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针灸治疗桥本甲状腺炎作用机制及临床研究进展
姚 远,马俊杰,杨 潇,王智民,金 哲,刘子玉,陈怡然,马铁明
0
(1.辽宁中医药大学,辽宁 沈阳,110847;2.辽宁中医药大学附属第二医院,辽宁 沈阳,110034;3.辽宁中医药大学附属医院,辽宁 沈阳,110032)
摘要:
系统梳理近年来针灸干预桥本甲状腺炎(hashimoto’s thyroiditis, HT)的相关研究,总结其作用机制与临床研究进展。机制方面,针灸主要通过调控下丘脑-垂体-甲状腺轴功能、调节肠道菌群平衡、纠正细胞免疫失衡、延缓细胞凋亡等多途径发挥作用,但部分机制仍缺乏直接实验验证;临床应用方面,针灸干预形式丰富,单纯针刺或针刺联合推拿、中药、西药、艾灸等疗法,均能有效改善患者临床症状及甲状腺功能,且疗效优于单纯西药治疗。目前该领域仍存在机制研究不深入、临床研究方法学质量偏低、可重复性不足等问题,未来需开展大样本、多中心规范研究,深化作用机制探索,建立可推广的针灸诊疗标准。
关键词:  桥本甲状腺炎  针灸疗法  中西医结合疗法  作用机制  临床研究  综述
DOI:
Mechanism of action of acupuncture in treatment of Hashimoto’s thyroiditis and clinical research advances
YAO Yuan,MA Junjie,YANG Xiao,WANG Zhimin,JIN Zhe,LIU Ziyu,CHEN Yiran,MA Tieming
(1. Liaoning University of Traditional Chinese Medicine, Shenyang 110847, Liaoning, China;2. The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110034, Liaoning, China;3. The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110032, Liaoning, China)
Abstract:
This article systematically reviews the recent studies on acupuncture for the treatment of Hashimoto’s thyroiditis (HT) and summarizes the advances in its mechanism of action and related clinical studies. As for the mechanisms, acupuncture exerts an effect through multiple pathways, including regulating the function of the hypothalamic-pituitary-thyroid axis, modulating intestinal flora balance, correcting cellular immune imbalance, and delaying cell apoptosis; however, there is still a lack of direct experimental verification for some mechanisms. In terms of clinical application, there are various forms of acupuncture interventions, such as acupuncture alone or in combination with massage, Chinese herbal medicine, Western medicine, and moxibustion, and these methods can effectively improve clinical symptoms and thyroid function, with a better clinical effect than Western medicine treatment alone. At present, there are still challenges such as insufficient depth in mechanistic research, low methodological quality in clinical studies, and inadequate reproducibility in this field, and large-scale multi-center standardized studies should be conducted in the future to deepen the exploration of mechanisms and establish the standards for acupuncture diagnosis and treatment.
Key words:  Hashimoto’s thyroiditis  acupuncture therapy  integrated traditional Chinese and Western medicine therapy  mechanism of action  clinical research  review

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