Acupuncture Research Center, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
Department of Traditional Chinese Medicine, Xijing Hospital, The Fourth Military Medical University, Xi'an, 710032, People's Republic of China.
BMC Complement Altern Med. 2017 Sep 26;17(1):470. doi: 10.1186/s12906-017-1979-6.
Cerebral edema, erupting simultaneously with severe ischemic stroke, might lead to increased intracranial pressure, cerebral herniation, and ultimately death. Studies conducted previously by our team have demonstrated the fact that bloodletting puncture at hand twelve Jing-well points (HTWP) could alleviate cerebral edema, which mainly results from the disruption of blood-brain barrier (BBB). The study, therefore, was first designed to demonstrate whether BBB-protection serves an important role in the edema-relief effect of HTWP bloodletting, based on which to research the molecular mechanism underlying.
The rats were made into model suffering from permanent middle cerebral artery occlusion (pMCAO) and then bloodletting puncture were treated at HTWP once a day. Wet and dry weight method was adopted to evaluate the degree of brain edema, evans blue extravasation and electron microscopy were used to evaluate the integrity of the BBB, and RT-qPCR was carried out to analyze the expression level of occludin, claudin-5, ICAM-1, and VEGF.
Results revealed that bloodletting puncture treatment could reduce water content of brain and the permeability of BBB caused by ischemic stroke. In bloodletting puncture group, ameliorated tight junctions could be observed under electron microscopy. It was demonstrated in further study that, in bloodletting group, compared with pMCAO one, the expression levels of occludin and claudin-5 were up-regulated, while ICAM-1 and VEGF were down-regulated.
In conclusion, bloodletting puncture at HTWP might play a significant role in protecting the tight junctions of BBB, thus alleviating cerebral edema induced by ischemic stroke. Therefore, the therapy of bloodletting puncture at HTWP may be a promising strategy for acute ischemic stroke in the future.
脑水肿与严重缺血性中风同时发生，可能导致颅内压升高、脑疝，最终导致死亡。我们团队之前的研究表明，针刺手十二井穴（HTWP）可以减轻脑水肿，这主要是由于血脑屏障（BBB）的破坏。因此，该研究首先旨在证明 BBB 保护在 HTWP 刺血减轻脑水肿的作用中是否起重要作用，并在此基础上研究其分子机制。
将大鼠制成永久性大脑中动脉闭塞（pMCAO）模型，然后每天一次对 HTWP 进行刺血治疗。采用干湿重法评估脑水肿程度，伊文思蓝外渗和电子显微镜观察评估 BBB 的完整性，采用 RT-qPCR 分析 occludin、claudin-5、ICAM-1 和 VEGF 的表达水平。
结果表明，刺血治疗可减轻缺血性中风引起的脑水含量和 BBB 通透性增加。在刺血组中，电镜下观察到紧密连接得到改善。进一步研究表明，与 pMCAO 组相比，刺血组 occludin 和 claudin-5 的表达水平上调，而 ICAM-1 和 VEGF 的表达水平下调。
综上所述，针刺 HTWP 可能在保护 BBB 的紧密连接方面发挥重要作用，从而减轻缺血性中风引起的脑水肿。因此，针刺 HTWP 的治疗方法可能是未来急性缺血性中风的一种有前途的策略。
Zotero 插件
