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以愉悦触觉通路为核心切入点，系统探讨其在推拿疗法中的关键中介作用。推拿缓慢而温和的机械刺激能够特异性激活C-触觉纤维，诱发愉悦触觉感受，这一过程通过脑岛、前扣带皮质及眶额皮质等核心脑区网络，实现奖赏效应加工、情绪状态调节及体感信息整合等多重作用；推拿可重塑默认模式网络与边缘系统情绪网络之间的功能连接模式，有效调控中枢感知系统与情绪反应通路的协同作用。推拿通过双向调节自主神经系统，优化下丘脑-垂体-肾上腺轴对刺激的反应，避免其过度应激，最终促进神经、免疫、内分泌三大系统功能的整体协调。推拿疗法“脑-身”一体化的双向调节特征，不仅为传统手法治疗的现代科学阐释提供了理论依据，也为推拿疗法的精准化应用奠定了机制基础。
Abstract：Based on pleasant touch feeling pathway, this paper systematically explores the key mediating role of the pleasant tactile pathway in Tuina. Gentle and slow mechanical stimulation during Tuina can specifically activate C-tactile afferent fibers, eliciting sensations of pleasant touch. This process engages core brain regions, including the insula, anterior cingulate cortex, and orbitofrontal cortex, to process reward effects, regulate emotional states, and integrate somatosensory information. Tuina can further reshape the functional connectivity between the default mode network and the limbic emotional network, effectively modulating the coordination between central sensory systems and emotional response pathways. Through bidirectional regulation of the autonomic nervous system, Tuina optimizes the responsiveness of the hypothalamic-pituitary-adrenal axis, preventing overstress and promoting overall coordination among the neural, immune, and endocrine systems. The brain-body bidirectional regulatory feature of Tuina provides a modern scientific explanation for traditional manual therapy and lays a mechanistic foundation for its precise application.
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基本信息:
DOI：10.13288/j.11-2166/r.2025.21.001
中图分类号:R244.1
引用信息:
[1]李景虎,张帅攀,周鑫,等.愉悦触觉介导推拿起效机制的理论探析[J].中医杂志,2025,66(21):2185-2190.DOI:10.13288/j.11-2166/r.2025.21.001.
基金信息:
上海市筋骨病中医推拿技术重点实验室（24dz2260200）; 国家自然科学基金（82474672,82030121）; 上海市进一步加快中医药传承创新发展三年行动计划（2025-2027年）[ZY(2025-2027)-3-1-1]