针康法对脑缺血后神经血管单元重塑的影响

Effect of Acupuncture- rehabilitation Method on Functional Remodeling Neurovascular Unit after Cerebral Ischemia

目的:观察针康法对脑缺血后神经血管单元组成成分的影响。方法:将90只清洁级雄性SD大鼠随机分成假手术组、模型组、针刺组、康复组及针康组5组,每组再分为3个亚组,每个亚组6只。采用线栓法阻闭大鼠大脑中动脉制作永久性局灶性脑缺血模型。假手术组、模型组不予任何治疗,针刺组采用头穴丛刺针法治疗,康复组采用跑台训练模拟临床康复治疗,针康组采用头穴丛刺针法结合跑台训练同步治疗。免疫组织化学法观察各时间点神经血管单元各组分胶质纤维酸性蛋白(GFAP)、成熟神经细胞核抗原(Neu N)的动态变化及微血管密度计数(MVD)。结果:术后7天、14天,与模型组相比,康复组、针刺组与针康组GFAP阳性细胞数减少(P<0.05);与康复组、针刺组比较,针康组GFAP阳性表达降低,差异显著(P<0.05)。术后7天、14天,与模型组相比,康复组、针刺组与针康组Neu N阳性表达增多(P<0.05);与康复组、针刺组比较,针康组Neu N阳性细胞数显著增加(P<0.05)。术后3天、7天,针刺组、康复组、针康组CD31蛋白阳性细胞数较模型组增加(P<0.05)。术后14天,与康复组、针刺组比较,针康组CD31蛋白阳性表达明显,差异显著(P<0.05)。结论:针康法通过下调缺血脑组织GFAP的表达,上调缺血脑组织Neu N的表达,增加微血管的数目,促进脑缺血后神经血管单元功能重塑。

Objective： To observe the effect of acupuncture- rehabilitation method on the composition of neurovascular unit after cerebral ischemia. Methods： 90 SD male rats were randomly divided into sham operation group,model group,acupuncture group,rehabilitation group and acupuncture- rehabilitation group. Each group was further divided into 3 subgroups,with 6 rats in each subgroup. Permanent focal cerebral ischemia models were made by suture occlusion in the middle cerebral artery of rats. The sham operation group and model group were without any treatment; the acupuncture group was treated by scalp acupuncture treatment; the rehabilitation group received treadmill training simulating clinical rehabilitation; the acupuncture- rehabilitation received scalp acupuncture combined with treadmill training synchronizing. The dynamic changes of the expression of glial acidic protein（ GFAP）,mature nerve cell nuclear antigen（ Neu N） and microvessel density（ MVD） were observed by immunohistochemistry. Results： Compared with the model group,GFAP positive cells in the rehabilitation group,acupuncture group and the acupuncture- rehabilitation group were decreased（ P 0. 05） on 7 d and 14 d post- operation. The positive expression of GFAP in the acupuncture- rehabilitation group was significantly decreased,compared with that of the rehabilitation group and acupuncture group（ P 0. 05）. Compared with the model group,Neu N positive expressions in the rehabilitation group,acupuncture group and acupuncture- rehabilitation group were increased on 7 d and 14 d post- operation（ P 0. 05）. The number of Neu N positive cells in acupuncture- rehabilitation group was significantly increased than that in the rehabilitation group and acupuncture group（ P 0. 05）. The number of CD31 positive cells in the acupuncture group,rehabilitation group and acupuncture- rehabilitation group was higher than that in model group on 3 d and 7 d post- operation（ P 0. 05）. Compared with rehabilitation group and acupuncture group,the positive expression of CD31 protein in the acupuncture group was significantly different on 14 d post- operation（ P 0. 05）. Conclusion： The acupuncture- rehabilitation method can promote functional remodeling of neurovascular unit after cerebral ischemia by way of down- regulating the expression of GFAP,up- regulating the expression of Neu N and increasing the number of micro vessels in ischemic brain tissue.