醒脑开窍针法结合康复训练对缺血性脑卒中大鼠神经修复和梗死灶周围皮质神经生长相关蛋白-43表达的影响

发布时间：2018-07-22 13:37

【摘要】：目的:观察醒脑开窍针法结合丰富康复训练对缺血性脑卒中大鼠运动功能及脑组织梗死灶周围皮质神经生长相关蛋白-43(GAP-43)表达的影响,探讨针刺配合康复治疗对缺血性脑卒中的作用机制。方法:SD大鼠随机分为假手术组、模型组、康复组、综合康复组,每组18只。每组分7、14、21d3个亚组,每组6只。采用热凝闭大脑中动脉法复制大鼠局灶性脑缺血模型。康复组给予丰富康复训练的方法治疗,每日1次;综合康复组在给予丰富康复训练的基础上针刺双侧"内关"及"水沟"穴,每日1次,每次30min。各组大鼠分别于相应治疗时间结束后进行神经功能评分,平衡木行走、转棒上行走实验评分,并行免疫组化SP法检测脑组织梗死灶周围皮质GAP-43表达。结果:各时间点模型组大鼠神经功能评分及平衡木行走、转棒上行走实验评分较假手术组均显著升高(P0.01)。造模7d后,康复组和模型组比较,大鼠平衡木行走、转棒上行走实验评分差异无统计学意义(P0.05);其余各时间点康复组、综合康复组大鼠神经功能评分及平衡木行走、转棒上行走实验评分均较模型组显著降低(P0.05)。各时间点综合康复组大鼠神经功能评分及平衡木行走、转棒上行走实验评分均较康复组显著降低(P0.05)。各时间点模型组大鼠脑组织中梗死灶周围皮质GAP-43阳性细胞数表达较假手术组均显著增加(P0.01)。各时间点康复组与综合康复组大鼠脑组织梗死灶周围皮质GAP-43阳性细胞数较模型组均显著增加(P0.01)。各时间点综合康复组大鼠脑组织中梗死灶周围皮质GAP-43阳性细胞数较康复组均显著增加(P0.01)。结论:醒脑开窍针法结合丰富康复训练的综合治疗方法可有效地促进缺血性脑卒中大鼠的神经功能恢复,增加大鼠脑组织梗死灶周围皮质GAP-43表达可能是其重要的机制之一。
[Abstract]:Objective: to observe the effects of Xingnao Kaiqiao acupuncture combined with rich rehabilitation training on motor function and the expression of nerve growth related protein 43 (GAP-43) in cerebral cortex of ischemic stroke rats. To explore the mechanism of acupuncture combined with rehabilitation therapy on ischemic stroke. Methods: Sprague-Dawley rats were randomly divided into sham-operation group, model group, rehabilitation group and comprehensive rehabilitation group with 18 rats in each group. Each group was divided into 3 subgroups with 6 rats in each group. The rat model of focal cerebral ischemia was established by thermocoagulation and occlusion of middle cerebral artery. The rehabilitation group was treated with abundant rehabilitation training once a day, and the comprehensive rehabilitation group was treated with acupuncture on the basis of abundant rehabilitation training at both sides of "Neiguan" and "Shuigou" points, once a day for 30 minutes. At the end of the corresponding treatment time, the rats in each group were assessed with neural function score, walking on balance beam, walking on the bar, and the expression of GAP-43 in the cortex around cerebral infarction was detected by immunohistochemical SP method. Results: the scores of nerve function, walking on balance beam and walking on rotating rod in model group were significantly higher than those in sham-operated group (P0.01). After 7 days of model making, there was no significant difference in the scores of walking on the balance beam and on the rotating rod between the rehabilitation group and the model group (P0.05), while in the other time points, the nerve function score and the balance beam walking in the comprehensive rehabilitation group were not significantly different from those in the other time points. The score of walking on the rotating rod was significantly lower than that of the model group (P0.05). The scores of nerve function, balance beam walking and walking on the rotating rod were significantly lower in the comprehensive rehabilitation group than in the rehabilitation group at each time point (P0.05). The expression of GAP-43 positive cells in the cerebral cortex of the model group was significantly higher than that in the sham-operated group (P0.01). The number of GAP-43 positive cells in the cortex around cerebral infarction in rehabilitation group and comprehensive rehabilitation group was significantly higher than that in model group (P0.01). The number of GAP-43 positive cells in the cerebral cortex of the rats in the comprehensive rehabilitation group was significantly higher than that in the rehabilitation group at each time point (P0.01). Conclusion: the comprehensive therapy of "Xingnao Kaiqiao acupuncture" combined with abundant rehabilitation training can effectively promote the recovery of neural function in rats with ischemic stroke, and increasing the expression of GAP-43 in the cortex around the infarct may be one of its important mechanisms.
【作者单位】：蚌埠医学院第一附属医院;
【基金】：安徽省重点实验室(蚌埠医学院)开放课题(No.BYKL 1305)
【分类号】：R245

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