电针联合丰富康复训练对脑缺血再灌注损伤大鼠海马神经细胞的保护机制  

Protective Mechanism of Electroacupuncture Combined with Enriched Rehabilitative Training on Hippocampal Neurons in Rats with Cerebral Ischemia-Reperfusion Injury

作　　者：龚丽 唐巍[1] 邱镇 李梦醒[1] GONG Li;TANG Wei;QIU Zhen;LI Mengxing(College of Acupuncture and Massage,Anhui University of Traditional Chinese Medicine,Hefei,Anhui 230038,China;College of Pharmaceutical Science,Zhejiang University of Traditional Chinese Medicine,Hangzhou,Zhejiang 310053,China)

机构地区：[1]安徽中医药大学针灸推拿学院,安徽合肥230038 [2]浙江中医药大学药学院,浙江杭州310053

出　　处：《康复学报》2019年第5期33-39,45,共8页Rehabilitation Medicine

基　　金：国家自然科学基金项目(81874500);安徽省学术与技术带头人后备人选培养资助项目(201310);安徽高校科研创新平台建设项目(2015TD033)

摘　　要：目的:观察电针联合丰富康复训练对脑缺血再灌注损伤大鼠内质网应激(ERS)相关蛋白的影响,探讨电针联合丰富康复训练对脑缺血再灌注损伤大鼠海马神经细胞的保护机制。方法:将108只SD大鼠按照随机数字表法分为正常组(Normal组)、假手术组(Sham组)、模型组(Model组)、电针组(EA组)、丰富康复训练组(RT组)和电针联合丰富康复训练组(EA+RT组)。使用改良线栓法制作大鼠脑动脉缺血再灌注模型。EA组和EA+RT组造模成功24 h后电针百会、神庭穴;RT组和EA+RT组设置丰富环境并参与多项康复运动。通过水迷宫实验对大鼠的学习记忆能力进行评估;采用TTC染色观察大鼠脑组织梗死体积;TUNEL法检测各组神经细胞凋亡指数;Western blot法检测大鼠脑梗死区组织ERS相关蛋白激酶样内质网激酶(PERK)、增强子结合蛋白环磷酸腺苷反应元件结合转录因子同源蛋白(CHOP)、B淋巴细胞瘤-2基因(Bcl-2)、Bcl-2相关X蛋白(Bax)表达、蛋白激酶B(Akt)及磷酸化蛋白激酶B(p-Akt)水平。结果:与Normal组、Sham组比较,Model组大鼠学习记忆能力下降(P<0.01),脑梗死体积、凋亡指数以及PERK、CHOP、Bcl-2及Bax蛋白表达均明显升高(P<0.01);3个治疗组与Model组比较,大鼠学习记忆能力上升(P<0.01),脑梗死体积、凋亡指数以及PERK、CHOP及Bax蛋白表达明显降低(P<0.01),Bcl-2蛋白表达和p-Akt水平均升高(P<0.01);EA+RT组分别与EA组和RT组进行比较,发现大鼠学习记忆能力更强(P<0.01),脑梗死体积、凋亡指数以及PERK、CHOP及Bax蛋白表达更低(P<0.05),Bcl-2蛋白表达和p-Akt水平更高(P<0.01);Normal组与Sham组比较、EA组与RT组比较,各项指标差异均无统计学意义(P>0.05)。结论:电针联合丰富康复训练对于缺血再灌注损伤有良好的治疗效果,优于单一使用电针或丰富康复训练治疗,其作用可能是通过抑制ERS相关蛋白PERK、CHOP及Bax的释放和激活,上调抗凋亡蛋白Bcl-2表达�Objective: To observe the effects of electroacupuncture combined with enriched rehabilitative training on endoplasmic reticulum stress (ERS)-associated proteins in rats with cerebral ischemia-reperfusion injury, and to investigate the protective mechanism of that in relation to the hippocampal neurons. Methods: A total of 108 enrolled Sprague-Dawley (SD) rats were divided into normal group, sham surgery group, model group, electroacupuncture group (EA group), enriched rehabilitative training group (RT group), and electroacupuncture combined with enriched rehabilitative training group (EA+RT group) according to the random number table method. Then cerebral ischemia-reperfusion models were established by modified thread thrombus method. After the successful modeling in the EA group and EA+RT group, electroacupuncture was performed at Baihui (GV20) and Shenting (GV24) acupoints. For the rats in the RT group and EA+RT group, an enriched environment was set up and they were involved in rehabilitative activities. The learning and memory abilities of rats were assessed by water maze test. The cerebral infarction volume was observed via TTC staining. The neuronal apoptotic index was determined by TUNEL method. Western blot was used to detect the expression of protein kinase-like endoplasmic reticulum kinase (PERK), CCAAT/enhancer binding protein homologous protein (CHOP), B-cell lymphoma-2 (Bcl-2), Bcl-2 associated X-protein (Bax), protein kinase B (Akt), and phosphory lated protein kinase B (p-Akt). Results: Compared with the normal group and sham group, learning and memory ability of rats in the model group were decreased (P<0.01), and cerebral infarction volume, apoptosis index, protein expression of PERK, CHOP, Bcl-2 and Bax in hippocampus of rats in the model group were significantly increased (P<0.01). Compared with the model group, learning and memory ability of the rats in the three treatment groups were increased (P< 0.01), cerebral infarction volume, apoptosis index, protein expression of PERK, CHOP and Bax wer

关 键 词：脑缺血再灌注损伤 电针联合丰富康复训练 内质网应激 相关蛋白 凋亡 

分 类 号：R245.97[医药卫生—针灸推拿学]