CAJ | 학술논문

目的：探讨电针结合游泳训练对脑缺血再灌注大鼠血管内皮生长因子（VEGF）表达的影响以及其促进大鼠受损功能恢复的机制。方法选取健康雄性SD大鼠50只，随机分为假手术组、对照组、电针组、训练组、联合治疗组，每组10只。采用线栓法制备左侧大脑中动脉阻塞（MCAO）2 h再灌注模型。电针组大鼠行电针治疗，每日1次，每次20 min；训练组行游泳训练，每日1次，每次20 min；联合治疗组行电针治疗与游泳训练，均为每日1次，每次20 min；对照组和假手术组大鼠不行任何治疗。采用Zausinger评分及前肢放置试验评定大鼠功能缺损情况，并采用RT-PCR法测定缺血侧大脑皮层VEGF mRNA表达量。结果假手术组无神经功能缺损。与对照组相比，电针组、训练组及联合治疗组受损神经功能均得以改善（P＜0.05）。训练组的Zausinger评分高于电针组，且前肢放置试验评分低于电针组，但差异均无统计学意义（P＞0.05）。联合治疗组与任何单一治疗的评分相比均具有显著差异（P＜0.05）。与电针组、训练组相比，联合治疗组 VEGF mRNA表达量明显增多，差异具有显著性（P＜0.05）。训练组VEGF mRNA表达量高于电针组，差异无显著性（P＞0.05）。结论电针疗法与运动训练均能够改善大鼠受损的运动、感觉功能及提高脑缺血再灌注大鼠大脑皮层中VEGF mRNA表达量，且联合治疗能够取得更好的效果；其机制可能与高表达的VEGF能够更好地促进血管的重塑与再生相关。
목적：탐토전침결합유영훈련대뇌결혈재관주대서혈관내피생장인자（VEGF）표체적영향이급기촉진대서수손공능회복적궤제。방법선취건강웅성SD대서50지，수궤분위가수술조、대조조、전침조、훈련조、연합치료조，매조10지。채용선전법제비좌측대뇌중동맥조새（MCAO）2 h재관주모형。전침조대서행전침치료，매일1차，매차20 min；훈련조행유영훈련，매일1차，매차20 min；연합치료조행전침치료여유영훈련，균위매일1차，매차20 min；대조조화가수술조대서불행임하치료。채용Zausinger평분급전지방치시험평정대서공능결손정황，병채용RT-PCR법측정결혈측대뇌피층VEGF mRNA표체량。결과가수술조무신경공능결손。여대조조상비，전침조、훈련조급연합치료조수손신경공능균득이개선（P＜0.05）。훈련조적Zausinger평분고우전침조，차전지방치시험평분저우전침조，단차이균무통계학의의（P＞0.05）。연합치료조여임하단일치료적평분상비균구유현저차이（P＜0.05）。여전침조、훈련조상비，연합치료조 VEGF mRNA표체량명현증다，차이구유현저성（P＜0.05）。훈련조VEGF mRNA표체량고우전침조，차이무현저성（P＞0.05）。결론전침요법여운동훈련균능구개선대서수손적운동、감각공능급제고뇌결혈재관주대서대뇌피층중VEGF mRNA표체량，차연합치료능구취득경호적효과；기궤제가능여고표체적VEGF능구경호지촉진혈관적중소여재생상관。
Objective To explore the influence of electro-acupuncture therapy and exercise training on the expression of Vascular Endothelial Growth Factor (VEGF) in rats with cerebral infarction, and to explore the possible mechanism that promoted the neurological recovery. Methods Fifty healthy male SD rats were randomly divided into a sham-operation group, a control group, an electro-acupuncture group (an EA group), a training group and a combined therapy group, 10 rats each. To establish animal model of cerebral ischemia-reperfusion in rats, the intraluminal thread method was applied to cause left middle cerebral artery occlusion (MCAO) for 2 h and before reperfusion. The rats of the EA group were treated by electro-acupuncture for 20 min, once each day. The rats of training group were swimming for 20 min, once each day. The rats of combined therapy group were treated by electro-acupuncture and swimming training, the time and frequency of which were the same with the above two groups. The rats of the sham-operation and control group were without any treatment. Neurological defects were assessed by Zausinger scores and forelimb placing test. It was examined by RT-PCR on the expressions of VEGF mRNA in the ischemia-reperfusion pallium. Results The rats of the sham-operation group had no neurological defects. Compared with the control group, EA group, train group and combined therapy group were able to improve the function of damaged nerve (P<0.05). Compared with the train group, the Zausinger scores of EA group were higher, and the forelimb placing test scores were lower, but the difference was not statistically significant (P>0.05). The scores of combined treatment group were higher than any single treatment score, the different of which was both significant (P<0.05). Compared with the EA group and the training group, the VEGF mRNA expressions of the combined therapy group were significantly increased, and the difference was significant (P<0.05). The VEGF mRNA expression level of the training group was higher than the EA group, and the difference was not statistically significant (P>0.05). Conclusions Electro-acupuncture therapy and exercise training could improve the injured motor and sensory function and increase the expressions of VEGF mRNA of the cerebral ischemia-reperfusion rats, and combination therapy could achieve better results, the mechanism of which may be associated with that increased VEGF could promote the regeneration of vascular remodeling.