ZHAO Suhong,WU Zhiwei,ZHU Qingguang,et al.Neuroplasticity‑based new interpretation of "external treatment inducing internal response" in tuina analgesia[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(9):27-31.
ZHAO Suhong,WU Zhiwei,ZHU Qingguang,et al.Neuroplasticity‑based new interpretation of "external treatment inducing internal response" in tuina analgesia[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(9):27-31. DOI: 10.16305/j.1007-1334.2025.z20250314003.
Neuroplasticity‑based new interpretation of "external treatment inducing internal response" in tuina analgesia
Chronic pain is a global health issue, and the development of integrated multidisciplinary management models has become widely accepted. The external treatment of pain with traditional Chinese medicine (TCM) tuina has demonstrated definite efficacy and a solid theoretical foundation, while the underlying mechanisms of its "internal response" therapeutic effects remain unclear. This gap has hindered the international promotion and application of tuina. Recent studies have identified molecular changes in somatic pain neural pathways as local "internal response" targets for tuina analgesia. However, these findings do not fully capture the integrative, coordinated mechanism guided by the holistic approach of TCM. Modern medicine acknowledges the significant role of neural plasticity in the initiation and maintenance of chronic pain, which shares common ground with the overall regulatory effects of tuina. By reviewing the origins and modern interpretations of the "external treatment inducing internal response" theory, this paper systematically explores the global mechanism of tuina analgesia from the perspective of neuroplasticity. The results show that tuina can modulate the neuroplasticity within the "spinal cord-brainstem-brain" pain network, providing scientific evidence for the "external treatment inducing internal response" theory in tuina analgesia.
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GBD 2021 Forecasting Collaborators . Burden of disease scenarios for 204 countries and territories, 2022-2050: a forecasting analysis for the Global Burden of Disease Study 2021 [J]. Lancet , 2024 , 403 ( 10440 ): 2204 - 2256 .
COHEN S P , VASE L , HOOTEN W M . Chronic pain: an update on burden,best practices, and new advances [J]. Lancet , 2021 , 397 ( 10289 ): 2082 - 2097 .
BANNISTER K , SACHAU J , BARON R , et al . Neuropathic pain: Mechanism-based therapeutics [J]. Annu Rev Pharmacol Toxicol , 2020 , 60 : 257 - 274 .
LIU Z F , WANG H R , YU T Y , et al . Tuina for peripherally-induced neuropathic pain: A review of analgesic mechanism [J]. Front Neurosci , 2022 , 16 : 1096734 .
SCHOLZ J , FINNERUP N B , ATTAL N , et al . The IASP classification of chronic pain for ICD-11:chronic neuropathic pain [J]. Pain , 2019 , 160 ( 1 ): 53 - 59 .
WANG L H , DING W Q , SUN Y G . Spinal ascending pathways for somatosensory information processing [J]. Trends Neurosci , 2022 , 45 ( 8 ): 594 - 607 .
MARZOLA P , MELZER T , PAVESI E , et al . Exploring the role of neuroplasticity in development,aging,and neurodegeneration [J]. Brain Sci , 2023 , 13 ( 12 ): 1610 .
GONZALEZ K C , NEGREAN A , LIAO Z , et al . Synaptic basis of feature selectivity in hippocampal neurons [J]. Nature , 2025 , 637 ( 8048 ): 1152 - 1160 .
MCCARBERG B , PEPPIN J . Pain pathways and nervous system plasticity:Learning and memory in pain [J]. Pain Med , 2019 , 20 ( 12 ): 2421 - 2437 .
LIU Y , LIU Q , WANG H , et al . Hippocampal synaptic plasticity injury mediated by SIRT1 downregulation is involved in chronic pain-related cognitive dysfunction [J]. CNS Neurosci Ther , 2024 , 30 ( 2 ): e14410 .
XIE R G , CHU W G , LIU D L , et al . Presynaptic NMDARs on spinal nociceptor terminals state-dependently modulate synaptic transmission and pain [J]. Nat Commun , 2022 , 13 ( 1 ): 728 .
CHEN Q Y , LI X H , ZHUO M . NMDA receptors and synaptic plasticity in the anterior cingulate cortex [J]. Neuropharmacology , 2021 , 197 : 108749 .
HIRAGA S I , ITOKAZU T , NISHIBE M , et al . Neuroplasticity related to chronic pain and its modulation by microglia [J]. Inflamm Regen , 2022 , 42 ( 1 ): 15 .
KOUROSH-ARAMI M , KOMAKI A . Reciprocal interaction of pain and brain: Plasticity-induced pain, pain-induced plasticity, and therapeutic targets [J]. CNS Neurol Disord Drug Targets , 2023 , 22 ( 10 ): 1484 - 1492 .
LEE J A , CHEN Q , ZHUO M . Synaptic plasticity in the pain-related cingulate and insular cortex [J]. Biomedicines , 2022 , 10 ( 11 ): 2745 .
SZYMONIUK M , CHIN J H , DOMAGALSKI Ł , et al . Brain stimulation for chronic pain management:a narrative review of analgesic mechanisms and clinical evidence [J]. Neurosurg Rev , 2023 , 46 ( 1 ): 127 .
SACHULA , YANG Z , YU T , et al . Exploring the mechanism of immediate analgesia induced by tuina intervention on minor chronic constriction injury in rats using LC-MS [J]. J Pain Res , 2024 , 17 : 321 - 334 .
ISENBURG K , MAWLA I , LOGGIA M L , et al . Increased salience network connectivity following manual therapy is associated with reduced pain in chronic low back pain patients [J]. J Pain , 2021 , 22 ( 5 ): 545 - 555 .
MA S J , ZHANG J P , HUA X Y , et al . Tuina therapy promotes behavioral improvement and brain plasticity in rats with peripheral nerve injury and repair [J]. Brain Behav , 2023 , 13 ( 9 ): e3174 .
WU Z , GUO G , ZHANG Y , et al . Resting-state functional magnetic resonance imaging reveals brain remodeling after Tuina therapy in neuropathic pain model [J]. Front Mol Neurosci , 2023 , 16 : 1231374 .
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