基于外泌体miR-146a介导Akt/NF-κB通路探讨针刺委中穴治疗腰痛的作用机制

“腰背委中求”是针灸四总穴歌理论之一，前国家自然科学基金等项目研究显示针刺委中穴可提升腰椎肌肉稳定系统与本体感觉功能治疗腰痛。最新研究表明骨骼肌提早衰老与腰痛发生直接相关，且外泌体miR-146a可介导Akt/NF-κB通路参与骨骼肌衰老与修复。预实验表明针刺委中穴可延缓竖脊肌衰老，防治腰痛。因此提出针灸委中穴可能通过调节血清外泌体miR-146a表达，介导Akt/NF-κB通路，改善骨骼肌衰老达到治疗腰痛的假说。本研究以骨骼肌衰老为切入点，观察骨骼肌衰老形态学变化，Elisa检测血清炎性因子（TNF-α、IL-1β、IL-6）释放量，PCR法检测miR-146a及其靶基因IRAK1、TRAF6表达水平，Western blot检测血清miR-146a、TRAF6、IRAK1、Akt、p-Akt、NF-κB等表达水平。从形态学、分子生物学等角度进一步挖掘“腰背委中求”防治腰痛的科学内涵。

“Low back pain treatent with weizhong poit”is one of the four general acupoint songs of acupuncture and moxibustion.The former national natural science foundation of China and other projects showed that acupuncture on weizhong acupoint could improve lumbar muscle stability system and proprioception function to treat low back pain.Recent studies have shown that early skeletal muscle aging is directly related to the occurrence of low back pain, and microRNA-146a can mediate the Akt/NF- B pathway in exosomes to participate in skeletal muscle aging and repair.Preliminary experiments show that acupuncture at weizhong point can delay senility of sacrospinal muscle and prevent and cure low back pain.Therefore, it is proposed that acupuncture at weizhong point may regulate the expression of microRNA-146a, mediate the Akt/NF- B pathway, thereby delaying skeletal muscle aging and inhibiting the occurrence of low back pain.In this study, skeletal muscle aging is used as a starting point to observe the morphological changes of skeletal muscle aging. The release levels of serum inflammatory factors (TNF-α、IL-1β、IL-6) are detected by Elisa, the RNA expression levels of mir-146a and its target genes IRAK1 and TRAF6 are detected by PCR, and the protein expression levels of serum TRAF6, IRAK1, Akt, p-akt and NF-κB are detected by Western blot.From the perspective of morphology and molecular biology, this study further verifies the scientific connotation of “Low back pain treatent with weizhong poit” for the prevention and treatment of low back pain.