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脑卒中后认知障碍(PSCI)是脑卒中后常见的致残性并发症。针刺能有效改善PSCI患者学习记忆功能,提高患者的远期生活质量,其机制研究也逐步从现象观察深入到多层面的作用机理探索。本文总结近年来针刺干预PSCI起效机制的相关文献,发现针刺通过多靶点协同从而系统改善PSCI。针刺起效的机制主要是通过抑制神经炎症减轻脑内免疫损伤,并通过增强神经可塑性来促进突触与记忆环路重建,而调控自噬和维持神经血管单元稳定作为重要的辅助路径,可协同清除损伤产物、维护神经元微环境。此外,调节肠道菌群、影响表观遗传及改善脑代谢等新兴方向,从系统层面拓展机制认知。然而,现有研究多孤立阐述各机制,缺乏对内在关联的整合,也未能充分阐明不同针刺方法与其效应优势的对应关系。因此,本文整合分散的机制证据,强调未来需借助多组学等方法,深入探究机制间的协同关系,并加强针刺方案特异性与临床效应的关联研究,以推动基础机制向临床实践转化。
Abstract：Post-stroke cognitive impairment(PSCI) is a common disabling complication after stroke.Acupuncture can effectively improve learning and memory function in patients with PSCI and enhance their quality of life in long term.Research on its effect mechanisms has evolved from phenomenological observation to multidimensional exploration progressively.In this paper,recent studies on effect mechanisms of acupuncture for PSCI were collected,which revealed that acupuncture can alleviate PSCI through multitarget synergism.The therapeutic mechanism of acupuncture primarily involves reducing immune damage in the brain by suppressing neuroinflammation,and promoting synaptic and memory circuit reconstruction through enhancing neural plasticity,egulating autophagy and maintaining the stability of neurovascular units as the critical auxiliary pathways,which can synergistically remove the damage products and preserve the neuronal microenvironment.Furthermore,emerging research directions such as modulating gut microbiota,influencing epigenetics,and improving brain metabolism expand the mechanistic understanding.However,existing studies predominantly isolate and describe individual mechanisms without integrating their intrinsic correlations,nor do they adequately elucidate the corresponding relationships between different acupuncture techniques and their therapeutic advantages.Therefore,this review integrates the fragmented mechanistic evidences,and emphasizes that future research need multiomics approaches,so as to explore the synergistic relationships among mechanisms,and to strengthen the correlative research between the specificity of acupuncture regimens and clinical effect,in order to facilitate bench-to-bedside translation.
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基本信息:
中图分类号:R246.6
引用信息:
[1]周明园,张东旭,齐鹏飞,等.多靶点协同与系统整合:针刺改善脑卒中后认知障碍的机制研究（英文）[J].World Journal of Acupuncture-Moxibustion,2026,36(02):89-98.
基金信息:
Supported by the National Key Research and Development Program:No.2022YFC3500403;No.2022YFC3500400~~
2026-04-15
2026-04-15