糖尿病周围神经病变（DPN）作为糖尿病常见的并发症之一，临床特征主要表现为疼痛、感觉异常及神经功能缺损，严 重影响患者的生活质量和预后。目前，DPN 的发病机制尚未完全阐明，以血糖管理和对症治疗为主的方案疗效有限，缺乏 理想的根治手段。火针作为一种传统中医疗法，通过针刺温热刺激能够激发机体的经络之气，推动气血运行。本文提出假 说，火针可能通过激活局部特定细胞（如成纤维细胞、免疫细胞、施万细胞等）的外泌体分泌，通过调控基因表达和信号通 路，介导神经修复、炎症抑制、微循环改善及神经细胞保护等多重生物学效应，最终改善DPN 病理进程，可为中医针刺机 制研究提供分子生物学视角，为探索中西医结合防治DPN 开辟了新的研究方向。

Diabetic peripheral neuropathy（DPN），a common complication of diabetes mellitus，is clinically characterized by pain，paresthesia，and neurological deficits，which severely impact patients’quality of life and prognosis. Currently，the pathogenesis of DPN remains not fully elucidated. Treatment strategies primarily focusing on glycemic control and symptomatic management offer limited efficacy，and an ideal curative approach is lacking. Fire needling，a traditional Chinese medicine therapy，is believed to activate the qi of the meridians and promote qi and blood circulation through warm stimulation via acupuncture. This paper proposes the hypothesis that fire needling may exert therapeutic effects by activating the secretion of exosomes from local specific cells（such as fibroblasts，immune cells，Schwann cells，etc.）. Through regulating gene expression and signaling pathways，it may mediate multiple biological effects including nerve repair， inflammation inhibition， microcirculation improvement，and neuronal protection，ultimately ameliorating the pathological progression of DPN. This hypothesis provides a molecular biology perspective for investigating the mechanisms of acupuncture in traditional Chinese medicine and opens new research directions for exploring the integrated traditional Chinese and western medicine approach to preventing and treating DPN.

R246.9

福建省科技厅高校产学合作项目（编号：2021Y4014）