目的研究电针(EA)结合经颅磁刺激(rTMS)对急性脑缺血大鼠神经干细胞激活、增殖以及学习、记忆能力的影响。方法将120只雄性Wistar大鼠随机分成正常组、模型组、EA组、rTMS组和EA加rTMS组。复制急性大脑中动脉缺血模型,选取1d作为开始治疗的时间点,分别施以EA、rTMS和EA加rTMS方法处理,大鼠在各相应时间点处死前12h内每4h腹腔注射溴脱氧尿嘧啶核苷(Brdu)1次,并对大鼠行电跳台试验、神经功能评分等评测,分别在治疗后的7,14,28d进行组织切片,采用氯化三苯基四氮唑(TTC)和Brdu免疫组化方法检测,观察鼠脑梗死面积以及鼠脑Brdu阳性细胞数。结果EA组、rTMS组和EA加rTMS组梗死侧海马齿状回颗粒细胞层(SGZ)、室管膜下层(SVZ)周围Brdu在7,14d表达较模型组增强(P〈0.05),尤其以EA加rTMS组明显,28d各组差异无统计学意义,EA组、rTMS组和EA加rTMS组在7,14,28d神经功能评分、电跳台试验成绩均较模型组改善(P〈0.05),尤以EA加rTMS组明显。结论EA结合rTMS治疗能促进大鼠神经干细胞的增殖和神经功能恢复,改善大鼠学习记忆能力。
Objective To study the effect of electroacupuncture (EA) combined with repetitive transcranial magnetic stimulation (rTMS) on endogenous neural stem cells, as well as learning and memory in rats with cerebral ischemia. Methods One hundred and twenty male Wistar rats were randomly divided into 5 groups: a normal group, a model group, an EA group, a rTMS group and an EA plus rTMS group. After establishing acute middle cerebral artery occlusion, the rats in the various experimental groups were treated with EA, rTMS or EA plus rTMS. The rats' ability to avoid an electric shock was observed using a jumping stand. Immunohistochemical techniques were used to measure the infarct area and the number of Brduositive cells. Results A small quantity of Brdu labelled cells was observed in the subgranular zone (SGZ) and the subventricular zone (SVZ) in rats in the normal group. In the EA, rTMS and EA plus rTMS groups, the numbers of Brdu labelled cells in the SVZ and SGZ was significantly higher than in the model group after both 7 and 14 days. The expression of Brdu around the SVZ and SGZ of the 3 treatment groups increased, especially in the EA plus rTMS group. At 7, 14 and 28 d there was significant improvement in the neural function and electric shock avoidance test scores in the EA, rTMS and EA plus rTMS groups compared with the model group,with the EA plus rTMS animals scoring best. Conclusion EA plus rTMS can promote the proliferation of nerve stem cells, facilitate neurological recovery and improve learning and memory in rats after cerebral ischemia.