世界中医药

目的：观察百会穴及足三里穴对急性脑缺血再灌注损伤模型鼠认知能力的影响，并通过Notch信号通路进一步探讨其可能的机制。方法：选取无特定病原体(SPF)级SD大鼠45只，随机分为空白组15只，造模组30只，其中24只造模成功，再次随机分为缺血组及干预组，每组12只。空白组及造模组大鼠无任何干预，干预组大鼠在造模后24 h开始百会穴、足三里按摩，每次持续20 min，2次/d，连续14 d。其中造模组鼠利用改良线栓法行大脑中动脉梗死（MCAO）制备急性脑缺血再灌注损伤模型，干预结束后用水迷宫评估各组大鼠认知能力变化，用2,3,5-氯化三苯基四氮唑染色法(TTC)观察各组脑梗死体积变化，利用透射电镜法观察各组大鼠海马组织超微结构变化，用Western blotting法检测Notch1、NICD蛋白的变化。结果：干预第14天空白组与缺血组、干预组比较,逃避潜伏期差异有统计学意义（P<0.05）;干预组与缺血组比较，差异有统计学意义（P<0.05）；空白组和干预组穿越平台次数比缺血组多，差异有统计学意义（P<0.05）。干预14 d后，TTC检测显示缺血组大鼠脑区出现明显的缺血梗死病灶，而干预组梗死体积较缺血组减少，差异有统计学意义（P<0.05）。透射电镜显示缺血组大鼠海马组织神经元结构破坏明显，导致脑组织细胞出现一系列变性坏死，而干预组大鼠缺血侧大脑海马神经元结构坏死及溶解明显减轻。Western blotting法显示经过干预后Notch1、NICD蛋白有明显提高，与缺血组比较，差异有统计学意义（P<0.05）。结论：百会穴、足三里穴按摩可改善大鼠的神经功能缺损情况，提高认知能力，减少脑梗死体积，促进脑的神经元细胞形态结构的修复，其作用机制可能通过Notch信号通路实现。

English Summary:

To observe the effects of Baihui (GV20) and Zusanli (ST36) on cognitive ability of rats with acute cerebral ischemia-reperfusion injury,and to further explore its possible mechanism through Notch signaling pathway.Methods:A total of 45 SPF SD rats were randomly divided into a blank group (n=15) and a model group (n=30).The model group was established by modified middle cerebral artery infarction (Middle Cerebral Artery Occlusion,MCAO),totally 24 were successfully modeled,which were then randomly divided into an ischemic group (n=12) and an intervention group (n=12).The rats in the blank group and the model group did not accept any intervention means,while the rats in the intervention group began massage at Baihui (GV20) and Zusanli (ST36) 24 hours after modeling,20 mins each time and twice a day for 14 days.After the intervention,the cognitive ability of rats in each group was evaluated by water maze.The volume of cerebral infarction was observed by 2,3,5-triphenyltetrazolium chloride staining (TTC),and the ultrastructural changes of hippocampus were observed by transmission electron microscopy (TEM).The changes of Notch1 and NICD proteins were detected by Western blotting.Results:1)On the 14th day of intervention,there was significant difference in escape latency between the blank group,the ischemia group and the intervention group (P<0.05),and there was significant difference between the intervention group and the ischemia group (P<0.05).The blank group and the intervention group crossed the platform more times than the ischemic group,and the difference was statistically significant (P<0.05).2)After 14 days of intervention,TTC showed that there were obvious ischemic infarction lesions in the brain region of the ischemic group,but the infarct volume in the intervention group was significantly decreased than that in the ischemic group,with statistically significant difference (P<0.05).3)The results of transmission electron microscope (TEM) showed that the structure of hippocampal neurons in the ischemic group was obviously destroyed,resulting in a series of signs of degeneration and necrosis of brain tissue cells.In the intervention group,the degree of necrosis and dissolution of hippocampal neurons on the ischemic side of the brain was significantly reduced in the intervention group.4)Western blotting showed that Notch1 and NICD protein were significantly increased after intervention,which were different from those in ischemic group (P<0.05).Conclusion:Massage at Baihui (GV20) and Zusanli (ST36) can improve the neurological deficit,improve cognitive ability,reduce the volume of cerebral infarction and promote the repair of neuronal morphology and structure,and the mechanism may be realized by Notch signaling pathway.

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