Research progress on central mechanism of acupuncture treatment for chronic fatigue syndrome

针刺调控慢性疲劳综合征中枢机制研究进展

Bin-bin LI（李彬彬）a，Chu-wen FENG（冯楚文）a,b，Yuan-yuan QU（屈媛媛）a，Zhong-ren SUN（孙忠人）c，Tao CHEN（陈涛）a，Yu-lin WANG（王玉琳）d，Qing-yong WANG（王庆勇）a，Jing LU（鲁菁）a，Yu-ying SHAO（邵玉莹）a，Tian-song YANG（杨添淞）b,c

a Graduate School of Heilongjiang University of Chinese Medicine, Harbin 150040, China (黑龙江中医药大学研究生学院，哈尔滨 150040，中国)

b Department of Acupuncture-Moxibustion, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China (黑龙江中医药大学附属第一医院针灸科，哈尔滨 150040，中国)

c Heilongjiang key Laboratory of Clinical (Encephalopathy) Neurobiology of Acupuncture and Moxibustion, Harbin 150040, China (黑龙江针灸临床（脑病）神经生物学省重点实验室，哈尔滨 150040，中国)

d Department of Acupuncture-Moxibustion, Second Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150001, China (黑龙江中医药大学附属第二医院针灸科，哈尔滨 150001，中国)

摘要：

慢性疲劳综合征是一种以长期、休息后无法缓解的疲劳为特征的神经系统疾病。受新冠病毒疫情影响，该病患者愈发增多。针刺治疗慢性疲劳综合征疗效显著，但作用机制尚不明确。本文从实验室检验和神经影像两类研究方法总结慢性疲劳综合征患者异常中枢机制的具体表现。通过实验室检验研究发现，慢性疲劳综合征患者存在额叶皮层、丘脑等脑组织结构改变；脑脊液中IFN-α、IL-10等因子异常；氧化和亚硝化应激以及下丘脑激素水平、神经递质含量等神经生化物质改变。通过神经影像研究发现，基于磁共振成像和正电子发射断层扫描探究表明，慢性疲劳综合征患者部分脑区存在灰质和白质体积减少的脑形态学变化；灌注减少的脑血流变化；连接异常的脑功能活动变化,此外还存在葡萄糖代谢明显减退；神经炎症反应；5-羟色胺能、胆碱能、谷氨酸能和γ-氨基丁酸能神经递质代谢紊乱。并阐述针刺对慢性疲劳综合征模型动物以上中枢异常改变的调控作用，分析进一步发展方向，为今后探讨针刺如何调控慢性疲劳综合征中枢机制研究提供思路。

Abstract

Chronic fatigue syndrome is a neurological disorder characterized by extreme fatigue that lasts for a long time and doesn't alleviate with rest. The number of the cases has been increasing during the era of COVID-19 pandemic. Acupuncture may have some effect on chronic fatigue syndrome, but its mechanism remains unclear. This article was to summarize the specific manifestations of abnormal central mechanism in patients with chronic fatigue syndrome through laboratory tests and neuroimaging. It was found from the laboratory evaluation that there were changes in the structure of the frontal cortex, thalamus and other brain tissues; factors, including IFN-α and IL-10 in cerebrospinal fluid were found abnormal; results of oxidative and nitrosative stress and changes in neurobiochemical substances, e.g. hypothalamus hormone levels and neurotransmitter concentrations, were observed. With magnetic resonance imaging and positron emission tomography, it was shown that the partial brain of persons with chronic fatigue syndrome had morphological changes with diminished grey matter and white; changes in cerebral blood flow velocity caused by decreased perfusion and functional activity with abnormal connectivity in brain were detected. In addition, there was significant decrease in glucose metabolism accompanied with neuroinflammatory response; metabolic disorders of serotonergic, cholinergic, glutamatergic and γ-aminobutyric acid energy neurotransmitters were also discovered. The regulatory effect of acupuncture on the above central neurological abnormalities in chronic fatigue syndrome model animals was elaborated, and the direction for further research was analyzed in order to provide ideas for further research on the central mechanism of acupuncture treatment for chronic fatigue syndrome.