清脑益元汤联合康复训练对脑缺血后神经功能损伤大鼠运动功能与缺血区NR2B表达的影响

Effect of Qingnao Yiyuan Decoction(清脑益元汤) Combined with Rehabilitation Training on Motor Function and Expression of NR2B in Ischemic Area of Rats with Neurological Injury Following Cerebral Ischemia

目的:探讨清脑益元汤联合康复训练对脑缺血后神经功能损伤大鼠运动功能与缺血区NR2B表达的影响。方法:选取160只SD大鼠,随机分为假手术组、模型组、A组和B组,每组40只,各组按造模后3、7、14、21d4个时间点处死,分为4个亚组,每亚组10只。各组按设计进行灌胃或康复训练7d后,模型组、A组和B组行大脑中动脉梗阻(MCAO)术,建立急性脑缺血损伤大鼠模型,待手术后,各组继续进行灌胃或康复训练,直至大鼠在设计的各时间点被处死。参照Longa的5分制法对各组大鼠神经功能缺损程度进行评价,采用平衡木试验法评价各组运动功能,并采集各组脑组织标本,运用免疫组化法检测NR2B蛋白表达,采用TUNEL法原位检测细胞凋亡。结果:假手术组大鼠未见神经功能缺损表现,运动功能正常,有少量NR2B表达及少量凋亡细胞存在;与假手术组比较,模型组大鼠神经功能缺损评分升高,运动功能降低,差异有统计学意义(P<0.05);造模3d后,A组、B组大鼠神经缺损及运动功能明显改善,改善程度明显高于同期模型组,差异有统计学意义(P<0.05);两组比较,B组大鼠神经缺损、运动功能改善更明显,差异有统计学意义(P<0.05);与假手术组比较,模型组大鼠梗死周围脑组织NR2B表达增多,凋亡细胞增多,差异有统计学意义(P<0.05);造模3d后,A组、B组大鼠NR2B表达下降,凋亡细胞数量降低,明显低于同期模型组,差异有统计学意义(P<0.05);两组比较,B组大鼠NR2B表达及凋亡细胞数量降低最明显,差异有统计学意义(P<0.05)。结论:清脑益元汤联合康复训练能显著改善脑缺血后神经功能损伤大鼠的神经缺损,提高其运动功能,其机制可能与康复训练可降低缺血区NR2B表达及凋亡细胞数量有关。

Objective:To explore the effects of Qingnao Yiyuan Decoction combined with rehabilitation training on motor function and expression of NR2B in ischemic area of rats with neurological injury after cerebral ischemia.Methods:A total of 160 SD rats were randomly divided into sham operation group,model group, group A and group B,with 40 groups in each group.Each group was divided into 4 sub-decades after 3 days, 7 days,14 days and 21 days,10 per subgroup.After 7 days of gavage or rehabilitation training in each group, MCAO was performed in model group,group A and group B to establish a rat model of acute cerebral ischemia. After operation,each group continued to undergo gastric or rehabilitation training until rats were sacrificed at various points in the design.The degree of neurological deficits in each group was evaluated by Longa's 5-point method.The motor function of each group was evaluated by the balance beam test method.Brain tissue samples were collected from each group,and NR2B protein expression was detected by immunohistochemistry. TUNEL method was used.Apoptosis was detected in situ.Results:In the sham operation group,no neurological deficits were observed;motor function was normal,and a small amount of NR2B expression and a small number of apoptotic cells were present.Compared with the sham operation group,the neurological deficit scores of the model group were increased,and the motor function was reduced,with statistical significance (P<0.05);after 3 days of modeling,the neurological deficits and motor function of group A and group B were significantly improved,and the improvement degree was significantly higher than that of the model group (P<0.05).Compared with the group A,the neurological deficit and motor function of the rats in group B were significantly improved (P <0.05).Compared with the sham operation group,the expression of NR2B in the infracted brain tissue of the model group increased,with more apoptotic cells.The difference was statistically significant (P <0.05).After 3 days of modeling,the expression of NR2B in group A and group B decreased,and the number of apoptotic cells decreased,which was significantly lower than that of the model group (P<0.05);Compared with the group A,the expression of NR2B and the number of apoptotic cells in group B were the most significant (P<0.05).Conclusion:Qingnao Yiyuan Decoction combined with rehabilitation training can significantly improve the neurological deficit and improve the motor function of rats with neurological injury after cerebral ischemia.The mechanism may be related to the reduction of NR2B expression and the number of apoptotic cells in the ischemic area.