针灸专题 |《针刺研究》《中国针灸》双语文章推荐

针灸作为中医瑰宝，历经数千年传承，在调节人体机能、防治疾病方面彰显出独特优势。随着现代医学技术的发展，针灸的临床价值与科学机制不断被挖掘，在疼痛管理、代谢调节、神经康复等多个领域展现出广阔的应用前景，为解决现代疑难病症提供了全新的治疗思路。本期为大家推荐发表于《针刺研究》《中国针灸》的 6 篇双语文章，它们从理论解析、机制探索、临床验证到技术创新，全方位展现了针灸学科的现代化发展成果。诚挚邀请大家深入研读这些优质成果，一同探索针灸的科学奥秘，见证传统智慧与现代医学的碰撞融合，为相关领域的研究与实践注入新的活力！

精选文章Selected Articles

01

论针灸的双向调节效应

On the bidirectional regulation effect of acupuncture

【摘要】中医维护健康的智慧是“阴平阳秘”。显而易见，“稳态”维持存在“过之”与“不及”的双重因素，生命过程必须有“双向调节”系统的维稳机制来护卫。因此，维持“稳态”平衡的双向调控涉及“矛”与“盾”相对独立的双方势能，还需依靠两套相对独立的调控系统才能完成。针灸是生命体发挥“双向调节效应”的优等担当者，但针灸的这种效应是否能由单一穴位引发？这本不是问题的问题却成了针灸学科的一大问题。针灸“双向调节”概念的过度拓展，中医理论难以如此兼顾，只不过是擅自扩大了理论外延的边界。本文从生命科学的角度阐述：针灸的“双向”效应主要是通过身体不同分区部位的穴位分别传入，通过两套相对独立的调控系统，以维持生命“稳态”平衡的双向调控。

【Abstract】The wisdom of Chinese medicine in maintaining health is "Yin Ping Yang Mi" (balance between yin and yang). Obviously, the maintenance of "homeostasis" contains dual factors of "excessiveness" and "falling short". The life process must be protected by the stability-maintaining mechanism of the "bidirectional regulation" system. Therefore, the two-way regulation of the "homeostasis" maintaining involves the relatively independent potential energy of the "spear" and "shield", and also depends on two sets of relatively independent regulatory systems to complete. Acupuncture is an excellent performer of the "bidirectional regulation effect" of living organisms, but can this effect be caused by a single acupoint stimulation? This issue, which was not a problem, has become a big problem in acupuncture-moxibustion discipline. The concept of "two-way regulation" of acupuncture is over-expanded, which is difficult for the theory of Chinese medicine to take into account. It is only a broad expansion of the boundary of theoretical extension arbitrarily. From the perspective of life science, the present paper expounds that the "bidirectional regulation effect" of acupuncture is obtained from the activation of the "integration center" (not necessarily limited to thebrain) by the stimulated acupoints at different somatic parts of the body, and through two sets of relatively independentregulation systems, so as to maintain the life's "homeostasis”.

02

不同强度电针对内脏痛大鼠的镇痛作用

Analgesic effects of electroacupuncture at different intensities on visceral pain in rats

【摘要】目的：观察不同强度电针对内脏痛大鼠的镇痛作用，并探讨其脊髓上中枢机制和量效关系。方法：雄性SD大鼠随机分为正常组、模型组、不同强度（0.5、1、2、3、6 mA）电针组，每组6只。采用芥子油灌肠法建立内脏痛大鼠模型。记录每组6只大鼠腹直肌肌电观察大鼠内脏运动反射：60 mm Hg直结肠扩张刺激（CRD）诱发各组大鼠腹直肌放电20 s，随后给予“足三里”1 min不同强度的电针干预（强度分别为0.5、1、2、3、6 mA，波宽为0.5 ms，频率为10 Hz），电针结束后再次进行20 s CRD，比较电针前后CRD诱发腹直肌肌电的曲线下面积。另取48只SD大鼠随机分为模型组及0.5、1、2、3、6 mA电针组，每组8只，多通道在体电生理技术记录模型组大鼠结直肠灌注芥子油后1 h延髓背侧网状亚核（SRD）神经元电活动的变化，各电针组在灌注芥子油10 min后给予1 min电针，观察比较不同强度电针前后SRD神经元伤害性电活动放电频率的改变，统计电针后放电频率减少超过20%的SRD神经元的比例。结果：与正常组比较，干预前模型组和不同强度电针组60 mm Hg CRD诱发的腹直肌肌电曲线下面积显著增加（P<0.001）；干预后与模型组比较，高强度（2、3、6 mA）电针组大鼠诱发的肌电曲线下面积显著减少（P<0.05，P<0.001）；与低强度（0.5 mA和1 mA）电针组比较，高强度（2、3、6 mA）电针组大鼠诱发的腹直肌肌电曲线下面积显著减少（P<0.01，P<0.001，P<0.05）。与造模前比较，灌注芥子油后大鼠SRD神经元电活动显著增加，在5～30 min能维持兴奋且处于相对平稳状态（P<0.05）；在第11分钟给予高强度（2、3、6 mA）电针后大鼠SRD神经元放电频率较电针前显著降低（P<0.01，P<0.001）；与0.5、1 mA相比，2、3、6 mA电针后神经元放电频率降低的差值不同程度增加（P<0.05，P<0.01，P<0.001），电针后的频率差值、神经元放电频率减少20%以上神经元的比例均随着电针强度的增加而升高。结论：高强度电针能够缓解大鼠内脏痛，抑制大鼠SRD神经元伤害性电活动，且抑制效果在一定范围内随电针强度增加而增强。

【Abstract】Objective To observe the analgesic effect of electroacupuncture (EA) at different intensities on visceral pain in rats and explore the supraspinal central mechanism and dose-response relationship. Methods Male SD rats were randomly divided into anormal group, a model group and the groups of EA at different intensities (0.5, 1, 2, 3 and 6 mA, 6 rats/group). The visceral pain rat model was established using mustard oil enema. Abdominal rectus electromyography (EMG) was used to observe visceral motor response in the rats. A colorectal distension (CRD) of 60 mm Hg was adopted to induce abdominal rectus muscle discharge for 20 s in each group. Afterwards, EA (0.5, 1, 2, 3, and 6 mA of intensity, 0.5 ms of pulse width, 10 Hz of frequency) was employed at “Zusanli” (ST 36) for 1 min. After the end of EA, CRD was performed again for 20 s. Before and after EA, the areas under the curve (AUC) of CRD-induced abdominal rectus EMG were compared. Another set of rats was randomly divided into a model group and the groups of EA at different intensities (0.5, 1, 2, 3 and 6 mA, 8 rats/group). Multi-channel in vivo electrophysiological technique was used to record the changes in electric activity of the subnucleus reticularis dorsalis (SRD) neurons in the medulla oblongate of rats, and SRD neural nociceptive electrical activity was observed 1 h after rectal mustard oil infusion. EA at different intensities was administered for 1min at the 10-minute mark after rectal mustard oil infusion, and the changes in discharge frequency of nociceptive electrical activity of SRD neurons were compared before and after EA at different intensities. The proportion of SRD neurons whose discharge frequency decreased by more than 20% after EA was calculated. Results Compared to the normal group, the AUC of abdominal rectus EMG induced by 60mm Hg CRD was increased in the model group and EA of different intensity groups before intervention (P<0.001). After intervention, compared with the model group, AUC was decreased in the high-intensity (2, 3 and 6 mA) EA groups (P<0.05, P<0.001). When compared with the low-intensity (0.5 and 1 mA) EA groups, AUC was reduced in the high-intensity EA groups (P<0.01, P<0.001, P<0.05). In comparison with the indicators before modeling, the electrical activity of SRD neurons after rectal mustard oil infusion increased and remained excited and relatively stable in the duration from the 5-minute mark to the 30-minute mark in the rats (P<0.05); and after high-intensity EA at 11-minute mark, the discharge frequency of SRD neurons was reduced (P<0.01, P<0.001). Compared with the low-intensity EA, after the high-intensity EA, the reduced difference of discharge frequency increased (P<0.05, P<0.01, P<0.001). The frequency difference and the proportion of discharge frequency increasing over 20% after EA were elevated with the increase of EA intensity. Conclusion High-intensity EA can alleviate visceral pain and inhibit nociceptive electrical activity of SRD neurons in rats and the inhibitory effects are strengthened with the increase of EA intensity within a certain range.

03

针刺通督养心组方治疗失眠症的人工智能辅助决策平台开发研究

Development and research of an AI-assisted decision-making platform in treatment of insomnia with acupuncture of Tongdu Yangxin acupoint prescription

【摘要】目的：构建并验证针刺通督养心组方治疗失眠症的疗效预测模型，开发开放共享的交互式人工智能（AI）辅助决策平台。方法：纳入接受针刺通督养心组方治疗的139例失眠症患者的临床资料。患者均采用针刺通督养心组方治疗，穴取百会、印堂、神门（双侧）和三阴交（双侧），百会和印堂连接电针，采用连续波，频率2 Hz。隔日1次，每周3次，共治疗2周。将匹兹堡睡眠质量指数（PSQI）评分减分率<50%的患者归类为“无应答组”，PSQI评分减分率≥50%的患者归类为“应答组”。采用1.5倍四分位距规则进行异常值处理，并运用预测均值匹配法对缺失值进行多重插补。随后，选取极端梯度提升与随机森林算法特征重要性结果的交集作为模型的特征集。在应用合成少数类过采样技术平衡类别后，划分20%数据作为验证集，对剩余数据通过固定比例随机分层采样得到200对3∶1的训练集与测试集，用于8种机器学习算法的模型训练与内部验证，进而筛选出用于构建最终模型的最佳算法和数据集划分方式，并进行外部验证。最终通过Streamlit将最佳模型线上部署，构建交互式AI辅助决策平台。结果：用于模型构建的关键特征包括失眠病程、PSQI总分、PSQI睡眠效率得分、N1期占总睡眠时长比例、N2期占总睡眠时长比例和睡眠期间最高脉率。基于类别型特征提升（CatBoost）算法构建的最佳模型在测试集上的曲线下面积（AUC）为0.92，平均精确率为0.77，准确率、平均召回率、平均F1分数均为0.75；在验证集上的AUC为0.84，准确率、平均精确率、平均召回率、平均F1分数均为0.72，表明该模型具有良好的预测性能。基于此模型开发了交互式人工智能辅助决策平台（https://tdyx-catboost.streamlit.app/）。结论：本研究成功构建并验证了基于CatBoost的针刺通督养心组方治疗失眠症的疗效预测模型，所开发的AI平台为针灸治疗失眠症提供了数据驱动的辅助决策支持。

【Abstract】Objective To construct and validate a predictive model for the therapeutic effect of acupuncture at Tongdu Yangxin prescription (acupoint prescription for promoting the circulation of the governor vessel and nourishing the heart) on insomnia, so as to develop an open-access interactive artificial intelligence (AI)-assisted decision-making platform. Methods Clinical data of 139 insomnia patients treated with Tongdu Yangxin acupuncture therapy were included. All the patients had received acupuncture at Baihui (GV 20), Yintang (GV24+), bilateral Shenmen (HT7), and bilateral Sanyinjiao (SP 6); and electric stimulation was attached to Baihui (GV20) and Yintang (GV24+), using a continuous wave and a frequency of 2 Hz. The treatment was delivered once every other day, 3 treatments a week, and for 2 consecutive weeks. Patients with Pittsburgh sleep quality index (PSQI) score reduction rate <50% were classified as the "no response group", and those with ≥50% were as the "response group". Outliers were addressed using the 1.5×IQR rule, and missing values were imputed via predictive mean matching. Key features were selected by intersecting the feature importance results from eXtreme Gradient Boosting (XGBoost) and random forest algorithms. After balancing class distribution using the Synthetic Minority Over-sampling Technique (SMOTE), 20% of the data was reserved as a validation set. The remained data underwent the stratified sampling iterations to generate 200 pairs of 3:1 training-test sets, which was employed for training and internal validation of 8 machine learning algorithms. The optimal algorithm and data partitioning strategy were selected to construct the final model, followed by external validation. The best-performing model was deployed online via Streamlit to create an interactive AI platform. Results Key predictive features for model construction included insomnia duration, the total PSQI score, PSQI sleep efficiency subscore, the proportion of N1 and N2 sleep stages in total sleep duration, and the maximum pulse rate during sleep. The CatBoost-based model achieved an AUC of 0.92, the average precision of 0.77, and accuracy, average recall, and average F1-score of 0.75 on the test set. On the validation set, it attained an AUC of 0.84, with accuracy, average precision, average recall, and average F1-score all at 0.72, demonstrating robust predictive performance. An interactive AI platform was subsequently developed (https://tdyx-catboost.streamlit.app/). Conclusion This study successfully establishes and validates a CatBoost-based efficacy prediction model for Tongdu Yangxin acupuncture therapy in treatment of insomnia. The developed AI platform provides data-driven decision support for acupuncture-based insomnia management.

04

基于真实世界的急性期针灸治疗特发性面神经麻痹：队列研究

Effect of acupuncture-moxibustion on idiopathic facial palsy at acute phase in the real world: a cohort study

【摘要】目的：比较急性期和恢复期介入针灸对特发性面神经麻痹（IFP）的影响。方法：根据是否在急性期内接受针灸干预将198例IFP患者分为早期针灸组（118例）和非早期针灸组（80例），经倾向性评分匹配（PSM），最终早期针灸组与非早期针灸组各纳入70例。在西医常规治疗基础上，两组均接受针灸治疗，早期针灸组于急性期（病程≤7 d）介入针灸，非早期针灸组于恢复期（病程>7 d）介入针灸。急性期予温针灸治疗，穴取患侧翳风、下关、合谷、足三里；恢复期予电针治疗，穴取患侧攒竹、丝竹空、阳白等，予疏密波，频率2 Hz/100 Hz。均每次30 min，隔日1次，每周3次，共治疗4周。比较两组患者治疗前、治疗1周和治疗4周后House-Brackmann（H-B）面神经功能分级、Sunnybrook面神经功能评分和面部残疾指数（FDI）评分。并于治疗1、4周后评定两组临床疗效和安全性。结果：治疗1、4周后，两组患者H-B面神经功能分级均较治疗前改善（P<0.05）；治疗4周后，早期针灸组H-B面神经功能分级优于非早期针灸组（P<0.05）。治疗1、4周后，两组患者Sunnybrook面神经功能评分、躯体功能评定（FDIP）评分较治疗前升高（P<0.05）；治疗4周后，早期针灸组Sunnybrook面神经功能评分、FDIP评分升高幅度大于非早期针灸组（P<0.05）。治疗4周后，两组社会生活功能评定（FDIS）评分较治疗前降低（P<0.05）。治疗4周后，早期针灸组总有效率（97.1%，68/70）高于非早期针灸组（87.1%，61/70，P<0.05）。两组不良事件发生率比较差异无统计学意义（P>0.05）。结论：在急性期介入针灸较恢复期介入针灸更有利于IFP患者受损面神经功能康复。

【Abstract】Objective To compare the effect of acupuncture-moxibustion on idiopathic facial palsy (IFP) at acute phase and recovery phase. Methods According to whether received acupuncture-moxibustion at acute phase or not, 198 IFP patients were divided into an early-phase intervention group (118 cases) and anon-early-phase intervention group (80 cases). With the propensity score matching employed, 70 cases were included in each group. On the basis of the conventional treatment of western medicine, acupuncture-moxibustion was supplemented in the two groups. In the early-phase intervention group, acupuncture-moxibustion was delivered at the acute phase (duration of illness ≤7 days); in the non-early-phase intervention group, acupuncture-moxibustion was operated at the recovery phase (duration of illness > 7 days). At the acute phase, warm needling was performed at Yifeng (TE 17), Xiaguan (ST 7), Hegu (LI 4) and Zusanli (ST 36) on the affected side; and at the recovery phase, electroacupuncture was delivered at Cuanzhu (BL 2), Sizhukong (TE 23) and Yangbai (GB 14), etc. on the affected side, with the disperse-dense wave and 2 Hz/100 Hz of frequency. The intervention was operated for 30 min each time, once every two days, three treatments weekly and for 4 weeks. Before treatment, 1 week and 4 weeks of treatment, the House-Brackmann (H-B) facial nerve function grade, the score of Sunnybrook facial nerve function, and the score of facial disability index (FDI) were compared between the two groups. The clinical effect in 1 and 4 weeks of treatment and safety were evaluated. Results In 1 and 4 weeks of treatment, the H-B grade was improved when compared with that before treatment in each group (P<0.05), and in 4 weeks of treatment, H-B grade in the early-phase intervention group was superior to that of the non-early-phase intervention group (P<0.05). In 1 and 4 weeks of treatment, Sunnybrook scores and the scores of physical function of FDI were elevated in comparison with those before treatment in the two groups (P<0.05); and in 4 weeks of treatment, the elevation of these two indexes in the early-phase intervention group was greater than that of the non-early-phase intervention group (P<0.05). In 4 weeks of treatment, the scores of social function in FDI were reduced when compared with those before treatment in the two groups (P<0.05). In 4 weeks of treatment, the total effective rate (97.1%, 68/70) in the early-phase intervention group was higher than that (87.1%, 61/70) of the non-early-phase intervention group (P<0.05). There was no significant difference in the incidence of adverse events between the two groups (P>0.05). Conclusion Acupuncture-moxibustion therapy starting at the acute phase is more beneficial to the functional recovery of the impaired facial nerve than at the recovery phase in the IFP patients.

05

电针调控下丘脑LKB1/AMPK信号通路对肥胖小鼠白色脂肪棕色化的影响

Electroacupuncture intervention promotes browning of white adipose tissue by regulating LKB1/AMPK pathway in obese mice

【摘要】目的：观察电针对肥胖小鼠下丘脑肝激酶B1（LKB1）/腺苷酸活化蛋白激酶（AMPK）信号通路、交感神经活性及白色脂肪棕色化的调控作用，探索电针促进白色脂肪组织棕色化减轻肥胖的中枢机制。方法：C57BL/6J小鼠随机分为正常组（8只）和造模组（30只），采用高脂饮食喂养建立肥胖小鼠模型。造模成功的16只小鼠随机分为模型组和电针组，每组各8只。电针组选取双侧“足三里”“天枢”电针治疗，30 min/次，5次/周，共治疗4周。观察治疗前后各组小鼠体质量并计算Lee’s指数；ELISA法测定空腹血清甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、去甲肾上腺素（NE）含量；称量腹部白色脂肪组织质量，采用苏木精-伊红染色法观察各组小鼠腹部白色脂肪组织形态改变；实时荧光定量PCR法检测小鼠下丘脑LKB1、AMPK及腹部脂肪组织过氧化物酶体增殖物激活受体γ共激活因子1α（PGC-1α）、解偶联蛋白-1（UCP1）、过氧化物酶体增殖物激活受体γ（PPAR-γ）、β3-肾上腺素能受体（β3-AR）mRNA表达；Western blot法检测小鼠下丘脑LKB1、AMPK和腹部白色脂肪组织PGC-1α、UCP1、PPAR-γ、β3-AR的蛋白表达。结果：与正常组比较，模型组小鼠体质量，Lee’s指数，血清TC、TG、LDL-C含量升高（P<0.01），HDL-C含量降低（P<0.01），腹部白色脂肪组织质量增加（P<0.01），腹部白色脂肪组织脂肪细胞直径明显增大、单位面积细胞数目减少，血清NE含量及白色脂肪组织β3-AR、PGC-1α、UCP1、PPAR-γ的mRNA和蛋白表达降低（P<0.01），下丘脑LKB1、AMPK的mRNA和蛋白表达升高（P<0.01）。与模型组比较，电针组小鼠体质量，Lee’s指数，血清TC、TG、LDL-C含量均显著降低（P<0.01），HDL-C含量升高（P<0.01），白色脂肪组织质量减少（P<0.01），腹部白色脂肪组织脂肪细胞直径减小、单位面积细胞数目增加，血清NE含量及白色脂肪组织β3-AR、PGC-1α、UCP1、PPAR-γ的mRNA和蛋白表达升高（P<0.01），下丘脑LKB1、AMPK的mRNA和蛋白表达降低（P<0.01）。结论：电针可以降低肥胖小鼠体质量、Lee’s指数，调节肥胖小鼠血脂水平，减轻腹部白色脂肪组织质量，其机制可能与通过调节下丘脑LKB1/AMPK信号通路，激活脂肪组织交感神经活性，促进白色脂肪棕色化有关。

【Abstract】Objective To observe the effect of electroacupuncture (EA) on hypothalamic liver kinase B1 (LKB1)/AMP-activated protein kinase (AMPK) signaling pathway, sympathetic nerve activity and browning of white adipose tissue (WAT) in obese mice, so as to explore the possible central mechanisms of EA in improving obesity. Methods C57BL/6J male mice were divided into normal group (n=8) and high fat diet group (n=30) randomly, and fed by normal diet and high fat diet for 8 weeks, respectively. In the high fat diet group, mice with body weight over 20% heavier than that of the normal group were considered as obese mice. The obese mice were divided into model and EA groups (n=8 in each group). Mice in the EA group were treated with EA (2 Hz/15 Hz, 1 mA, 3 mm needling depth) at “Zusanli” (ST36) and “Tianshu” (ST25) for 30 min, 5 times a week for 4 weeks. The mice’s body weight and length were measured for calculating the Lee’s index. The contents of serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and noradrenaline (NE) were detected by ELISA. The weight of abdominal white adipose tissue was weighed, and the morphological changes of abdominal adipose tissue were observed by HE staining. The mRNA and protein expression levels of LKB1 and AMPK in hypothalamus, peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α), uncoupling protein-1 (UCP1), peroxisome proliferator-activated receptor γ (PPAR-γ) and β3-adrenergic receptor (β3-AR) in abdominal white adiposetissue were detected by real-time fluorescence quantitative PCR and Western blot, respectively. Result Compared with the normal group, the body weight, Lee’s index, serum contents of TC, TG and LDL-C, abdominal WAT mass, hypothalamus LKB1, AMPK mRNA and protein expression were increased (P<0.01), while serum HDL-C and NEcontents, mRNA and protein expression of β3-AR, PGC-1α, UCP1 and PPAR-γ in adipose tissue were decreased (P<0.01) in the model group. The diameter of adipocytes in abdominal WAT was significantly increased, and the number of cells per unit area was decreased in the model group. Following EA intervention, the body weight, Lee’s index, serum contents of TC, TG and LDL-C, abdominal WAT mass, hypothalamus LKB1, AMPK mRNA and protein expression were decreased (P<0.01), while the serum HDL-C and NE contents, mRNA and protein expression of β3-AR, PGC-1α, UCP1 and PPAR-γ were increased (P<0.01). The diameter of adipocytes in abdominal WAT was decreased and the number of cells per unit area was increased in the EA group. Conclusion EA can reduce the body weight and Lee’s index in obese mice, regulate blood lipids, and reduce the weight of abdominal WAT, which may be closely related to its effect in regulating the hypothalamic LKB1/AMPK signaling pathway, activating the adipose tissue sympathetic nerve activity, and promoting the browning of WAT.

06

基于转录组学技术探讨基底外侧杏仁核参与电针治疗癌痛及其诱发的抑郁情绪的分子机制

Molecular mechanism of basolateral amygdala involved in electroacupuncture-induced amelioration of cancer pain and concomitant depression based on transcriptomics techniques

【摘要】目的：观察电针对癌痛模型小鼠疼痛及其诱发的抑郁情绪的影响，采用转录组学技术从基因层面探讨基底外侧杏仁核（BLA）参与癌痛多维度调节效应的分子机制。方法：将C57BL/6小鼠分为假手术组、模型组、电针组，每组10只。于股骨内注射含有Lewis肺癌细胞的PBS悬液建立骨癌痛模型。电针组小鼠在造模后第10天开始进行电针干预“足三里”“三阴交”，每日1次，每次20 min，连续干预12 d。采用X线和HE染色观察荷瘤股骨远端骨质损伤情况；von Frey检测小鼠机械性痛阈值变化；糖水偏好实验和强迫游泳实验观察小鼠抑郁情绪；提取小鼠BLA组织RNA建库，转录组学测序筛选差异基因并进行生物信息学分析；实时荧光定量PCR检测差异表达基因肿瘤坏死因子超家族8（Tnfsf8）、骨髓基质细胞抗原1（Bst1）、前强啡肽原（Pdyn）、电压门控钠离子通道β4（Scn4b）mRNA表达水平。结果：X线和HE染色可见小鼠股骨远端显著骨质损伤。与假手术组比较，模型组小鼠造模后第1、4、7、10、14、21天机械性痛阈值显著降低（P<0.001，P<0.000 1），糖水偏好指数显著降低（P<0.001），强迫游泳不动时间显著延长（P<0.001）。与模型组比较，电针组小鼠造模后第14、21天机械痛阈值显著升高（P<0.000 1），糖水偏好指数显著升高（P<0.05），强迫游泳不动时间显著缩短（P<0.01）。与假手术组比较，模型组小鼠BLA共筛选出404条差异基因，与模型组比较，电针组小鼠BLA共筛选出329条差异基因，其中在模型组表达上调而在电针组下调的基因共45条，在模型组表达异常上调而被电针干预下调的基因共28条。将筛选的差异表达基因进行基因本体（GO）注释和京都基因组百科全书（KEGG）通路分析，GO注释结果显示上述差异基因主要功能富集在与神经炎性反应相关的配体受体活性、细胞因子受体结合及细胞因子活性，以及与神经元兴奋相关的神经肽信号通路、钙离子介导的信号传导等方面；KEGG通路分析显示差异基因主要富集在与炎性反应相关的通路如白细胞介素-17通路等。模型组Tnfsf8、Bst1 mRNA的表达较假手术组显著升高（P<0.01，P<0.05），电针组较模型组显著下降（P<0.01，P<0.05）；模型组Pdyn、Scn4b mRNA的表达较假手术组显著下降（P<0.01），电针组较模型组显著升高（P<0.05，P<0.01），实时荧光定量PCR结果与基因测序结果变化趋势相一致。结论：电针可以显著缓解癌痛及其诱发的抑郁样情绪，其机制可能与模型动物BLA内神经炎性反应的缓解及特定神经元的异常活动的恢复有关。

【Abstract】Objective To observe the effect of electroacupuncture (EA) of “Zusanli” (ST 36) and “Sanyinjiao” (SP 6) on cancer pain and concomitant negative emotion in cancer pain model mice, and to explore its molecular mechanisms in the basolateral amygdala (BLA) by using transcriptomics techniques. Methods C57BL/6 mice were randomized into sham operation, model and EA groups, with 10 mice in each group. The cancer pain model was established by injecting PBS suspension containing Lewis lung cancer cells into the femur. The mice in the EA group received EA stimulation (1 mA, 2 Hz) on ST 36 and SP 6 from the 10th day after modeling, 20 min per day for 12 successive days. The bone damage of the distal femur was observed with X-ray and H.E. staining, respectively. The mechanical pain threshold (MPT) was detected by using von Frey. The depression-like behavior was detected by using sucrose-preference test (sucrose preference index in 12 h), and the immobility (feeling of despair) duration of forced swimming within 4 min. The BLA tissue was extracted for RNA sequencing (RNA library construction, and screening differential gene profiling by transcriptomic sequencing) and bioinformatics analysis. The real-time PCR was used to validate the mRNA expression of differentially expressed genes: tumor necrosis factor superfamily 8 (Tnfsf8), bone marrow stromal cell antigen 1 (Bst1), prodynorphin (Pdyn) and voltage-gated sodium channelβ4 (Scn4b). Results H.E. staining and X-ray showed significant bone damage in the distal femur in cancer pain mice. In contrast to the sham operation group, the MPT on the 1st, 4th,7th, 10th, 14th and 21st day after modeling and sucrose preference index were significantly decreased (P<0.001, P<0.000 1), and the immobility time of the forced swimming was considerably increased in the model group (P<0.001). In contrast to the model group, the MPT values on the 14th and 21st day and sucrose preference index were obviously increased (P<0.000 1, P<0.05), and the immobility time was strikingly decreased in the EA group (P<0.01). RNA sequencing showed that a total of 404 differentially expressed genes (205 up-regulated, 199 down-regulated) were screened in the model group compared with the sham operation group, and a total of 329 differentially expressed genes (206 up-regulated and 123 down-regulated) were screened in the EA group compared with the model group. Venn diagram analysis of the differentially expressed genes showed that 45 up-regulated and 28 down-regulated genes in the model group were completely reversed by EA. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of the screened differentially expressed genes revealed that the above differential genes were mainly enriched in the ligand receptor activity, cytokine receptor binding, and cytokine activity related to neuro-inflammation, as well as in neuropeptide signaling pathways related to neuronal excitability, and calcium ion mediated signal transduction. The analysis of KEGG pathway showed that the differentially expressed genes were mainly enriched in the inflammation-related pathways, such as interleukin-17 pathway. Validation analysis of the differentially expressed genes showed that the expression levels of Tnfsf8 and Bst1 were significantly up-regulated in the model group compared with the sham operation group (P<0.01, P<0.05), and down- regulated by EA (P<0.01, P<0.05), while the expression levels of Pdyn and Scn4b were down-regulated in the model group in comparison with the sham operation group (P<0.01), and up-regulated by EA (P<0.05, P<0.01), which was consistent with the changing trend of the gene sequencing results. Conclusion Acupuncture of ST36 and SP6 can significantly relieve cancer pain and concomitant negative emotion in cancer pain mice, which may be related to its functions in alleviating neuro-inflammation and relieving the abnormal activities of specific neurons in the BLA.

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