【目的】 探讨“双固一通”针法对脑缺血再灌注损伤（CIRI）大鼠的治疗作用及机制。【方法】 将75只大鼠随机分为假手 术组，模型组，针法组（选择肾俞、足三里、百会、水沟穴），依达拉奉组，TAK-242 [Toll 样受体 4（TLR4）/核转录因子 κB （NF-κB）抑制剂]组，每组 15只。除假手术组，其他各组大鼠采用大脑中动脉闭塞（MCAO）法制备 CIRI模型。造模成功后， 分组干预。干预结束后，比较各组大鼠神经功能评分、脑梗死面积、缺血侧大脑CA1区病理情况、海马CA1区神经元凋亡 情况、炎症因子肿瘤坏死因子α（TNF-α）、白细胞介素1β（IL-1β）水平及脑组织内TLR4、NF-κB P65蛋白表达情况。【结果】 与假手术组比较，模型组神经功能评分，脑梗死面积，海马CA1区神经元凋亡率，TNF-α、IL-1β含量及TLR4、NF-κB P65 蛋白表达水平显著升高（P＜0.05）；与模型组比较，针法组、依达拉奉组、TAK-242 组神经功能评分，脑梗死面积，海马 CA1区神经元凋亡率，TNF-α、IL-1β含量及 TLR4、NF-κB P65蛋白表达水平显著降低（P＜0.05），且针法组改善作用优于 依达拉奉组、TAK-242组（P＜0.05）。【结论】“双固一通”针法可能通过抑制TLR4/NF-κB信号途径减轻CIRI大鼠炎症反应，从 而改善神经功能缺损。

Objective To investigate the therapeutic effect and mechanism of “Shuanggu Yitong” Acupuncture （a therapeutic approach reinforcing fundamental constitution and unblocking pathogens） on cerebral ischemiareperfusion injury （CIRI） in rats. Methods Seventy-five rats were randomly divided into five groups： shamoperation group， model group， acupuncture group [acupoints： Shenshu（BL23）， Zusanli（ST36）， Baihui （GV20），and Shuigou（GV26）]，edaravone group，and TAK-242 group [a Toll-like receptor 4（TLR4）/nuclear factor κB （NF- κB） inhibitor group]， with 15 rats in each group. Except for the sham-operation group， CIRI models were established in the other groups using the middle cerebral artery occlusion （MCAO） method. After successful modeling， interventions were administered according to the group assignments. After intervention， neurological function scores， cerebral infarct volume， pathological changes in the CA1 region of the ischemic hemisphere， neuronal apoptosis in the hippocampal CA1 region， levels of inflammatory factors tumor necrosis factor α（TNF-α） and interleukin 1β（IL-1β），and protein expression of TLR4 and NF-κB P65 in brain tissue were compared among the groups. Results Compared with the sham-operation group， the model group showed significantly increased neurological function scores， cerebral infarct volume， neuronal apoptosis rate in the hippocampal CA1 region，levels of TNF-α and IL-1β，and TLR4，NF-κB P65 protein expression levels （P＜0.05）. Compared with the model group，the acupuncture group，edaravone group，and TAK-242 group exhibited significantly reduced neurological function scores， cerebral infarct volume， neuronal apoptosis rate in the hippocampal CA1 region，levels of TNF-α and IL-1β，and TLR4，NF-κB P65 protein expression levels （P＜ 0.05）. Moreover，the improvement in the acupuncture group was superior to that in the edaravone and TAK-242 groups （P＜0.05）. Conclusion“Shuanggu Yitong” Acupuncture may alleviate the inflammatory response in CIRI rats by inhibiting the TLR4/NF-κB signaling pathway，thereby improving neurological deficits.

R245

陕西省自然科学基础研究基金项目（编号：2019JM-325）