The mechanism of electroacupuncture for depression on basic research: a systematic review.
The mechanism of electroacupuncture for depression on basic research: a systematic review.
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电针治疗抑郁症机制的基础研究综述。
DOI：
10.1186/s13020-020-00421-y
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发表时间：
2021-01-13
期刊：
影响因子：
4.9
通讯作者：
Xu S
中科院分区：
文献类型：
--
作者：
Han X;Gao Y;Yin X;Zhang Z;Lao L;Chen Q;Xu S
电针（EA）通常被认为是缓解抑郁症的一种安全无害的治疗方法。然而，存在与EA的使用相关的若干挑战。虽然EA已被证明是有效的治疗抑郁症，但分子机制尚不清楚。揭示电针治疗抑郁症的疗效及其可能机制。 我们根据PRISMA指南进行了系统检索。我们电子检索了PubMed、Web of Science（WOS）、中国知网（CNKI）、万方数据信息网站和VIP动物研究信息数据库，从这些数据库成立到2019年12月31日，均为英文。使用以下检索词对PubMed、WOS、CNKI、万方和VIP数据库进行电子检索：（抑郁症或抑郁障碍或抗抑郁药）、（大鼠或小鼠）和（针灸或EA）。数据主要由一位作者提取，其他作者进行了随访审查。28篇文章符合纳入标准。在动物模型中，最常用的诱导抑郁的方法是21天的慢性不可预测的轻度应激。对于抑郁模型，最常选择的电针频率为2Hz。在28项选定的研究中，有11项研究观察了抑郁相关行为，并将其作为EA疗效的指标。其他17项研究集中在机制上，并评估了已知由抑郁症引起的异常指标，然后在EA治疗后恢复到正常范围。电针治疗抑郁症涉及多种治疗机制，包括抑制HPA轴过度活跃和炎症，调节神经肽和神经递质，调节特定基因的表达，恢复海马突触可塑性，增加BDNF的表达，以及调节几种信号通路。本文综述了针灸的作用机制涉及多个途径和靶点，提示针灸是一种整体治疗，而不是治疗疾病。我们的研究结果也解释了为什么针灸可以治疗除抑郁症以外的各种疾病。
Electroacupuncture (EA) is generally accepted as a safe and harmless treatment option for alleviating depression. However, there are several challenges related to the use of EA. Although EA has been shown to be effective in treating depression, the molecular mechanism is unclear. To reveal the therapeutic effect of EA and its possible mechanism in the treatment of depression. We performed a systematic search according to PRISMA guidelines. We electronically searched PubMed, Web of Science (WOS), the China National Knowledge Infrastructure (CNKI), Wanfang Data Information Site and the VIP information database for animal studies in English published from the inception of these databases to December 31, 2019. Electronic searches of PubMed, WOS, the CNKI, Wanfang and the VIP database were conducted using the following search terms: (depression OR depressive disorder OR antidepressive), (rat OR mouse) AND (acupuncture OR EA). The data were extracted primarily by one author, and a follow-up review was conducted by the other authors. Twenty-eight articles met the inclusion criteria. The most commonly used method for inducing depression in animal models was 21 days of chronic unpredictable mild stress. For the depression model, the most commonly selected EA frequency was 2 Hz. Among the 28 selected studies, 11 studies observed depression-related behaviors and used them as indicators of EA efficacy. The other 17 studies focused on mechanisms and assessed the indexes that exhibited abnormalities that were known to result from depression and then returned to a normal range after EA treatment. Treatment of depression by EA involves multiple therapeutic mechanisms, including inhibition of HPA axis hyperactivity and inflammation, regulation of neuropeptides and neurotransmitters, modulation of the expression of particular genes, restoration of hippocampal synaptic plasticity, increased expression of BDNF, and regulation of several signaling pathways. This review reveals that the mechanisms underlying the effect of acupuncture involve multiple pathways and targets, suggesting that acupuncture is a wholistic treatment for people rather than for diseases. Our findings also explain why acupuncture can treat various disorders in addition to depression.
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