【摘要】 脑卒中是一种严重威胁人类健康的恶性脑血管事件，具有高发病率、高致残率、高病死率的特点，对脑卒中发病机制及有效治疗方法的探索是中西医研究的重点和难点。自噬作为真核细胞重要的分解代谢机制，在维持细胞内稳态、应对氧化应激、调节能量代谢等方面发挥关键作用。研究发现，自噬在脑卒中病程中具有双向调控作用：适度自噬有利于清除受损细胞器和蛋白质，维持能量稳态，发挥保护作用；过度或不足的自噬可能促发炎症反应和细胞死亡。此外，在不同的脑卒中病理时期，自噬的作用也存在动态变化。针灸是中国传统医学的瑰宝，已被证实在促进中枢神经系统疾病恢复方面发挥着显著的作用。针刺治疗脑卒中具有安全性高、疗效确切的优势。机制研究表明，针刺可以通过调控自噬关键蛋白，影响多个信号通路，既能促进自噬的正常激活，帮助细胞自我修复，又能抑制过度自噬，减少细胞死亡，从而实现神经保护和功能恢复。针刺对脑卒中的疗效与其动态调节自噬水平密切相关，这种调节作用并非简单的激活或抑制，而是基于疾病阶段、病理类型的对应调节。本文将系统综述自噬在脑卒中中的作用机制，总结针刺调控自噬治疗脑卒中的潜在作用，为针刺治疗脑卒中提供更丰富的理论支持。更多还原

【Abstract】 Stroke is defined as a severe malignant cerebrovascular event that poses a significant threat to human health. It is distinguished by a high incidence, high disability rate and high mortality rate. The exploration of the pathogenesis and effective treatment methods of stroke is a key and challenging focus of both traditional Chinese medicine and Western medicine research. Autophagy, a pivotal degradation and metabolic mechanism in eukaryotic cells, plays a crucial role in maintaining cellular homeostasis, responding to oxidative stress and regulating energy metabolism. Researchers have demonstrated that autophagy exhibits a bidirectional regulatory function in the context of stroke: moderate autophagy is beneficial for clearing damaged organelles and proteins, maintaining energy homeostasis, and exerting protective effects; however, excessive or insufficient autophagy may promote inflammatory responses and cell death. Furthermore, the role of autophagy exhibits dynamic variation across the various pathological stages of stroke. Acupuncture, a fundamental element of traditional Chinese medicine, has been demonstrated to play a substantial role in promoting recovery from central nervous system diseases. Among its advantages are high safety and proven therapeutic efficacy in the treatment of stroke. Mechanistic studies have demonstrated that acupuncture can regulate key autophagy proteins and affect multiple signaling pathways, thus promoting normal autophagy activation to aid cellular self-repair, while also inhibiting excessive autophagy to reduce cell death, achieving neuroprotection and functional recovery. The therapeutic effect of acupuncture on stroke is closely related to its dynamic regulation of autophagy levels. This regulatory process is not simply activation or suppression, but is tailored according to disease stages and pathological types. This review methodically summarizes the mechanisms of autophagy in stroke, and the potential role of acupuncture in regulating autophagy for stroke treatment, with the objective of providing more comprehensive theoretical support for acupuncture therapy in stroke.更多还原