针刺百会、曲鬓穴对急性期脑出血大鼠的影响及其作用机制研究  

Interventional Effect and Mechanism of Acupuncture at Baihui(GV 20)and Qubin(GB 7)Acupoints on Rats with Acute Cerebral Hemorrhage

作　　者：陈秋欣[1,2] 唐一鹤 刘晓莹 徐宁 徐思禹 CHEN Qiuxin;TANG Yihe;LIU Xiaoying;XU Ning;XU Siyu(The First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin,Heilongjiang 150040,China;School of Clinical Medicine,Heilongjiang University of Chinese Medicine,Harbin,Heilongjiang 150040,China)

机构地区：[1]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [2]黑龙江中医药大学临床医学院,黑龙江哈尔滨150040

出　　处：《康复学报》2024年第2期124-132,共9页Rehabilitation Medicine

基　　金：国家自然科学基金青年科学基金项目(82004442);黑龙江省自然科学基金联合引导项目(LH2022H081)。

摘　　要：目的 观察针刺百会、曲鬓穴对急性期脑出血(ICH)大鼠白细胞分化抗原36(CD36)、Toll样受体4(TLR4)表达的影响,探讨针刺治疗脑出血的作用机制。方法 选择144只Wistar雄性大鼠,采用随机数字表法分为假手术组、模型组、针刺组、抑制剂组4组,每组36只,每组按1、3、7 d时间点再分为3个亚组,每组12只。采用立体定位自体血注入法建立ICH大鼠模型。模型组仅接受ICH模型制备,不进行任何治疗;假手术组接受类似模型组各项手术操作,但不进行注血制作;抑制剂组造模后6 h,腹腔注射TLR4抑制剂TAK242,3 mg/kg,1次/d,连续5 d;造模12 h后,针刺组各亚组开始接受针刺治疗,穴位选择百会穴(顶骨正中)、右侧曲鬓穴,采用透刺方法,进针深度20 mm,以100 r/min小幅度捻转,持续捻转2 min,每间隔5 min捻针1次,共留针30 min,期间捻转3次,1次/d,针刺组各亚组分别治疗1、3、7 d。分别于治疗后第1、3、7天,采用改良神经功能缺损评分(mNSS)评估大鼠神经功能;检测脑组织血肿体积;采用Western blot法检测脑组织CD36、TLR4蛋白表达水平;采用免疫荧光法观察CD36、TLR4在星形胶质细胞中的表达。结果 (1) mNSS评分:与假手术组同一时间点比较,模型组、针刺组、抑制剂组治疗后1、3、7 d mNSS评分均明显升高(P<0.05);与模型组同一时间点比较,针刺组、抑制剂组治疗后1、3、7 d mNSS评分均明显降低(P<0.05);与针刺组同一时间点比较,抑制剂组治疗后1 d mNSS评分明显降低(P<0.05)。(2)血肿体积:与模型组同一时间点比较,针刺组、抑制剂组治疗后3、7 d脑血肿体积均明显降低,抑制剂组治疗后1、3、7 d脑血肿体积明显降低(P<0.05);与针刺组同一时间点比较,抑制剂组治疗后1、3、7 d脑血肿体积明显降低(P<0.05)。(3) CD36、TLR4蛋白表达水平:与假手术组同一时间点比较,模型组、针刺组、抑制剂组治疗后1、3、7 d CD36、TLR4蛋白表达水平均明显升高Objective To investigate the interventional effect of acupuncture at Baihui(GV 20)and Qubin(GB 7)acupoints on the expression of recombinant cluster of differentiation 36(CD36)and Toll-like receptor 4(TLR4)in rats with acute cerebral hemorrhage(ICH),and to explore the mechanism of acupuncture treatment for ICH.Methods A total of 144 male Wistar rats were randomly divided into sham operation group,model group,acupuncture group and inhibitor group,with 36 cases in each group,and then each group was divided into three subgroups at the 1st,3rd and 7th day,with 12 cases in each subgroup.The stereotaxic autolo‐gous blood injection method was used to establish a rat model of ICH.The model group only received ICH model preparation with‐out any treatment.The sham operation group received various operations similar to the model group,but without blood injection.The inhibitor group received an intraperitoneal injection of the TLR4 inhibitor TAK242 at 6 hours after modeling,and the dose was 3 mg/kg,once daily for 5 days.At 12 hours after model establishment,all subgroups of the acupuncture group received penetrative needling at Baihui(GV 20)and Qubin(GV 25)acupoints.The needle was retained at a depth of 20 mm and twisted at a frequency of 100 r/min for three sessions of 2 min each at an interval of 5 min during the 30-min needle retention period.Acupuncture was given once a day and lasted for 1,3,and 7 days in the three acupuncture subgroups,respectively.At the 1st,3rd and 7th day after treat‐ment,modified neurological severity score(mNSS)was used to assess neurological function.The volume of hematoma in brain tis‐sue was detected.Western blot was used to detect the protein expression level of CD36 and TLR4 in brain tissue.Immunofluores‐cence method was used to detect the expression of CD36 and TLR4 in astrocytes.Results(1)mNSS score:compared with the sham operation group at the same time,mNSS score of the model group,the acupuncture group and the inhibitor group at 1,3,7 days after treatment increased significantly

关 键 词：脑出血 针刺 百会穴 曲鬓穴 神经功能 白细胞分化抗原36 TOLL样受体4 

分 类 号：R245[医药卫生—针灸推拿学]