Chen Qiu-Xin, Zou Wei, Sun Xiao-Wei, Yu Xue-Ping, Dai Xiao-Hong, Niu Ming-Ming, Teng Wei, Bao Yu, Yu Wei-Wei, Ma Hui-Hui
The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150040, China.
Heilongjiang University of Chinese Medicine, Harbin 150040.
Zhen Ci Yan Jiu. 2016 Oct 25;41(5):410-6.
To observe the effect of penetrative needling of "Baihui" (GV 20) to "Qubin" (GB 7) on neurologic functions and expression of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and toll-like receptor 4 (TLR-4, involving in inflammatory reactions) in the tissue around the local cerebral hematoma in rats with intracerebral hemorrhage (ICH), so as to provide evidence for clinical treatment of ICH.
Fifty-four male Wistar rats were randomly divided into sham control, mo-del and acupuncture groups, and then further divided into three time-point subgroups(1,3,7 days after modeling, =6/subgroup). The ICH model was established by injection of the rat's autoblood (50 μL) into the putaman region (P:0.2 mm, R:3.5 mm) in a stereotaxic apparatus and confirmed by Berderson's neurologic examination grading system (0-3 points). The neurologic function was assessed by using Longa's scoring (5-points) and footfault asymmetry testing[footfault index=(contra faults-ipsi faults)/total steps in 2 min]. For penetrative needling, an acupuncture needle was inserted into GV 20 and controlled to advance to GB 7 on the affected side and retained for 30 min, once daily. The expression of TNF-α, IL-6 and TLR-4 in the cerebral tissue around the putaman was detected by immunohistochemistry.
After penetrative needling stimulation, the increased Longa's score and footfault asymmetry score in ICH rats were significantly decreased on day 1, 3 and 7 after modeling (<0.01), suggesting an improvement of neurologic function after the treatment. Immunohistochemical staining outcomes of the cerebral tissue surrounding the autoblood injection site showed that the expression levels of TNF-α, IL-6 and TLR-4 proteins on day 1, 3 and 7 were considerably higher in the model group than in the control group (<0.01), and markedly lower in the acupuncture group than in the model group (<0.01), suggesting a suppression of the proinflammatory factors and TLR-4 levels around the locus of the brain after needling intervention. A positive correlation existed between the expression levels of TLR-4 and IL-6/TNF-α.
Penetrative needling stimulation of GV 20 to GB 7 can reduce the levels of proinflammatory factors TNF-α and IL-6, and TLR-4 in the ICH tissues in rats with cerebral hemorrhage, which may contribute to its effect in improving neurological function.
观察针刺“百会”（GV 20）透“曲鬓”（GB 7）对脑出血（ICH）大鼠神经功能及局部脑血肿周围组织中肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6和参与炎症反应的Toll样受体4（TLR-4）表达的影响，为ICH的临床治疗提供依据。
54只雄性Wistar大鼠随机分为假手术对照组、模型组和针刺组，再进一步分为3个时间点亚组（造模后1、3、7天，每组6只）。采用立体定向仪将大鼠自体血（50 μL）注入壳核区（P：0.2 mm，R：3.5 mm）建立ICH模型，并通过Berderson神经功能检查评分系统（0~3分）进行确认。采用Longa评分（5分制）和足错误不对称测试[足错误指数=（对侧错误-同侧错误）/2分钟内总步数]评估神经功能。针刺时，将针灸针插入GV 20，控制其向患侧GB 7推进并留针30分钟，每日1次。采用免疫组织化学法检测壳核周围脑组织中TNF-α、IL-6和TLR-4的表达。
针刺刺激后，ICH大鼠造模后1、3、7天升高的Longa评分和足错误不对称评分显著降低（<0.01），提示治疗后神经功能改善。自体血注射部位周围脑组织的免疫组织化学染色结果显示，模型组第1、3、7天TNF-α、IL-6和TLR-4蛋白表达水平显著高于对照组（<0.01），针刺组显著低于模型组（<0.01），提示针刺干预后可抑制脑损伤部位周围促炎因子和TLR-4水平。TLR-4与IL-6/TNF-α表达水平呈正相关。
针刺刺激GV 20透GB 7可降低脑出血大鼠ICH组织中促炎因子TNF-α、IL-6和TLR-4水平，这可能是其改善神经功能的作用机制。
