【作者】 冯丽娟；

【导师】 金荣疆；

【作者基本信息】 成都中医药大学 ， 康复医学与理疗学， 2011， 硕士

【摘要】 目的：观察康复训练结合电针治疗对脑卒中肢体痉挛大鼠突触结合蛋白I表达的影响,探讨康复训练结合电针治疗对脑卒中后偏瘫肢体痉挛的作用机制。方法：将75只SD大鼠随机分为5组：空白组、模型组、康复训练组(简称康复组)、电针治疗组(简称电针组)和综合治疗组(简称综合组)。采用线栓法复制局灶性脑缺血动物模型。造模成功后第三天开始,分别采用康复训练、电针治疗、康复训练结合电针治疗三种不同的治疗方法,每天治疗1次,连续治疗6天。各组大鼠在术后1天、3天、9天分别以Bederson神经功能评分来评估神经功能、以平衡木行走评分、网屏试验测评来评估运动功能,并于治疗前后观察肌张力变化。治疗结束后处死大鼠,应用免疫组织化学法测定各组大鼠脑干、脊髓颈膨大和腰膨大中突触结合蛋白I(Syt I)的表达情况。结果：1. Bederson(?)神经功能评分、平衡木行走评分、网屏试验测评：术后1天,与空白组比较,模型组和治疗组评分分值均显著升高,差异具有统计学意义(P<0.05),但其组间无明显差异(P>0.05)。术后3天,模型组和治疗组评分分值均有降低的趋势,但其差异无统计学意义(P>0.05)。术后9天,与模型组比较,康复组、电针组、综合组评分分值均显著降低(P<0.05),以综合组最为明显(P<0.05)。2.肌张力评定：治疗前,与空白组比较,模型组、治疗组肌张力均有不同程度的增高,差异具有统计学意义(P<0.05),但其组间无明显差异(P>0.05)。治疗后,与模型组比较,康复组、电针组、综合组的肌张力均有所改善,差异均有统计学意义(P<0.05),以综合组改善效果最为明显(P<0.05)。3.SytI的表达：与空白组比较,模型组大鼠脑干、脊髓颈膨大、腰膨大中Syt I的表达显著减少(P<0.05)；与模型组比较,康复组、电针组、综合组大鼠脑干、脊髓颈膨大、腰膨大中Syt I的表达均显著增多(P<0.05),以综合组增多最为明显(P<0.05)。结论：1.康复训练、电针治疗、康复训练结合电针治疗均可改善脑卒中肢体痉挛大鼠的神经功能和运动功能,而以康复训练结合电针治疗更优。2.康复训练、电针治疗、康复训练结合电针治疗均可降低脑卒中肢体痉挛大鼠的肌张力,而以康复训练结合电针治疗更优。3.康复训练、电针治疗、康复训练结合电针治疗均可上调SytⅠ的表达,而以康复训练结合电针治疗的上调效果更为明显。康复训练结合电针治疗能更多地促进SytⅠ的表达,这可能是康复训练结合电针治疗缓解脑卒中肢体痉挛的内在机制之一。更多还原

【Abstract】 Objective: To study the effects of rehabilitation training combined with electroacupunctue on expression of Synaptotagmin I in limb spasm of cerebral infarction rats.and partly search for the mechanism of rehabilitation training combined with electroacupunctue treatment of spasmodic limbs of hemiparalysis after cerebral infarction.Methods: The 75 Sprague-Dawley rats was divided into 5 groups at random:the empty group,the model group, the rehabilitation training group,the electroacupuncture group, and the comprehensive treatment group.Rats were established to the middle cerebral artery occlusion (MCAO) induced by Zea-Longa method. After three days, the rats were respectively treated by rehabilitationtraining,electroacupuncture,rehabilitation training combined with electroacupuncture treatment, one time a day and last for 6 days.To evaluate neural function with Bederson neurobehavioral scores and evaluate movement function with balance beam walk scores and nets screen test at days 1,3,9 after surgery, and observe the change of muscle tension before and after treatment. Synaptotagmin I of brainatem, intumescentia cervicalis and intumescentia lumbalis were detected using immunohistochemical methods after treatment.Results:1. Bederson neurobehavioral scores, balance beam walk scores and nets screen test: After 1 day of surgery, compared with the empty group there was statistical significance between the model group and all the treatment groups(p<0.05),but there is no statistical significance between them(p>0.05). After 3 days of surgery, there was no statistical significance between he model group and all the treatment groups (p>0.05).After 9 days of surgery,there was statistical significance between the model group and the rehabilitation group, electroacupuncture group,comprehensive group (p<0.05).The statistical significance of comprehensive group was more obverous than the rehabilitation group and electroacupuncture group(p<0.05).2. Musculer tension evaluation:before the treatment,compared with the empty group there was statistical significance between the model group and all the treatment groups(p<0.05),but there was no statistical significance between them(p>0.05).After the treatment there was statistical significance between the model group and the other three groups (p<0.05). The statistical significance of comprehensive group was more obverous than the rehabilitation group and electroacupuncture group (p<0.05).3. The expression of Synaptotagmin I:Compared with the empty group Synaptotagmin I of brainatem, intumescentia cervicalis and intumescentia lumbalis in the model group obverously reduced (p<0.05), compared with the model group, Synaptotagmin I of brainatem, intumescentia cervicalis and intumescentia lumbalis in the rehabilitation group, electroacupuncture group and comprehensive group were improved (p<0.05), escecially in the comprehensive group (p<0.05).Conclusion:1. Rehabilitation training, electroacupuncture treatment and rehabilitatition training combined with electroacupuncture treatment could improve the neural function and movement function of limb spasm of cerebral infarction rats, but rehabilitation training combined with electroacupuncture treatment was better.2. All the therapy methods could reduce the musculer tension of limb spasm of cerebral infarction rats,but rehabilitation training combined with electroacupuncture treatment was better.3. All the therapy methods could improve the expression of Synaptotagmin I, but rehabilitation training combined with electroacupuncture treatment was more obervous. Rehabilitation training combined with electroacupuncture treatment could improve more Synaptotagmin I expression,it was maybe one of the mechanism of rehabilitation training combined with electroacupunctue treatment of spasmodic limbs of hemiparalysis after cerebral infarction.更多还原