自主运动锻炼是神经退行性疾病的一支“神经保护剂”吗？证据来自临床及临床前研究

doi:10.12114/j.issn.1007-9572.2020.00.612

摘要/Abstract

摘要： 人口老龄化进程的持续加快凸显了神经退行性疾病（NDD）的严峻性。高发病率、高致残及致死率使这一全球公共卫生难题成为个人、家庭和医疗保健系统正在面临的最大社会和经济挑战之一。NDD至今仍没有特效的治疗及预防方案。越来越多的研究尝试在补充及替代医学领域（包括运动疗法）寻找潜在的防治策略。目前已有不少临床及临床前研究支持自主运动锻炼可能是一种适用于NDD及其他年龄相关性认知障碍的潜在“神经保护剂”，但对于这些研究证据尚缺乏系统的回顾及梳理。本文通过对大量高质量证据进行整理及评价，发现规律的自主运动锻炼可显著减缓正常生理及病理性衰老过程中的认知衰退，且这种效益可能是其抑制系统及神经炎症、增强神经可塑性、促进神经发生、减轻氧化应激损害、修复内皮功能损伤及改善胰岛素敏感性等多通路、协同作用的共同结果。

关键词: 自主运动锻炼, 神经变性疾病, 神经保护, 临床及临床前研究

Abstract: Continued acceleration of the aging population highlights the seriousness of neurodegenerative diseases （NDD）.With high morbidity，disability and mortality，this global public health problem is becoming one of the biggest social and economic challenges faced by individuals，families and healthcare systems.No specific treatment and prevention approaches are available for NDD.Increasing studies are trying to seek for potential preventive and management strategies from complementary and alternative medicine，including physical activity.Several clinical and preclinical studies currently support that autokinetic physical activity may be a potential 'neuroprotectant' for NDD and other age-related cognitive disorders，although there is a lack of comprehensive review of these evidence.Hence，this article reviews as well as evaluates a large amount of high-quality evidence，and finds regular autokinetic physical activity has shown critical potentials in slowing cognitive decline during normal and pathological aging，and this beneficial effect may be a multi-signaling pathway and interaction of exercise-induced inhibition of systemic- and neuro- inflammation，enhancement of neuroplasticity and neurogenesis，mitigation of oxidative stress damage，repair of endothelial injury and improvement of insulin sensitivity.

Key words: Autokinetic physical activity, Neurodegenerative diseases, Neuroprotection, Clinical- and preclinical- studies

赵非一,郭盛楠,徐燕,等. 自主运动锻炼是神经退行性疾病的一支“神经保护剂”吗？证据来自临床及临床前研究[J]. 中国全科医学, 2021, 24(5): 517-525. DOI: 10.12114/j.issn.1007-9572.2020.00.612.
ZHAO Feiyi,GUO Shengnan,XU Yan, et al. Is Autokinetic Physical Activity a “Neuroprotectant” for Neurodegenerative Diseases：Evidence from Clinical and Preclinical Studies　[J]. Chinese General Practice, 2021, 24(5): 517-525. DOI: 10.12114/j.issn.1007-9572.2020.00.612.

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