【摘要】：目的:觀察醒腦開竅針法結(jié)合豐富康復(fù)訓(xùn)練對(duì)缺血性腦卒中大鼠運(yùn)動(dòng)功能及腦組織梗死灶周圍皮質(zhì)神經(jīng)生長(zhǎng)相關(guān)蛋白-43(GAP-43)表達(dá)的影響,探討針刺配合康復(fù)治療對(duì)缺血性腦卒中的作用機(jī)制。方法:SD大鼠隨機(jī)分為假手術(shù)組、模型組、康復(fù)組、綜合康復(fù)組,每組18只。每組分7、14、21d3個(gè)亞組,每組6只。采用熱凝閉大腦中動(dòng)脈法復(fù)制大鼠局灶性腦缺血模型�？祻�(fù)組給予豐富康復(fù)訓(xùn)練的方法治療,每日1次;綜合康復(fù)組在給予豐富康復(fù)訓(xùn)練的基礎(chǔ)上針刺雙側(cè)"內(nèi)關(guān)"及"水溝"穴,每日1次,每次30min。各組大鼠分別于相應(yīng)治療時(shí)間結(jié)束后進(jìn)行神經(jīng)功能評(píng)分,平衡木行走、轉(zhuǎn)棒上行走實(shí)驗(yàn)評(píng)分,并行免疫組化SP法檢測(cè)腦組織梗死灶周圍皮質(zhì)GAP-43表達(dá)。結(jié)果:各時(shí)間點(diǎn)模型組大鼠神經(jīng)功能評(píng)分及平衡木行走、轉(zhuǎn)棒上行走實(shí)驗(yàn)評(píng)分較假手術(shù)組均顯著升高(P0.01)。造模7d后,康復(fù)組和模型組比較,大鼠平衡木行走、轉(zhuǎn)棒上行走實(shí)驗(yàn)評(píng)分差異無統(tǒng)計(jì)學(xué)意義(P0.05);其余各時(shí)間點(diǎn)康復(fù)組、綜合康復(fù)組大鼠神經(jīng)功能評(píng)分及平衡木行走、轉(zhuǎn)棒上行走實(shí)驗(yàn)評(píng)分均較模型組顯著降低(P0.05)。各時(shí)間點(diǎn)綜合康復(fù)組大鼠神經(jīng)功能評(píng)分及平衡木行走、轉(zhuǎn)棒上行走實(shí)驗(yàn)評(píng)分均較康復(fù)組顯著降低(P0.05)。各時(shí)間點(diǎn)模型組大鼠腦組織中梗死灶周圍皮質(zhì)GAP-43陽性細(xì)胞數(shù)表達(dá)較假手術(shù)組均顯著增加(P0.01)。各時(shí)間點(diǎn)康復(fù)組與綜合康復(fù)組大鼠腦組織梗死灶周圍皮質(zhì)GAP-43陽性細(xì)胞數(shù)較模型組均顯著增加(P0.01)。各時(shí)間點(diǎn)綜合康復(fù)組大鼠腦組織中梗死灶周圍皮質(zhì)GAP-43陽性細(xì)胞數(shù)較康復(fù)組均顯著增加(P0.01)。結(jié)論:醒腦開竅針法結(jié)合豐富康復(fù)訓(xùn)練的綜合治療方法可有效地促進(jìn)缺血性腦卒中大鼠的神經(jīng)功能恢復(fù),增加大鼠腦組織梗死灶周圍皮質(zhì)GAP-43表達(dá)可能是其重要的機(jī)制之一。
[Abstract]:Objective: to observe the effects of Xingnao Kaiqiao acupuncture combined with rich rehabilitation training on motor function and the expression of nerve growth related protein 43 (GAP-43) in cerebral cortex of ischemic stroke rats. To explore the mechanism of acupuncture combined with rehabilitation therapy on ischemic stroke. Methods: Sprague-Dawley rats were randomly divided into sham-operation group, model group, rehabilitation group and comprehensive rehabilitation group with 18 rats in each group. Each group was divided into 3 subgroups with 6 rats in each group. The rat model of focal cerebral ischemia was established by thermocoagulation and occlusion of middle cerebral artery. The rehabilitation group was treated with abundant rehabilitation training once a day, and the comprehensive rehabilitation group was treated with acupuncture on the basis of abundant rehabilitation training at both sides of "Neiguan" and "Shuigou" points, once a day for 30 minutes. At the end of the corresponding treatment time, the rats in each group were assessed with neural function score, walking on balance beam, walking on the bar, and the expression of GAP-43 in the cortex around cerebral infarction was detected by immunohistochemical SP method. Results: the scores of nerve function, walking on balance beam and walking on rotating rod in model group were significantly higher than those in sham-operated group (P0.01). After 7 days of model making, there was no significant difference in the scores of walking on the balance beam and on the rotating rod between the rehabilitation group and the model group (P0.05), while in the other time points, the nerve function score and the balance beam walking in the comprehensive rehabilitation group were not significantly different from those in the other time points. The score of walking on the rotating rod was significantly lower than that of the model group (P0.05). The scores of nerve function, balance beam walking and walking on the rotating rod were significantly lower in the comprehensive rehabilitation group than in the rehabilitation group at each time point (P0.05). The expression of GAP-43 positive cells in the cerebral cortex of the model group was significantly higher than that in the sham-operated group (P0.01). The number of GAP-43 positive cells in the cortex around cerebral infarction in rehabilitation group and comprehensive rehabilitation group was significantly higher than that in model group (P0.01). The number of GAP-43 positive cells in the cerebral cortex of the rats in the comprehensive rehabilitation group was significantly higher than that in the rehabilitation group at each time point (P0.01). Conclusion: the comprehensive therapy of "Xingnao Kaiqiao acupuncture" combined with abundant rehabilitation training can effectively promote the recovery of neural function in rats with ischemic stroke, and increasing the expression of GAP-43 in the cortex around the infarct may be one of its important mechanisms.
【作者單位】： 蚌埠醫(yī)學(xué)院第一附屬醫(yī)院;
【基金】：安徽省重點(diǎn)實(shí)驗(yàn)室(蚌埠醫(yī)學(xué)院)開放課題(No.BYKL 1305)
【分類號(hào)】：R245

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