤,继发性损伤则是由于炎症等化学反应造成的可逆性损伤。
细胞自噬:是真核细胞中以实现细胞器更新及自身代谢为主要目的,以依赖溶酶体消化外源性物质或细胞代谢产物为主要功能,以维持细胞稳态为主要结局的一种广泛存在的调节机制。

背景:中医疗法如中医药及针灸取穴通过调节自噬在脊髓损伤的治疗中显示出良好效果,并逐渐在脊髓损伤的治疗中占据重要地位。
目的:总结中医药调控细胞自噬治疗脊髓损伤的研究进展。
方法:以“spinal cord injury,autophagy,traditional Chinese medicine,signal”为检索词检索PubMed数据库,以“脊髓损伤、自噬、中医、信号通路”为检索词检索中国知网数据库,检索时限为2014年1月至2022年1月,排除与文章研究目的无关及重复性文章,纳入符合标准的72篇文献进行综述。
结果与结论:①从脊髓损伤的中医机制及治疗来说,脊髓损伤早期一系列症状常是由于督脉受损引起,与受损后产生气滞血瘀密切相关,因此可以进行活血化瘀和督脉论治。②自噬的中医理论主要联系“阴阳”和“气血”,并且根据不同疾病主要围绕脾、肝、肾进行脏腑辨证。③大量实验研究表明,中医药及针灸可以调控细胞自噬蛋白、信号通路的表达且可以有效抑制脊髓损伤后的炎症反应,有利于减轻脊髓损伤后炎症反应并保护脊髓神经元,改善损伤后运动及神经元的受损情况。④中医药调控细胞自噬治疗脊髓损伤是目前研究热点,但大部分研究停留在理论阶段,有些中医疗法的具体作用机制尚未明确。⑤中医药领域对自噬的研究与西医相比较少,其中通过调控自噬治疗脊髓损伤研究的科研力度尤其应该加强。⑥未来希望研究者们对典型中医药进行配伍,联合针灸、西药治疗,进行针对性实验研究,以期找到治疗脊髓损伤更有效的中医疗法及中西结合疗法。

https://orcid.org/0000-0002-8434-3806(王雅欣);https://orcid.org/0000-0001-5890-019X(贺小平) 

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程

关键词: 细胞自噬, 脊髓损伤, 信号通路, 中医药, 针灸, 神经, 机制, 阴阳, 气血, 综述

Abstract: BACKGROUND: Traditional Chinese medicine therapies such as traditional Chinese medicine and acupuncture have shown good effects on the treatment of spinal cord injury by modulating autophagy, and gradually occupy an important position in the treatment of spinal cord injury.
OBJECTIVE: To summarize the research progress addressing the regulation of cellular autophagy for treating spinal cord injury using Chinese medicine.
METHODS: The PubMed database was searched with “spinal cord injury, autophagy, traditional Chinese medicine, signal” as the main search terms. CNKI database was searched with “spinal cord injury, autophagy, traditional Chinese medicine, signal pathway” as the main search terms. The search period was from January 2014 to January 2022. Irrelevant and repetitive articles were excluded and 72 articles that met the criteria were included in the review.
RESULTS AND CONCLUSION: (1) Regarding the traditional Chinese medicine mechanism and treatment of spinal cord injury, a series of symptoms in the early stage of spinal cord injury are often caused by the damage of the Directing Vessel, which is strongly associated with the production of qi stagnation and blood stasis after the damage, so the treatment can be carried out to activate blood circulation and remove blood stasis and the Directing Vessel. (2) The traditional Chinese medicine theory of autophagy is mainly associated with “yin and yang” and “qi and blood”. According to different diseases, the identification of internal organs is mainly based on the spleen, liver, and kidney. (3) Numerous experimental studies have confirmed that traditional Chinese medicine and acupuncture can modulate the expression of cellular autophagy proteins and signaling pathways and can effectively suppress the inflammatory response after spinal cord injury, which is conducive to reducing the inflammatory response after spinal cord injury and protecting spinal cord neurons, and improving motor and neuronal damage after injury. (4) Autophagy regulation by traditional Chinese medicine for spinal cord injury is a current research hotspot. Nevertheless, most of the studies are at the stage of theory, and the specific action mechanisms of some methods are not yet clear. (5) The research concerning autophagy is less in the field of traditional Chinese medicine compared with western medicine. In particular, the scientific research on the treatment of spinal cord injury by regulating autophagy should be strengthened. (6) In the future, it is hoped that researchers will formulate typical traditional Chinese medicine, combine with acupuncture and western medicine, and take targeted experimental studies to find effective traditional Chinese medicine methods or even combined Chinese and western therapies for the treatment of spinal cord injury. 

Key words: cellular autophagy, spinal cord injury, signaling pathway, Chinese medicine, acupuncture, nerve, mechanism, Yin and Yang, qi and blood, review

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