摘要：
Objective To observe the effect of electroacupuncture (EA)combined with rehabilitation training on motor function and expression of neuronal growth associated protein 43 (GAP-43)and synaptophysin (SYP)in hippocampal CA 3 region in rats with focal cerebral ischemia/reperfusion injury (CI/RI).Methods A total of 46 SD rats were randomized into normal control,CI/RI model,rehabilitation training (RT),paralysis-side (unilateral)-EA+RT,and bilateral-EA+RT groups (n =6 in the normal control group,and n = 1 0 in each of the other group).The CI/RI model was established by occlusion of the middle cerebral artery (MCAO)and reperfusion.EA (5 Hz/1 0 Hz,2 mA)was applied to the unilateral “Quchi”(LI 1 1 )and “Housanli”(ST 36) on the affected side or bilateral LI 1 1 and ST 36 for 30 min,once daily for two weeks except the Sunday.The neurological deficit severity (Zea Longa score)was assessed 24 h,7 and 1 4 days after modeling.The immunoactivity of GAP-43 and SYP in the CA 3 region of the hippocampus was detected using immunohistochemistry.Pathological changes of the prefrontal cortex was ob-served after H.E.staining.Results Following modeling,the neurological deficit scores of the model,RT,unilateral-EA+RT and bilateral-EA+RT groups were gradually decreased,and were significantly lower on day 7 and 1 4 in the bilateral-EA+ RT group and on day 1 4 in the unilateral-EA+RT group than in the model group (P 0.05),and the expression levels of GAP-43 and SYP protein in the bilateral-EA+RT were significantly higher than those in the unilateral EA+RT group (P <0.05).H.E.staining showed that the ischemic injury of cells (neuronal apoptosis and enlargement of intercellular space)of the prefrontal cortex was relatively milder in the EA+RT groups. Conclusion EA plus RT can promote the recovery of motor function in CI/RI rats,which may be associated with its function in increasing the expression of GAP-43 and SYP in hippocampal CA 3 region.The effects of bilateral-EA+RT is obviously better than those of unilateral EA+RT.%目的：：探讨应用双侧电针结合康复训练对局灶性脑缺血/再灌注损伤(CI/RI)大鼠运动功能及海马 CA 3区神经生长相关蛋白43(GAP-43)和突触素(SYP)表达的影响。方法：SD 大鼠随机分为模型组、康复组、患侧电针康复组、双侧电针康复组,每组各10只,另设空白组6只。参考改良 Zea Longa 线栓法制备大脑中动脉阻塞/再灌注大鼠模型,患侧电针康复组电针患侧“曲池”“后三里”“百会”配合康复训练,双侧电针组电针双侧“曲池”“后三里”及“百会”配合康复训练,康复组单纯采用康复训练,均每天治疗1次,共治疗12次。术后24 h,7、14 d 时进行神经行为学评分,免疫组化法检测海马 CA 3区 GAP-43、SYP 表达。结果：术后7、14 d,双侧电针康复组的神经行为学评分均明显低于模型组、康复组和患侧电针康复组(P <0.05)。与空白组比较,模型组 GAP-43、SYP 表达显著增加(P <0.05)；与康复组或模型组比较,患侧电针康复组及双侧电针康复组 GAP-43、SYP 表达均显著增加(P <0.05)；与患侧电针康复组比较,双侧电针康复组 GAP-43、SYP 表达显著增加(P <0.05)。结论：电针结合康复训练能促进大鼠神经功能的恢复及海马 CA 3区GAP-43、SYP 的表达,而在针刺方法上,双侧电针法较患侧电针法能更好地促进 CI/RI 大鼠的中枢神经系统功能重塑。
