皮肤微生态在针和灸倚重效应中的作用与机制

针法与灸法有不同的适宜病种和作用途径：针刺注重快速的、靶器官相对明确的神经调节，灸法注重缓慢持续的、多靶点的内分泌-免疫调节；表明针与灸具有各自倚重的生物学特性。随着皮肤微生态概念的发展，穴位的微生态环境对针灸效应的影响应当受到关注。我们原创性提出针灸、特别是灸疗产生的免疫调节与局部的微生态环境密切相关。本项研究重点在于探讨灸疗与皮肤微生态的关系，确定灸疗倚重的免疫调节与施灸后皮肤的微创伤所致的局部屏障破坏，“原驻微生物”与“暂住微生物”的平衡发生紊乱、导致“致炎菌”入侵，随后与皮肤免疫细胞共同触发致炎–抗炎系统的程序性级联反应“免疫激活”存在密切关联，并可能导致与免疫反应相关的细胞因子和皮肤“皮-脑轴”的HPA响应。进一步阐述针灸引发免疫调节的最佳刺激方式和强度，厘清穴位微生态环境改变可能影响针灸免疫调节的模式和质量，为临床针刺和灸法的优化选择提供科学依据。

There are alternate choices between acupuncture and moxibustion in treating different diseases. Different diseases have their own specific reliance on one of them. Acupuncture shows rapid, organ explicit neuromodulation, while moxibustion takes part in slowly sustaining, multiple targets endocrine-immune regulation. These differences elucidate the reliant biological characterization between acupuncture and moxibustion. Researchers should pay attention to the effect of acupuncture and moxibustion affected by microecological environment of acupoints along with the development of skin microecology. We hypothesized that immune regulation induced by acupuncture and moxibustion, especially moxibustion is closely related to microecological environment of the skin. This project will discuss the relationship between moxibustion and skin microbial ecology, the main reliant immune regulation induced by moxibustion and the change of microbiome caused by skin micro-lesion at the moxibustion location. The unbalance of “resident microbiota” and “transient microbiota” leading to the invasion of inflammatory bacteria" and the following dermal immune cells closely related to procedural modulational cascade reaction- “immune activation”, then HPA and the immune related cytokines may respond. We will further explore the optimal stimulation mode and intensity in which acupuncture and moxibustion trigger immune regulation and clarify the effect of acupoints microecology on the mode and quality of acupuncture induced immune regulation. This study will provide scientific evidence for clinical optimal choice between acupuncture and moxibustion.