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1.河南中医药大学,郑州 450000
2.河南中医药大学第三附属医院,郑州 450000
Received:02 February 2025,
Revised:2025-09-11,
Online First:06 May 2026,
Published:25 May 2026
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郭娅静,温婧,薛聪,等.艾灸上调PPARγ/CD36表达及小胶质细胞M2表型极化促进脑出血大鼠血肿清除[J].针刺研究,2026,51(5):632-639.
GUO Ya-jing,WEN Jing,XUE Cong,et al.Moxibustion promotes hematoma clearance in rats with intracerebral hemorrhage by up-regulating the expression of PPARγ/CD36 and M2 phenotype polarization of microglia[J].Acupuncture Research,
郭娅静,温婧,薛聪,等.艾灸上调PPARγ/CD36表达及小胶质细胞M2表型极化促进脑出血大鼠血肿清除[J].针刺研究,2026,51(5):632-639. DOI: 10.13702/j.1000-0607.20250094.
GUO Ya-jing,WEN Jing,XUE Cong,et al.Moxibustion promotes hematoma clearance in rats with intracerebral hemorrhage by up-regulating the expression of PPARγ/CD36 and M2 phenotype polarization of microglia[J].Acupuncture Research, DOI:10.13702/j.1000⁃0607.20250094.
目的
2
观察艾灸对原发性脑出血(ICH)大鼠血肿清除及神经功能恢复的干预效应,探讨艾灸改善ICH后继发性脑损伤的可能机制。
方法
2
SD大鼠随机分为空白组、模型组、针刺组及艾灸组,每组15只。尾状核注射胶原酶法建立ICH模型。针刺组及艾灸组于造模后第3天起每日针刺、艾灸“百会”20 min,每日1次,连续5 d。采用神经功能缺损评分(mNSS)及旷场实验分别观察各组大鼠神经缺损及运动功能损伤情况;冠状连续脑组织切片及LFB染色分别观察血肿体积及髓鞘损伤情况;Western
blot法观察血肿周围组织血肿清除相关蛋白过氧化物酶体增殖物激活受体γ(PPARγ)、CD36表达水平;免疫荧光染色检测血肿周围M1型[诱导型一氧化氮合酶(iNOS)和CD68共表达]及M2型(CD206
+
CD68
+
)小胶质细胞表达,观察小胶质细胞极化状态。
结果
2
治疗前与空白组相比,模型组mNSS及旷场静止时间升高(
P
<
0.01),旷场移动总路程、跨格次数减少(
P
<
0.01),血肿体积增大(
P
<
0.05),髓鞘染色稀疏,存在较多空泡,有明显脱髓鞘改变,M1、M2型小胶质细胞比例明显增多(
P
<
0.01,
P
<
0.05)。治疗后与模型组相比,艾灸组和针刺组mNSS及旷场静止时间降低(
P
<
0.05,
P
<
0.01),移动总路程及跨格次数增加(
P
<
0.01,
P
<
0.05),血肿体积明显减小(
P
<
0.05);脑组织PPARγ、CD36蛋白表达水平升高(
P
<
0.05,
P
<
0.01);血肿周围M1型小胶质细胞比例降低(
P
<
0.05),M2型小胶质细胞比例增加(
P
<
0.05),有髓纤维的排列得到改善,空泡样改变减少。
结论
2
艾灸可有效减轻ICH大鼠神经功能损伤,促进血肿清除,这种作用可能是通过上调PPARγ及CD36表达从而影响小胶质细胞极化状态而实现的。
Objective
2
To observe the effects of moxibustion on hematoma clearance and neurological functional recovery after intracerebral hemorrhage (ICH) in rats, and to explore the potential mechanisms by which moxibustion mitigates secondary brain injury after ICH.
Methods
2
SD rats were randomly divided into control, model, acupuncture, and moxibustion groups, with 15 rats in each group. The ICH model was established by collagenase injection into the caudate nucleus of rats. The rats in the acupuncture group and moxibustion group received treatments at “Baihui” (GV20) for 20 min, once daily for 5 consecutive days from the 3
rd
day after modeling. The modified neurological severity score (mNSS) and the open field test were used to evaluate the neurological deficits and motor function of ICH rats. Hematoma volume was observed in serial coronal brain sections. Myelin integrity and demyelination around the hematoma were evaluated by luxol fast blue myelin staining. The expression levels of hematoma clearance-rela
ted proteins, peroxisome proliferator-activated receptor γ (PPARγ) and CD36, in perilesional brain tissue were measured by Western blot. Immunofluorescence was used to detect M1 (iNOS
+
CD68
+
) and M2 (CD206
+
CD68
+
) microglia around the hematoma to assess microglial polarization in ICH rats.
Results
2
Compared with the control group, the mNSS and immobility time in the open field of the model group were increased significantly (
P
<
0.01), whereas the total moving distance and the number of grid crossings in the open field were decreased significantly (
P
<
0.01),volume of the hematoma was increased (
P
<
0.05), the myelin staining was sparse, there were many vacuoles, and there were obvious demyelination changes, the proportions of M1 and M2 types of microglia in the model group were significantly increased(
P
<
0.01,
P
<
0.05). After treatment, compared with the model group, the mNSS and immobility time in the open field of the rats in the acupuncture group and moxibustion group were significantly decreased (
P
<
0.05,
P
<
0.01), the total moving distance and the number of grid crossings were significantly increased (
P
<
0.01,
P
<
0.05), and the hematoma volume was significantly decreased (
P
<
0.05); the expression levels of PPARγ and CD36 in brain tissue were significantly increased (
P
<
0.05,
P
<
0.01); the ratio of M1 microglia decreased (
P
<
0.05), while M2 microglia ratio increased significantly (
P
<
0.05) around the hematoma.
Conclusion
2
Moxibustion can effectively reduce the neurological injury and promote the clearance of hematoma in ICH rats. The mechanisms may involve up-regulation of PPARγ and CD36 expression, and modulation of microglial polarization.
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