近5年推拿修复骨骼肌损伤的作用机制研究进展

Research progress on the mechanism of tuina in treating skeletal muscle injury in the past 5 years

关键词:  骨骼肌损伤  推拿  修复  作用机制

Key words:  skeletal muscle injury  tuina  repair regulation  mechanism

摘要:

牵拉伤、钝挫伤以及失神经支配损伤等常见损伤都可以造成骨骼肌的损害，若修复不完全则容易形成瘢痕，影响肌肉功能。骨骼肌损伤在中医学中属于“筋伤”的范畴，推拿作为传统治疗筋伤病的重要方式之一，在治疗骨骼肌损伤中有广泛的应用。近些年逐渐开展了关于推拿修复骨骼肌损伤机制的研究，通过文献总结，发现推拿可通过磷脂酰肌醇激酶（PI3K）、丝裂原活化蛋白激酶（MAPK）、Notch、Wnt及过氧化物酶体增殖因子活化受体（PPAR）信号通路对骨骼肌的修复产生影响。推拿以肌卫星细胞为重点，通过促进如成肌调节因子（MRFs）、胰岛素样生长因子-1（IGF-1）、碱性成纤维细胞生长因子（bFGF）等正向调节因子的表达，抑制如转化生长因子-β（TGF-β）、生长分化因子-8（GDF-8）、结缔组织生长因子（CTGF）等负向调节因子的表达，以及下调肿瘤坏死因子-α（TNF-α）及白细胞介素-6（IL-6）等炎性因子的浓度，来发挥促进肌纤维重塑、防止细胞外基质过度沉积、减轻炎症反应以及减缓骨骼肌纤维化的作用。除此之外，推拿还可以通过促进细胞合理自噬、修复细胞膜、调节氧化应激及脂肪代谢等反应促进组织修复。本文聚焦于推拿修复骨骼肌损伤的机制，以期为进一步研究提供参考。

Abstract:

Common injuries such as traction，blunt trauma，and innervation injuries can cause damage to skeletal muscle. Incomplete repair is prone to scar formation，affecting muscle function. Skeletal muscle injury belongs to the category of “jinshang” in traditional Chinese medicine，and tuina，as one of the important ways of treating “jinshang”， is widely used in the treatment of skeletal muscle injury. In recent years，research on the mechanism of tuina in treating skeletal muscle injury has been widely conducted，and through the search of relevant literature，it is found that tuina can repair skeletal muscle injury through PI3K，MAPK，Notch，Wnt，and PPAR signaling pathways. Moreover，tuina focuses on muscle satellite cells，by promoting the expression of positive regulators such as myogenic regulatory factors，insulin-like growth factor，and basic fibroblast growth factor，inhibiting the expression of negative regulators such as transforming growth factor-β，growth differentiation factor-8，connective tissue growth factor，and downregulating the concentration of inflammatory factors such as tumor necrosis factor and interleukin-6，to promote muscle fiber remodeling，prevent excessive deposition of extracellular matrix，reduce inflammatory response and slow down skeletal muscle fibrosis. In addition，tuina can also promote tissue repair by promoting rational autophagy，repairing cell membranes，regulating oxidative stress，and fat metabolism. This article focuses on the repair mechanism of tuina in the treatment of skeletal muscle injury，to provide a reference for further research.