CAJ | 학술논문

目的探讨针刺结合运动训练对脑梗死大鼠患侧海马CA3区微管相关蛋白-2(MAP-2)表达的影响及其促进学习记忆功能恢复的可能机制。方法将80只Wistar大鼠分为假手术组（8只）和手术组（72只），后者制成右侧大脑中动脉闭塞(MCAO)模型后再分为模型组、运动训练组、针刺运动训练组，每组24只，于术后第1，3，5周用免疫组化方法检测患侧海马CA3区MAP-2的表达，同时在术后第5周时进行学习记忆能力测评。结果假手术组MAP-2阳性纤维排列整齐，分布密集。梗死后患侧海马CA3区阳性神经元及树突纤维减少。术后1周针刺运动训练组MAP-2阳性纤维稍有增多，与模型组、运动训练组比较差异均有统计学意义(P＜0.01)；在术后第3周、5周时MAP-2阳性表达明显增多，光密度值高于运动训练组(P＜0.05)和模型组(P＜0.01)。术后第5周针刺运动训练组在Y迷宫分辨学习测试中记忆力明显优于模型组(P＜0.01)和运动训练组(P＜0.05)。结论针刺配合运动训练可明显促进脑梗死后患侧海马CA3区树突结构可塑性变化，且MAP-2表达增加与学习记忆功能恢复成正相关。
목적 탐토침자결합운동훈련대뇌경사대서환측해마CA3구미관상관단백-2(MAP-2)표체적영향급기촉진학습기억공능회복적가능궤제。방법 장80지Wistar대서분위가수술조（8지）화수술조（72지），후자제성우측대뇌중동맥폐새(MCAO)모형후재분위모형조、운동훈련조、침자운동훈련조，매조24지，우술후제1，3，5주용면역조화방법검측환측해마CA3구MAP-2적표체，동시재술후제5주시진행학습기억능력측평。결과 가수술조MAP-2양성섬유배렬정제，분포밀집。경사후환측해마CA3구양성신경원급수돌섬유감소。술후1주침자운동훈련조MAP-2양성섬유초유증다，여모형조、운동훈련조비교차이균유통계학의의(P＜0.01)；재술후제3주、5주시MAP-2양성표체명현증다，광밀도치고우운동훈련조(P＜0.05)화모형조(P＜0.01)。술후제5주침자운동훈련조재Y미궁분변학습측시중기억력명현우우모형조(P＜0.01)화운동훈련조(P＜0.05)。결론 침자배합운동훈련가명현촉진뇌경사후환측해마CA3구수돌결구가소성변화，차MAP-2표체증가여학습기억공능회복성정상관。
Objective To study the expression of microtubule-associated protein-2 (MAP-2) in the CA3 region of the hippocampus and any effect of acupuncture combined with exercise training on the recovery of learning and memory after experimental cerebral infarction.Methods Eighty Wistar rats were randomly divided into a sham-operation group (n = 8 ) and an operation group (n = 72 ) subdivided randomly and equally into a model group, an exercisetraining group and an acupuncture plus exercise training group, with 24 rats in each group. After right middle cerebral artery occlusion or a mock operation, the expression of MAP-2 in the CA3 region of the hippocampus was detected with immunohistochemistry 1, 3 and 5 weeks after the operation. Learning and memory function was assessed at the 5th week post operation.Results MAP-2- positive fibers were arranged in an orderly way and distributed densely in the shamoperation group. After cerebral infarction, number of MAP-2 positive neurons and dendrite fibers decreased in the CA3 region of the affected side. A week after the operation, MAP-2 positive fibers had increased significantly in the acupuncture plus exercise group compared with the model group and the exercise group. At the 3rd and 5th week post operation, expression of MAP-2 and optical density had increased significantly compared with the model group and the exercise training group. At the 5th week post operation, Y maze discrimination and learning tests showed that learning and memory had improved significantly more in the acupuncture plus exercise training group compared with the model group and the exercise training group.Conclusions Exercise training combined with acupuncture can promote changes in dendritic plasticity and increase MAP-2 expression in the CA3 region after cerebral infarction. This may be correlated positively with the recovery of learning and memory after cerebral infarction, at least in rats.