电针“曲池”-“阳陵泉”缓解脑卒中大鼠痉挛状态脑突触结构可塑性的实验研究  

Experimental study of electroacupuncture at“Quchi”(LI 11)-“Yanglingquan”(GB 34)on relieving the plas⁃ticity of brain synapse structure in rats with stroke

作　　者：郭斌 王彭汉 黄麟荇 谢志强 谢丽娜 刘未艾[2] 易丽贞 刘欣 岳增辉[1] GUO Bin;WANG Penghan;HUANG Linxing(College of Acu-moxibustion and Massage,Hunan University of TCM,Changsha,410208;不详)

机构地区：[1]湖南中医药大学针灸推拿学院,长沙410208 [2]湖南中医药大学第二附属医院针灸科

出　　处：《中国康复医学杂志》2020年第7期787-793,共7页Chinese Journal of Rehabilitation Medicine

基　　金：国家自然科学基金项目(81673886);国家重点基础研究发展计划“973”中医专项(2014CB543102);湖南省自然科学基金项目(2018JJ2294);湖南省中医药科研计划项目(201862);2018年湖南省研究生科研创新项目(CX2018B488)。

摘　　要：目的:通过动物实验观察电针治疗对脑卒中痉挛状态下SD大鼠的神经损伤与肌张力情况,皮质运动区突触超微形态变化及大脑皮质内突触可塑性相关蛋白(synaptophysin,SYN;GABA transporter,GAT-1;post-synaptic density95,PSD-95)表达的影响,揭示电针“曲池”“-阳陵泉”缓解痉挛的疗效及其作用机制。方法:将77只SD大鼠经两次随机分组分为电针组、假手术组、模型组、空白对照组,采用改良Zea-Longa线栓法+内囊注射NMDA受体法制备脑卒中肢体痉挛大鼠模型,行为学评分确认模型成功后,开始在双侧曲池、阳陵泉行电针治疗,每次30min,每日1次,持续5d。行为学检测神经功能与肌张力,电镜观察各组皮质突触的超微结构变化,采用逆转录-聚合酶链反应检测皮质中SYN、GAT-1、PSD-95相应mRNA的表达,采用蛋白质印迹法检测皮质中SYN、GAT-1、PSD-95相应蛋白的表达。结果:①Zea-longa神经功能评分与改良Ashworth肌张力评分结果显示,模型组评分增高(P<0.01);与模型组相比,电针组评分降低(P<0.05)。②电镜图像观察,模型组较空白组、假手术组突触数量减少明显,囊泡数量减少密度不均,前后膜及间隙发生融合界限模糊,突触后细胞终末胞质变性溶解显著,突触后致密带的密度也下降;电针组较模型组的突触数量明显增多也相对密集,囊泡数量增多,新生的凹形突触增加,突触后致密物增厚,间隙变得规则紧致。未进行统计学分析。③同模型组比较,电针组SYN、GAT-1、PSD95蛋白与受体基因的表达均有升高(P<0.01);而与空白对照组、假手术组比较,模型组SYN、GAT-1、PSD95蛋白与受体基因的表达均降低(P<0.05)。结论:电针“曲池”“-阳陵泉”能够改善了脑卒中后痉挛状态,其作用机制可能是调节大脑皮质内突触可塑性相关蛋白与基因的表达,促进了皮质突触的重塑,从而改善中枢神经系统的运动功能。Objective:To observe the neurological injury of SD rats under spasticity of cerebral apoplexy(SCA)by animal electroacupuncture,to detect the changes of synaptic ultrastructural in the cortex and the expression of synaptic plasticity related proteins(SYN,GAT-1,PSD-95),to reveal the efficacy and mechanism of electroacupuncture at“Quchi”(LI 11)-“Yanglingquan”(GB 34).Method:Thirty-six Sprague-Dawley rats were randomly divided into electroacupuncture group,sham operation group,model group and blank control group.The model of limb spasticity after stroke was prepared by modified Zea-longa suture method+internal capsule injection of NMDA receptor method.After confirming the successful model by behavioral score,the electroacupuncture treatment was given in the bilateral Quchi and Yanglingquan,once every 30 minutes,once a day for 5 days.The ultrastructural changes of synapses in each group were observed by electron microscopy.The mRNA expression of SYN,GAT-1 and PSD-95 in cortex were detected by Rt-PCR.The protein expressions of SYN,GAT-1 and PSD-95 were detected by Western Blot.Result:①The Ashworth scores of the model group were significantly higher(P<0.01).Compared with the model group,the electroacupuncture group scores were statistically significantly decreased(P<0.05).②Under electron microscope,the number of synapses in the model group was significantly lower than that in the blank group and the sham operation group,accompanied by the reduced number of vesicles.The fusion boundary between the anterior and posterior membranes and the gap were blurred,and the terminal cytoplasmic degeneration of the postsynaptic cells was significantly dissolved.The density of post-synaptic dense bands also decreased;the number of synapses in the electroacupuncture group was significantly increased compared with the model group,the number of vesicles increased,the new concave synapses increased,and the post-synaptic denses thickened and the gap changed.③Compared with the model group,the expressions of SYN,GAT1,PSD95 prote

关 键 词：脑卒中 痉挛 电针 皮质 突触素 GABA转运蛋白 突触后致密物95 

分 类 号：R245[医药卫生—针灸推拿学] R49[医药卫生—中医临床基础]