李占标,邢章民,张振燕,等.电针刺激对脑缺血再灌注大鼠神经功能恢复的影响[J].中华物理医学与康复杂志,2019,41(11):823-828
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| 电针刺激对脑缺血再灌注大鼠神经功能恢复的影响 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2019.11.005 |
| 中文关键词: 电针 预刺激 脑缺血再灌注 蛋白激酶A 神经再生 |
| 英文关键词: Electroacupuncture Pretreatment Cerebral ischemia and reperfusion Rats Nerve regeneration |
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| 中文摘要: |
| 目的 观察电针刺激对脑缺血再灌注大鼠缺血侧脑梗死体积、脑细胞凋亡及大脑皮质蛋白激酶A（PKA）表达的影响，初步探讨电针刺激的脑保护作用机制。 方法 采用随机数字表法将120只健康成年雄性SD大鼠分为假手术组、模型组、电针组及电针预刺激组。采用线栓法将模型组、电针组及电针预刺激组大鼠制成左侧大脑中动脉阻塞（MCAO）2 h再灌注模型。电针预刺激组大鼠于造模前采用电针连续刺激百会、大椎及右侧内关穴5 d，每日1次，每次30 min。电针组和电针预刺激组均于制模后继续电针刺激百会、大椎及右侧内关穴，每日1次，每次30 min。模型组及假手术组大鼠在相同时间内予以捆绑固定，不给予任何特殊处理。于电针刺激5 d、10 d时，分别采用Garcia评分法评价各组大鼠神经功能缺损情况，采用氯化三苯基四氮唑(TTC)染色法观察各组大鼠缺血侧脑梗死体积，通过流式细胞仪测定各组大鼠缺血侧皮质细胞凋亡率，采用免疫组织化学法测定各组大鼠缺血侧皮质PKA阳性细胞表达率。 结果 模型组大鼠神经功能严重受损，假手术组大鼠无神经功能缺陷。电针组、电针预刺激组在制模后5 d、10 d时其Garcia评分、脑梗死体积、脑细胞凋亡率及PKA阳性细胞表达率均明显优于模型组同时相点水平（P<0.05）；并且电针预刺激组上述时间点Garcia评分、脑梗死体积、脑细胞凋亡率及PKA阳性细胞表达率亦显著优于电针组同时相点水平（P<0.05）。 结论 电针刺激能促进脑缺血再灌注大鼠受损神经功能恢复，如辅以电针预刺激能进一步改善受损神经功能，其疗效明显优于单纯电针刺激；关于电针预刺激的脑保护作用机制可能与减小脑梗死体积、抑制脑细胞凋亡、促进PKA阳性细胞表达等因素有关。 |
| 英文摘要: |
| Objective To observe the effect of electroacupuncture on the volume of cerebral infarction, apoptosis of cerebral cells and the expression of protein kinase A (PKA) in the cerebral cortex of rats after ischemia and reperfusion so as to explore how electroacupuncture stimulates brain protection. Methods One hundred and twenty healthy, adult, male Sprague-Dawley rats were randomly divided into a sham operation group, a model group, an electroacupuncture group and an electroacupuncture with pre-stimulation group. All except the rats in the sham operation group received occulusion of the left middle cerebral artery using the intraluminal thread method for 2h and then reperfusion. Before the operation, the rats in the electroacupuncture with pre-stimulation group were given 30 minutes of electroacupuncture at the baihui, dazhui and right neiguan points every day for 5 days. After the operation both the electroacupuncture group and the pre-stimulated group were given that same electroacupuncture regimen. The other two groups received no special treatment. Garcia scoring was used to evaluate the neurological deficits of all of the rats 5 and 10 days after the intervention. Meanwhile, the ischemic volume, apoptosis of cortical cells and PKA-positive cells were determined using flow cytometry and immunohistochemistry after triphenyltetrazolium chloride (TTC) staining. Results The neurological function of the injured rats was severely impaired, while no neurological deficit was found in the sham operation group. The average Garcia score, cerebral infarction volume, cerebral apoptosis rate and PKA-positive cell expression rate of the electroacupuncture and electroacupuncture with pre-stimulation groups were all significantly better than those of the model group at the same time points. The averages of the electroacupuncture with pre-stimulation group were all significantly superior to those of the electroacupuncture group at the same time points. Conclusions Pre-stimulation using electroacupuncture can promote the recovery of injured nerves after cerebral ischemia and reperfusion, at least in rats. Electroacupuncture′s protective mechanism may be related to its reducing the infarcted volume, inhibiting apoptosis of brain cells and promoting PKA expression. |
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