目的 探讨基于ERK-Nrf2信号通路“通督调气法”麦粒灸治疗对抑郁症模型大鼠的海马神经保护作用机制。方法 将32只SD大鼠，随机分为空白组，模型组，麦粒灸组，氟西汀组，每组8只。其中空白组进行正常饲养，其余3组采用21 d孤养结合慢性不可预见性的温和应激方法构建抑郁大鼠模型，运用行为学、糖水偏爱、体质量测量对各组大鼠进行模型评价。造模后，模型组不予任何治疗；麦粒灸组干预选取百会、大椎、至阳、合谷（双）、太冲（双）进行麦粒灸治疗；氟西汀组给予氟西汀（1.8 mg·kg-1）灌胃治疗，两组连续治疗10 d。10 d后，进行行为学、糖水偏爱及体质量测量以对疗效进行初步评定，通过透射电镜观察海马神经元形态结构改变，蛋白免疫印迹法（Western Blot）检测p-ERK、Nrf2的蛋白表达水平。结果 与空白组比较，模型组行为学评分、糖水偏爱度、体质量显著下降，海马神经元细胞结构异常、胞浆内细胞器数量减少，p-ERK、Nrf2蛋白表达降低（P< 0.05）；与模型组比较，麦粒灸组及氟西汀组行为学评分、糖水偏爱度、体质量显著上升，海马神经元细胞结构改善、胞浆内细胞器数量增多，p-ERK、Nrf2蛋白表达升高（P < 0.05）；与氟西汀组比较，麦粒灸组行为学评分、糖水偏爱度、体质量、海马神经元细胞结构及胞浆内细胞器数量无显著差异（P>0.05）。结论 麦粒灸可有效改善抑郁症模型大鼠的抑郁症状，其机制可能与通过上调海马组织ERK的磷酸化水平P-ERK，促进诱导Nrf2蛋白表达上升，抑制炎症反应及氧化应激，避免细胞凋亡，修复神经损伤有关。
Objective To explore the neuroprotective mechanism of wheat moxibustion therapy based on ERK-Nrf2 signaling pathway “Tongdu-Tiaoqi Methods” on the hippocampus of rats with depression. Methods 32 SD rats were randomly divided into blank group, model group, wheat moxibustion group and fluoxetine group. Among them, the blank group was fed normally, and the other three groups were treated with 21d solitary feeding combined with chronic unpredictability and mild stress to construct a depressive rat model. Behavioral behavior, sugar and water preference, and body mass measurement were used to evaluate the model of each group of rats. After modeling, the model group was not given any treatment; In the wheat moxibustion group, Baihui (DU20), Dazhui (DU14), Zhiyang (DU9), Hegu (LI4) (bilateral) and Taichong (LR3) (bilateral) were selected for wheat moxibustion treatment. Fluoxetine (1.8 mg·kg-1) was given to the fluoxetine group by gavage, and the 2 groups were treated continuously for 10 days. After 10 days, behavioral, glucose and water preference and body mass measurements were performed to preliminarily evaluate the efficacy. Morphological and structural changes of hippocampal neurons were observed by tem, and protein expression levels of P-ERK and Nrf2 were detected by Western Blot. Results Compared with the blank group, behavioral scores, sugar and water preference, and body mass in the model group were significantly decreased, hippocampal neurons were structurally abnormal, intracytoplasmic organoli were decreased, and protein expressions of P-ERK and Nrf2 were decreased (P < 0.05). Compared with the model group, behavioral scores, sugar and water preference, and body mass in the wheat moxibustion group and the fluoxetine group increased significantly, hippocampal neuron structure improved, intracytoplasmic cell number increased, and protein expressions of P-ERK and Nrf2 increased (P < 0.05). Compared with fluoxetine group, there were no significant differences in behavioral scores, sugar and water preference, body mass, hippocampal neuron structure and intracytoplasmic organelle number in wheat moxibustion group (P > 0.05). Conclusion Wheat moxibustion can effectively improve the depressive symptoms of depression model rats, and its mechanism may be related to the up-regulation of phosphorylation level of ERK in hippocampal tissue P-ERK, promoting the induction of increased Nrf2 protein expression, inhibiting inflammatory response and oxidative stress, avoiding apoptosis, and repairing nerve damage.