目的：研究早期针刺是否通过调控vPAG区P2rx7受体激活神经元活性，影响TBI大鼠觉醒。方法：将48只雄性SD大鼠随机分为Con组、Sham组、Mod组、Acu组，每组12只。对Mod组和Acu组大鼠使用TBI的电子可控性皮质撞击仪（eCCI）进行造模；Sham组仅开颅，不进行皮质撞击；Con组大鼠定量饲养。采用I-Ⅵ级意识量表、昏迷持续时间测定、神经功能缺损评分评估大鼠损伤与恢复程度；取材大鼠中脑组织，在组织形态学上，透射电镜观察各组大鼠vPAG区神经元超微结构；采用Western Blot、RT-qPCR检测各组大鼠中脑组织中P2rx7、Fos原癌基因（c-Fos）蛋白及mRNA水平表达。结果：与Mod组相比，Acu组造模后12 h呈现意识等级呈现最明显变化、昏迷时长明显缩短，神经功能缺损评分在24 h后呈稳定趋势（P＜0.01）。透射电镜结果显示，Acu组细胞核较完整、突触前后膜完整及突触后致密区蛋白增多。与Mod组比较，Acu组TBI大鼠P2rx7、c-Fos蛋白水平显著升高（P＜0.01）、P2rx7、c-Fos的mRNA表达量显著升高（P＜0.01）。结论：早期针刺可能通过激活vPAG区P2rx7受体，改善神经元活性并修复受损脑区，促醒TBI昏迷大鼠。

Objective: To investigate whether early acupuncture affects arousal in rats with traumatic brain injury (TBI) by regulating P2rx7 receptor-mediated neuronal activity in the ventrolateral periaqueductal gray (vPAG) region. Methods: Forty-eight male Sprague-Dawley rats were randomly divided into four groups (n=12 each): control (Con), sham, model (Mod), and acupuncture (Acu). TBI was induced in the Mod and Acu groups using an electronic controlled cortical impact (eCCI) device. The sham group underwent craniotomy only without cortical impact, and the Con group received standardized housing. Injury severity and recovery were assessed using the Level I-VI consciousness scale, coma duration measurement, and neurological deficit score. Midbrain tissue was harvested, and the ultrastructure of vPAG neurons was examined by transmission electron microscopy. Protein and mRNA expression levels of P2rx7 and c-Fos in the midbrain were determined by Western blot and RT-qPCR. Results: Compared with the Mod group, the Acu group showed the most pronounced change in consciousness level at 12 h after modeling, significantly shortened coma duration, and a stabilized neurological deficit score after 24 h (P<0.01). Transmission electron microscopy revealed relatively intact nuclei, intact pre- and postsynaptic membranes, and increased postsynaptic density protein in the Acu group. Compared with the Mod group, the Acu group exhibited significantly elevated protein and mRNA expression levels of P2rx7 and c-Fos (P<0.01). Conclusion: Early acupuncture may promote arousal in comatose TBI rats by activating P2rx7 receptors in the vPAG region, thereby improving neuronal activity and repairing damaged brain tissue.