神阙穴干预对脑肠轴功能影响的系统评价与 Meta 分析及机制探讨

子正 黄(北京市羊坊店医院康复科，中国)

摘要

系统评价神阙穴干预（针灸、艾灸、穴位贴敷）对脑肠轴功能的调节效应。方法：纳入23项随机对照试验及队列研究，采用Meta分析整合胃肠激素、肠道菌群及症状缓解率等指标数据。结果：神阙穴干预显著提高消化促进性激素水平改善率（RR=1.23，95%CI 1.08-1.40）、有益菌丰度改善率（RR=1.15，95%CI 1.02-1.30）及症状缓解率（RR=1.18，95%CI 1.05-1.33）。亚组分析显示针灸组在神经内分泌调节方面优势显著，艾灸组对肠道微生态重建突出，穴位贴敷组在症状管理上更佳。红外热成像分析发现干预后局部温度升高与胃泌素浓度呈正相关（r=0.47，P=0.002），皮质醇水平下降17.5%。敏感性分析与Egger检验提示结论稳健。结论：神阙穴干预可通过多靶点调节脑肠轴功能，研究初步提出”穴位热效应-神经内分泌调控-肠屏障功能”三联假说框架，为中医特色疗法的循证转化提供依据。

关键词

神阙穴干预；脑肠轴功能；Meta分析；胃肠激素；肠道菌群

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DOI: http://dx.doi.org/10.12345/yzlcyxzz.v9i5.39826