伏隔核中慢性疼痛与负面情绪共病的神经与针刺机制研究进展*

Research progress on the neural and acupuncture mechanisms of chronic pain and negative emotions comorbidity in the nucleus accumbens*

摘要:

慢性疼痛常伴随焦虑、抑郁等负面情绪障碍。这些负面情绪又反过来加剧疼痛敏感性，形成疼痛-负面情绪-疼痛加重的恶性循环。在慢性疼痛状态下，NAc会发生结构与功能的改变，这表明该区域可能通过特定神经机制参与疼痛调控过程。针灸能有效缓解疼痛并改善与疼痛相关的负面情绪，其作用机制与针刺对特定NAc神经环路的调控密切相关。本文首先综述NAc的生理功能，继而从神经回路与分子信号角度总结NAc在慢性疼痛及相关负面情绪中的病理机制。随后阐述针灸通过作用于NAc神经回路治疗慢性疼痛及相关负面情绪的机制，旨在为针灸治疗慢性疼痛及相关负面情绪的未来研究与应用提供理论依据。

Abstract:

Chronic pain is frequently accompanied by negative emotional disorders such as anxiety and depression. These negative emotions in turn exacerbate pain sensitivity, forming a vicious cycle of pain-negative emotions-pain intensification. Under chronic pain conditions, structural and functional alterations occur within the NAc, suggesting this region may participate in pain regulation through specific neural mechanisms. Acupuncture effectively alleviates pain and improves pain-related negative emotions, with its mechanism closely linked to the regulation of specific NAc neural circuits by needle stimulation. This paper first reviews the physiological functions of the NAc, then summarises its pathological mechanisms in chronic pain and associated negative emotions from the perspectives of neural circuits and molecular signalling. Subsequently, it elucidates the mechanisms by which acupuncture treats chronic pain and related negative emotions by acting on NAc neural circuits, aiming to provide a theoretical basis for future research and applications of acupuncture in managing chronic pain and associated negative emotions.