目的 观察针康法对脑缺血大鼠神经功能及缺血半暗区cleaved-caspase-8、cleaved-caspase-3和细胞凋亡抑制蛋白1 (cIAP1)表达的影响。方法 雄性Sprague-Dawley大鼠90只,随机分为假手术组、模型组、针刺组、康复组和针康组,每组再分为3 d、7 d和14 d亚组,每个亚组6只。后四组采用改良Koizumi线栓法制备脑缺血模型。假手术组和模型组不予治疗,针刺组行头穴丛刺治疗,康复组行跑台康复训练,针康组同时进行以上两种治疗。预定时间点采用改良神经功能缺损评分(mNSS)、转棒测试进行评定,Western blotting检测脑缺血半暗区cleaved-caspase-8、cleaved-caspase-3、cIAP1蛋白表达。结果 术后各时间点,与模型组比较,各治疗组mNSS评分均降低(P<0.05),转棒上停留时间均延长(P<0.05),cleaved-caspase-8、cleaved-caspase-3蛋白表达均下降(P<0.05),cIAP1蛋白表达均上调(P<0.05);术后7 d、14 d,与针刺组、康复组比较,针康组mNSS评分进一步降低(P<0.05),转棒上停留时间进一步延长(P<0.05),cleaved-caspase-8、cleaved-caspase-3蛋白表达进一步下调(P<0.05),cIAP1蛋白表达进一步上调(P<0.05)。结论 针康法能改善脑缺血大鼠神经功能,促进运动功能恢复,优于单纯针刺、康复训练,可能与抑制caspase-8、aspase-3蛋白活化,促进cIAP1蛋白表达,从而抑制caspases介导的细胞凋亡级联反应有关。
Objective To investigate the effect of acupuncture-rehabilitation therapy on the neurological function and the expression of cleaved-caspase-8, cleaved-caspase-3 and cellular inhibitor of apoptosis 1 (cIAP1) in ischemic penumbra of rats with cerebral ischemia. Methods A total of 90 male Sprague-Dawley rats were randomly divided into sham group, model group, acupuncture group, rehabilitation group and acupuncture-rehabilitation group. Each group was divided into three days, seven days and 14 days subgroups (n=6). The cerebral ischemia model was established with the modified Koizumi suture method. The sham group and the model group received no treatment. The acupuncture group received cluster needling of scalp acupuncture, the rehabilitation group received treadmill training, and the acupuncture-rehabilitation group received both acupuncture and treadmill training. Three days, seven days and 14 days after modeling, their neurological function was assessed with modified Neurological Severity Score (mNSS) and Rota-rod test, and the expression of cleaved-caspase-8, cleaved-caspase-3 and cIAP1 protein in cerebral ischemic penumbra were detected with Western blotting. Results Compared with the model group, the mNSS scores decreased, the retention time of Rota-rod test increased, the expression of cleaved-caspase-8, cleaved-caspase-3 protein decreased and the expression of cIAP1 protein increased in each treatment group at each time point (P<0.05). Compared with the other two treatment groups, the mNSS scores further decreased, the retention time further increased, the expression of cleaved-caspase-8, cleaved-caspase-3 protein further decreased, and the expression of cIAP1 protein further increased (P<0.05) seven days and 14 days after modeling in the acupuncture-rehabilitation group.Conclusion Acupuncture-rehabilitation therapy can improve the neurological function in rats with cerebral ischemia, that is better than the simple acupuncture or exercise, which may relate to the inhibition of caspase-8 and caspase-3 protein activation, and promotion of cIAP1 protein expression, to inhibit the apoptotic caspases cascade reaction.
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