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  

Effect of “Xingnao Kaiqiao Zhenfa”(Acupuncture Technique for Restoring Consciousness)Combined with Rehabilitation Training on Nerve Repair and Expression of Growth-associated Protein-43 of Peri-ischemic Cortex in Ischemic Stroke Rats

作　　者：徐磊[1] 闫兴洲[1] 李震宇[1] 曹小芳[1] 王敏[1] 

机构地区：[1]蚌埠医学院第一附属医院,安徽蚌埠233004

出　　处：《针刺研究》2017年第3期223-228,共6页Acupuncture Research

基　　金：安徽省重点实验室(蚌埠医学院)开放课题(No.BYKL 1305)

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(P<0.01)。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(P>0.05);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(P<0.05)。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(P<0.05)。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(P<0.01)。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(P<0.01)。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(P<0.01)。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。Objective To observe the effect of ＂Xingnao Kaiqiao Zhenfa＂ （acupuncture technique for restoring consciousness） combined with enriched rehabilitation training on motor function and expression of growth-associated protein-43 （GAP-43） of peri-ischemic cortex in ischemic stroke rats, so as to investigate its mechanism underlying improvement of ischemic stroke. Methods SD rats were randomly divided into sham operation, model, rehabilitation and comprehensive rehabilitation groups, which were further divided into 3 time-points： 7, 14 and 21 d （n = 6 in each）. Cerebral ischemia（CI） model was established by occlusion of the middle cerebral artery with heat-coagulation. The rehabilitation group was treated by enriched rehabilitation training, once a day. The comprehensive rehabilitation group was treated by acupuncture combined with enriched rehabilitation training. Acupuncture was applied to bilateral ＂Neiguan＂（PC 6） and ＂Shuigou＂（GV 26） for 30 min, once a day. The neurological function score, balance-beam walking test and rotating-rod walking test were evaluated at the end of the corresponding treatment time. The expression of GAP-43 in peri-ischemic cortex was detected by immunohistochemistry. Results In comparison with the sham operation group, the scores of neurological function, beam walking test and rotating-rod walking test were significantly higher in the model group （P〈0.01）. There were no significant changes in the scores of balance-beam walking and rotating-rod walking tests in the rehabilitation group compared with the model group on day 7 （ P〈0.05）. Compared with the model group at the other time points, the scores of neurological function, balance-beam walking test and rotating-rod walking test were significantly lower in the rehabilitation and comprehensive rehabilitation groups （ P〈0.05）. Compared with the rehabilitation group, the scores of neurological function, balance-beam walking test and rotating-rod walking test were significantly lower in th

关 键 词：醒脑开窍法 康复训练 缺血性脑卒中 神经生长相关蛋白-43 

分 类 号：R245.311[医药卫生—针灸推拿学]