针刺对缺血再灌注脑组织形态结构和酶活性影响的实验研究

目的 :观察针刺对缺血再灌注脑组织形态结构和酶活性的影响。方法 :采用闭塞大鼠四条动脉的全脑缺血再灌注模型 ,以组织化学方法观察缺血再灌注脑组织形态结构的变化及针刺对其变化的影响 ,同时测定脑组织中丙二醛 (MDA)含量和谷胱甘肽过氧化物酶 (GSH px)、离子泵的活性及针刺对其活性的影响。结果 :缺血再灌注组出现明显的神经细胞变性、死亡和胶质细胞增生现象 ,针刺治疗组Ⅱ无明显的细胞受损后形态学变化 ;缺血组和缺血再灌注组MDA含量显著高于假手术组 ,经针刺治疗后MDA含量明显下降 ;GSH px活性在脑缺血过程中首先代偿性升高 ,在再灌注过程中明显下降 ,经针刺治疗后酶活性复又升高 ;离子泵的活性在缺血及再灌注过程均有不同程度的下降 ,经针刺治疗后各离子泵的活性均升高至与假手术组相近。结论 :在缺血和再灌注过程中神经元的变性乃至死亡与膜脂质过氧化作用加强、自由基清除能力下降及能量代谢异常密切相关 ,而针刺“百会”和“曲池”可有效改善缺血再灌注造成的神经元延迟性损伤。

Effects of Acupuncture on Cerebral Ischemia-reperfusion Induced Changes of Morphology and Enzymatic Activity in Rats

Objective: To observe the effects of acupuncture on cerebral structure and enzymatic activity after cerebral ischemia and to analyze the mechanisms of acupuncture in improving stroke. Methods: 35 SD rats were randomized into sham operation group (n=6), ischemia group (n=9), ischemia+reperfusion group (n=6), acupuncture I group (n=6) and acupuncture II group (n=8). "Baihui"(GV 20) and bilateral "Quchi"(LI 11) were punctured and stimulated electrically with parameters of 7 Hz, 0.7 V and duration of 30 min, which was respectively given after inducing cerebral ischemia (30 min) in acupuncture I group and 3 hr after ischemia+reperfusion in acupuncture II group. Cerebral ischemia model was established using four artery (bilateral vertebral arteries and bilateral common carotid arteries) occlusion and reperfusion method. Glutathione peroxidase (GSH px), ATPase activity and malonyldialdehyde (MDA) in cerebral cortex and hippocampus tissues were assayed according to instructions of the reagent kits. Results: ① Following ischemia+reperfusion, cerebral tissue injury including neuron degeneration, death, gliocyte proliferation, etc was found in the hippocampus and cerebral cortex tissues in ischemia and ischemia+reperfusion groups, but in acupuncture II group no very apparent injury changes appeared. ②compared with the sham operation group, MDA contents in cellular plasma, membrane and mitochondria in ischemia group and ischemia+reperfusion group increased significantly in comparison with sham operation group (P<0.05, 0.001). Following acupuncture (both acupuncture I and II groups), MDA contents reduced significantly (P<0.001) compared with those of ischemia or ischemia+reperfusion groups (P<0.01). ③ Compared with the sham operation group, GSH px activity in cellular plasma, membrane and mitochondria increased in ischemia group (P<0.05); but compared with ischemia group, GSH px decreased very notably in ischemia+reperfusion group (P<0.01). After acupuncture, GSH px activity recovered basically compared with sham operation group. ④ Regarding ATPase activity, after ischemia and ischemia reperfusion, Na +,K + ATPase, Mg 2+ ATPase and Ca 2+ ATPase in plasma, membrane and mitochondria all lowered particularly in ischemia+reperfusion group (P<0.05). Following acupuncture (acupuncture II), the 3 types of ATPase activity in cellular membrane and mitochondria recovered completely while the 3 types of ATPase activity in plasma was even evidently higher than that of sham operation group (P<0.001). Conclusion: Acupuncture of "Baihui"(GV 20) and "Quchi"(LI 11) can effectively reduce cerebral ischemia reperfusion induced neuronal degeneration, death and hyperactivity of membrane lipid peroxidation, attenuation of free radical clearing ability and energy metabolic abnormality in the ischemic cortex and hippocampus .