脑卒中后运动功能障碍（PSMD）是重大公共卫生问题，针刺遵循“治痿独取阳明”原则治疗PSMD疗效确切，但其现代神经机制尚未阐明。本文基于“经穴-督脉-脑神-形体”理论框架，结合现代神经解剖学与康复医学研究，认为阳明经穴的针刺效应可能与其局部感受器富集、体表分布广泛的解剖特征相关。在此基础上，提出“外周-中枢-外周”闭环调控假说：针刺阳明经穴通过浅表躯体感觉、深层本体感觉及躯体-内脏反射三重通路激活感觉传入，经“感觉传入-脊髓传导-皮层重塑”自下而上修复中枢功能，再经下行通路调控外周效应器，形成闭环，从而改善PSMD。该假说将传统经络理论与现代神经科学相结合，以期为针刺整体调控机制的研究提供新视角。

Post-stroke motor dysfunction (PSMD) is a major public health problem. Acupuncture following the principle of “Yangming is essential for treating Wei syndrome” has definite efficacy in treating PSMD, yet its modern neural mechanisms remain to be elucidated. Based on the theoretical framework of “Meridian-Acupoint-Governor Vessel-Brain Spirit-Body Form” and drawing on research in modern neuroanatomy and rehabilitation medicine, this study suggests that the acupuncture effects of Yangming meridian acupoints may be related to their anatomical characteristics of local receptor enrichment and extensive distribution on the body surface. On this basis, we propose the “peripheral-central-peripheral” closed-loop regulation hypothesis: acupuncture at Yangming meridian acupoints activates sensory afferents through three pathways-superficial somatic sensation, deep proprioception, and somatic-visceral reflex-restores central function in a bottom-up manner via “sensory afferent-spinal cord conduction-cortical remodeling,” and then regulates peripheral effectors through descending pathways to form a closed loop, thereby improving PSMD. This hypothesis combines traditional meridian theory with modern neuroscience, aiming to provide a new perspective for research on the overall regulatory mechanism of acupuncture.

国家自然科学基金青年项目；福建省科技创新联合资金项目；福建省卫生健康中青年领军人才研修培养项目