Acupuncture, Inflammation, and the Circulatory System

The circulatory system is a continuous, closed network that reaches every part of the body. Modern research recognizes inflammation as a central pathological basis of atherosclerosis, hypertension, and many other circulatory diseases, as well as a major complicating factor that accelerates disease progression.

When cardiovascular tissues are injured or invaded by pathogens, necrotic cells release damage-associated molecular patterns (DAMPs). These DAMPs act on receptors such as toll-like receptors (TLRs) and nod-like receptors (NLRs), activating intracellular inflammasome signaling and initiating a strong innate immune response. This inflammatory cascade plays a key role in myocardial injury and structural remodeling of the heart.

1. Electroacupuncture at PC6 and Ventricular Function Protection

Experimental studies summarized in Table S1 of the cited paper show that electroacupuncture (EA) pretreatment at Neiguan (PC6) significantly improves ventricular remodeling associated with inflammation.

EA at PC6 has been shown to:

• Reduce myocardial infarct size
• Increase left ventricular fractional shortening (FS)
• Increase ejection fraction (EF)
• Improve overall ventricular remodeling and pump function

Mechanistically, EA at PC6 appears to modulate the balance of macrophage phenotypes in the heart and spleen:

• Inhibits activation of M1 macrophages in the myocardium and spleen
• Promotes M2 macrophage activation, shifting toward an anti-inflammatory, tissue-repairing state
• Suppresses activation of the NLRP3 inflammasome in M1 macrophages
• Reduces caspase-1 and IL-1β levels in myocardial tissue

Together, these changes help to reduce inflammatory damage to the heart and support structural and functional protection of the myocardium.

2. Broader Cardiovascular Effects of Acupuncture

Beyond direct modulation of inflammatory pathways, multiple lines of evidence suggest that acupuncture exerts a wide range of regulatory effects on the circulatory system by adjusting:

• Plasma proteins
• Blood ammonia levels
• Electrolyte balance
• Enzyme activities
• Other biologically active substances

Through these changes, acupuncture can:

• Regulate and improve vascular function
• Promote the formation of collateral vessels and neovascularization
• Enhance microcirculation
• Support ventricular function remodeling in a protective direction

3. Research Gaps: Inflammation-Focused Mechanisms Need More Study

Although clinical and experimental data strongly suggest that acupuncture can effectively treat circulatory system diseases, research that specifically focuses on inflammation-related mechanisms is still relatively limited.

Future studies that examine how acupuncture regulates innate immune activation, inflammasome signaling, cytokines, and macrophage phenotypes in cardiovascular disease will be essential for building a more complete mechanistic model of acupuncture’s cardioprotective effects.

循環系統是一個分布全身的連續封閉管道系統。 現代醫學已普遍認為，發炎是 動脈粥樣硬化、高血壓等多種心血管疾病的主要病理基礎之一，同時也是這些疾病 惡化過程中的重要併發因素。

當心血管組織受傷，或心血管系統遭受病原微生物入侵時，壞死細胞會釋放 DAMPs（損傷相關分子模式），進一步作用於 TLR（樣受體）與 NLR，啟動細胞內發炎小體 （inflammasome）訊號，進而引發強烈的先天免疫反應。 這一連串發炎級聯反應，在心肌損傷與心血管結構重塑中扮演關鍵角色。

一、內關（PC6）電針預處理對心室功能的保護

文獻（表格 S1）指出，電針內關（PC6）預處理，可以明顯改善與發炎相關的 心室功能重塑，並提升心臟收縮功能。

研究顯示，電針 PC6 可：

• 減少心肌梗塞面積
• 提高左心室縮短率（fractional shortening, FS）
• 提升射出分率（ejection fraction, EF）
• 改善心室重塑與整體泵血功能

在機制上，電針 PC6 似乎透過調節心肌與脾臟中的巨噬細胞極化狀態發揮作用：

• 抑制 M1 型巨噬細胞在心肌與脾臟中的活化
• 促進 M2 型巨噬細胞，偏向抗發炎與組織修復角色
• 抑制 NLRP3 發炎小體的啟動
• 降低心肌組織中的 caspase-1 與 IL-1β 表達

這些改變共同減少了心肌的發炎性損傷，有助於保護心肌結構與功能。

二、針灸在心血管與循環系統中的廣泛調節作用

除了直接影響發炎訊號外，許多研究也指出，針灸能調節多項與循環系統功能相關的 生化指標，包括：

• 血漿蛋白
• 血氨（blood ammonia）
• 電解質平衡
• 酵素活性
• 其他多種生物活性物質

透過這些調節，針灸可以：

• 改善血管功能
• 促進側支循環與新生血管（neovascularization）的形成
• 提升微循環
• 協助心室功能重塑往較健康的方向調整

三、研究缺口：發炎機轉仍有待深入

儘管現有實驗與臨床證據顯示，針灸對多種心血管與循環系統疾病具有明顯療效， 但從「調控發炎反應」這一角度，去系統性探討其作用機制的研究仍然相對不足。

未來若能進一步聚焦於針灸如何影響先天免疫啟動、發炎小體訊號、細胞激素網絡、 巨噬細胞極化等層面，將有助於建立更完整的心血管保護機轉模型， 也讓針灸在循環系統疾病中的應用更具科學說服力。