【目的】 探讨电针百会和大椎对缺血性脑卒中大鼠的长期和短期治疗作用及机制。【方法】 将30只大鼠随机分为假手术 组、模型组和电针组，每组10只。模型组和电针组大鼠采用改良的Longa方法建立大脑中动脉阻塞（MCAO）模型。电针组 电针百会（GV20）和大椎（GV14）1周，每日 1次。于 MCAO术后 14、21和 28 d，进行粘贴去除试验和前肢放置试验评估长期 神经恢复情况。MCAO术后第2天，透射电子显微镜观察脑皮层组织病理变化，采用免疫荧光法检测脑皮层组织Iba-1的表 达，Western Blot法检测脑皮层组织缺氧诱导因子 1α（HIF-1α）、血管内皮生长因子（VEGF）、白细胞介素 1β（IL-1β）和肿瘤 坏死因子 α（TNF-α）的表达。【结果】（1）与假手术组同时间点比较，模型组 MCAO 术后 14、21、28 d 拆除胶带的时间延长， 前肢踏步次数增加（P＜0.05）；与模型组同时间点比较，电针组大鼠MCAO术后14、21、28 d 胶带去除时间显著缩短，前肢 踏步次数减少（P＜0.05）。MCAO术后28 d内，胶带去除时间逐渐缩短、前肢步数逐渐减少。（2）MCAO术后第2天：与假手术 组比较，模型组脑皮层缺血半暗带小胶质细胞变性和坏死，线粒体损伤，脑皮层组织 Iba-1 的表达水平升高，HIF-1α、 VEGF及 IL-1β和 TNF-α的表达水平升高，差异均有统计学意义（P＜0.05）；与模型组比较，电针组脑皮层缺血半暗带小胶 质细胞损伤得到改善，脑皮层组织Iba-1的表达水平降低，HIF-1α、VEGF及IL-1β和TNF-α的表达水平降低，差异均有统 计学意义（P＜0.05）。【结论】 电针百会和大椎可长期改善缺血性脑卒中大鼠症状，短期改善脑皮层缺血半暗带小胶质细胞的变 性和坏死，其机制可能与下调脑皮层组织HIF-1α、VEGF、IL-1β和TNF-α表达，并抑制小胶质细胞向M1表型的转化有关。

Objective To explore the long-term and short-term therapeutic effects and mechanisms of electroacupuncture at Baihui（GV20） point and Dazhui（GV14） point in rats with ischemic stroke. Methods Thirty rats were randomly divided into a sham-operated group，a model group，and an electroacupuncture group，with 10 rats in each group. The model group and the electroacupuncture group were subjected to middle cerebral artery occlusion （MCAO） using the modified Longa method. The electroacupuncture group received electroacupuncture at Baihui point and Dazhui point once daily for one week. Long-term neurological recovery was assessed using the adhesive removal test and the forelimb placement test at 14，21 and 28 days after MCAO. On the second day after MCAO， cerebral cortical histopathological changes were observed using transmission electron microscopy， the expression of Iba-1 in cortical tissue was detected by immunofluorescence，and the expression levels of hypoxiainducible factor 1α（HIF-1α），vascular endothelial growth factor （VEGF），interleukin 1β（IL-1β），and tumor necrosis factor α（TNF- α） in cortical tissue were measured by Western Blot. Results （1） Compared with the sham-operated group at the same time points， the model group showed prolonged adhesive removal time and increased forelimb stepping times at 14，21 and 28 days after MCAO （P＜0.05）. Compared with the model group at the same time points，the electroacupuncture group exhibited significantly shortened adhesive removal time and reduced forelimb stepping times at 14，21 and 28 days after MCAO （P＜0.05）. Within 28 days after MCAO，the adhesive removal time was gradually decreased，and forelimb stepping times were gradually reduced.（2） On the second day after MCAO： compared with the sham-operated group， the model group showed degeneration and necrosis of microglia in cortical ischemic penumbra， mitochondrial damage， increased expression of Iba-1 in cortical tissue， and elevated levels of HIF-1α， VEGF， IL-1β and TNF- α， with statistically significant differences （P＜0.05）. Compared with the model group，the electroacupuncture group exhibited the improvement of microglia injury in cortical ischemic penumbra，reduced expression of Iba-1 in cortical tissue and decreased levels of HIF-1α，VEGF，IL-1β and TNF-α，with statistically significant differences （P＜0.05）. Conclusion Electroacupuncture at Baihui point and Dazhui point can improve symptoms in rats with ischemic stroke in the long term and ameliorate degeneration and necrosis of cortical microglia in the ischemic penumbra in the short term. The mechanism may be related to the downregulation of HIF-1α，VEGF，IL-1β and TNF-α expressions in cerebral cortical tissue and the inhibition of microglial transformation to the M1 phenotype.

R245.31

湖北省自然科学基金课题（编号：LHJJ2023000133）