循阳明经按摩对脑卒中大鼠神经功能的影响及其机制

目的 观察循经按摩对脑卒中大鼠模型血清脑源性神经营养因子（brain derived neurotrophic factor，BDNF）表达及脑组织超微结构的影响，探究循经按摩改善脑卒中后神经功能的作用机制。方法 采用线栓法复制大鼠中动脉阻塞（middle cerebral artery occlusion，MCAO）模型。将72只实验大鼠随机分为模型组、循经按摩组、假手术组，每个组又按照时间分为4个亚组分别为3天组、7天组、14天组、21天组，循经按摩组在模型复制成功后24 h开始干预。采用Longa评分评定神经功能，采用光学显微镜和透射电子显微镜下分别观察大鼠脑组织变化，采用实时定量PCR检测BDNF mRNA表达水平，采用ELISA法检测BDNF蛋白的表达水平。结果 与假手术组比较，模型组、循经按摩组大鼠各时间点Longa评分均明显提高（P＜0.05）；与模型组比较，循经按摩组大鼠各个时间点Longa评分均降低（P＜0.05）。光学显微镜下发现，与模型组相比，循经按摩组皮质层损伤部位神经细胞水肿的变性随时间的推移而明显减轻，海马层神经细胞排列逐渐规律，且随着时间的推移排列逐渐紧密；透射电子显微镜下发现，与模型组相比，循经按摩组大鼠脑组织细胞肿胀、自噬和凋亡明显减少。与假手术组比较，模型组各个时间点大鼠BDNF mRNA及蛋白表达水平均明显下调（P＜0.05）；与模型组比较，循经按摩组各个时间点大鼠BDNF mRNA及蛋白表达水平均明显上调（P＜0.05）。结论 循经按摩可以上调BDNF表达水平，减少脑组织神经细胞的变性、凋亡，达到改善神经功能损伤的作用。

Effect of Massage along Yangming Meridian on the Neurological Function of Rats with Cerebral Infarction and Its Mechanism

Objective To observe the effect of meridian massage on the expression of brain-derived neurotrophic factor (BDNF) in serum and the ultrastructure of brain tissue in a rat model of stroke, and to explore the mechanism of meridian massage in improving the neurological function after stroke. Methods A rat model of middle cerebral artery occlusion was established by the suture method. Seventy-two rats were randomly divided into model group, meridian massage group, and sham operation group. Each group was divided into four subgroups according to time: 3-d, 7-d, 14-d, and 21-d groups. In the meridian massage group, intervention began at 24 hours after the model was successfully established. The neurological function was evaluated by Zea Longa score; the changes of brain tissue were observed under optical microscope and transmission electron microscope; the mRNA and protein expression levels of BDNF were measured by quantitative real-time PCR and ELISA. Results Compared with the sham operation group, the model group and the meridian massage group showed significant increases in Zea Longa score at each time point (P<0.05); compared with the model group, the meridian massage group showed a significant reduction in Zea Longa score at each time point (P<0.05). The optical microscopy showed that compared with the model group, the meridian massage group showed significantly reduced edema of nerve cells in the injured part of the cortical layer over time and increasingly ordered and dense arrangement of nerve cells in the hippocampal layer. The transmission electron microscopy showed that compared with the model group, the meridian massage group showed significant reductions in swelling, autophagy, and apoptosis of brain cells. Compared with the sham operation group, the model group had significantly down-regulated mRNA and protein expression of BDNF at each time point (P<0.05), and compared with the model group, the meridian massage group had significantly up-regulated mRNA and protein expression of BDNF at each time point (P<0.05). Conclusion Meridian massage can increase the expression of BDNF and reduce the degeneration and apoptosis of nerve cells in brain tissue to improve nerve injury.