基于“温阳通络”理论从ROS-NLRP3通路探讨针灸夹脊穴干预带状疱疹大鼠止痛机制

带状疱疹（HZ）神经痛是HZ最常见且严重的并发症，常规疗效欠佳或副作用多。水痘带状疱疹病毒（VZV）的炎症损伤导致神经脱髓鞘是主要机制之一。中医核心病机为阳气虚弱致湿瘀阻络、不通则痛。抑制早期的炎症损伤是减轻并预防长期疼痛的关键。研究证实ROS-NLRP3通路与炎性疼痛密切相关。我们前期研究发现，夹脊穴针刺或注射能显著减轻HZ急性神经痛并预防长期病理性疼痛，而夹脊穴可激发经络阳气、化湿行瘀、通络止痛。研究表明温阳行气、化湿通络的针刺和中药可抑制ROS生成并下调NLRP3炎症小体的激活而抑制炎症过程。基于此，课题组提出针灸夹脊穴可能通过抑制ROS-NLRP3炎症小体通路阻止VZV病毒介导的神经炎症毁损而达到止痛作用的科学假说。为验证此假说，本课题组通过构建HZ神经痛大鼠模型，探索针灸夹脊穴温阳理论对带状疱疹神经痛的止痛机制，为针灸夹脊穴治疗HZ提供新的视角。

Herpes zoster neuralgia is its most common and serious complication. The conventional treatment of this disease is not effective or has many side effects.VZ virus inflammatory injury leads to demyelination of the involved nerve is one of the currently recognized mechanisms. In traditional Chinese medicine, the core pathogenesis is Yang qi deficiency, which leads to dampness and blood-stasis stagnation syndrome.When there is stoppage,there is pain. Inhibiting early inflammatory damage is the key to reducing and preventing long-term pain.Studies have confirmed that the ROS-NLRP3 pathway is closely related to inflammatory pain. Our previous research found that acupuncture or injection at Jiaji acupoints can significantly reduce acute neuralgia and prevent long-term pathological pain in HZ, while Jiaji acupoints can stimulate meridian yang qi and transform dampness free stasis to relieve pain. The study also showed that warming yang to move qi, dredging the collateral by resolving damp of acupuncture and Chinese medicine can inhibit the generation of ROS, and down-regulate the activation of NLRP3 inflammatory bodies to inhibit the inflammatory process.Based on this, the research group proposed that acupuncture at Jiaji acupoint may achieve the analgesic effect by inhibiting the ROS-NLRP3 inflammatory corpuscle pathway to prevent the damage of neuronal inflammation mediated by VZ virus. To verify this hypothesis, the research group explored the analgesic mechanism of acupuncture at Jiaji points to herpes zoster neuralgia by constructing a HZ neuralgia rat model, and provided a new perspective for acupuncture at Jiaji points in the treatment of HZ.