经皮穴位电刺激对痴呆大鼠认知功能的影响及机制研究  

Transcutaneous Electrical Accupoint Stimulation Improves Cognitive Function of Total Cerebral Ischemia Dementia Rats and Its Mechanism

作　　者：温优良[1] 唐小冬[1] 郭才添 张铭金[1] 

机构地区：[1]赣南医学院附属康复医院,江西赣州341000

出　　处：《现代医院》2017年第10期1510-1514,1518,共6页Modern Hospitals

基　　金：江西省教育厅科学技术研究项目(编号:150966);赣南医学院人才启动基金项目(编号:QD201501)

摘　　要：目的从行为学、形态学、电生理学和分子生物学等不同层面观测经皮穴位电刺激(TEAS)对全脑缺血性痴呆大鼠认知功能的影响及相关机制研究。方法采用永久性结扎双侧椎动脉结合短时间阻断双侧颈总动脉建立痴呆大鼠模型,造模成功后根据随机数字表法将45只雄性SD大鼠分为:模型组(n=15)、安慰刺激组(n=15)和TEAS组(n=15)。治疗后进行Morris水迷宫行为学测试和跳台实验,记录各组大鼠海马长时程增强效应(LTP)。治疗4周后处死大鼠,留取大脑海马组织。应用Western Blot技术检测海马脑源性神经营养因子(BDNF)的表达;采用光镜(HE染色)及电镜,观察各组大鼠海马CA1、CA3区细胞形态及神经元可塑性;免疫组化法(TUNEL染色)观察海马组织中细胞凋亡的变化。结果安慰刺激组和TEAS组水迷宫检测均显示全时程平均逃避潜伏期较模型组明显延长(P<0.05),TEAS组较安慰刺激组明显缩短(P<0.05);TEAS组和安慰刺激组与模型组相比较,原平台象限游泳路程比及游泳时间缩短明显,TEAS组较安慰刺激组明显延长(P<0.05)。安慰刺激组和TEAS组跳台实验均显示跳台潜伏期明显延长,错误次数明显减少(P<0.01);与安慰刺激组比较,TEAS组跳台潜伏期延长,错误次数减少(P<0.05)。TEAS组LTP,海马BDNF表达较安慰刺激组显著升高(P<0.01)。光镜下可见TEAS组海马CA1、CA3区神经细胞排列、层次数量、细胞受损程度均明显改善;电镜下可见TEAS组示病理改变基本同安慰刺激组,但髓鞘病理改变减轻,且突触间隙宽度及PSD的厚度等反映可塑性变化的重要指标高于该组,未见断裂现象;TUNEL检测显示安慰刺激组和TEAS组阳性细胞数目较模型组减少,且TEAS组减少更为明显。结论 TEAS可上调大鼠海马BDNF的表达,减少细胞凋亡的形成以促使LTP和突触的可塑性提高,使痴呆大鼠认知功能得到改善。Objective To explore the outcome of transcutaneous electrical accupoint stimulation（ TEAS） on learning and memory of total cerebral ischemia dementia rats and study its mechanism. Methods After establishing rat model of total cerebral ischemia dementia by blocking the bilateral vertebral artery permanently and the carotid artery temporarily. 45 grade clean adult male SD rats were randomly divided into 3 groups： model group,pseudo stimulation group and TEAS group,15 in each group. Their spatial learning and memory were assessed by Morris water maze test and step down test after TEAS.Their LTP was recorded. After treatment of 4 weeks,all rats were killed and hippocampal tissue was collected. Expression of BDNF and apoptosisin in hippocampus was detected by Western blot and immunohistochemistry（ tunel） respectively. Morphology of cells in CA1 and CA3 and neuronal plasticity were observed with HE staining and electron microscope. Results Morris water maze test showed that the average escape lantent period was significantly longer in pseudo stimulation group and TEAS group than in model group（ P〈0. 05）. Step down test showed that the average jump lantent period was significantly longer（ P〈0. 05） and the number of errors was significantly less in pseudo stimulation group and TEAS group than in model group（ P〈0. 05） and significantly shorter in TEAS group than in pseudo stimulation group（ P〈0. 01）. The swimming time and the swimming distance proportion of the total distance in platfor quadrant were significantly shorter in pseudo stimulation group and TEAS group than in model group（ P〈0. 05）. The LTP and expression levels of BDNF were significantly higher,and the number of apoptosis was significantly less in TEAS group than in pseudo stimulation group（ P〈0. 01）. HE staining and electron microscope showed that the arrangement and damage of nerve cells in CA1 and CA3,and neuronal synaptic plasticity were noticeably improved in TEAS group. Conclusion TEAS promotes LTP by upregu

关 键 词：经皮穴位电刺激 痴呆 脑源性神经营养因子 凋亡 认知 

分 类 号：R735.37[医药卫生—肿瘤]