中医正骨
中醫正骨
중의정골
THE JOURNAL OF TRADITIONAL CHINESE ORTHOPEDICS AND TRAUMATOLOGY
2014年
9期
6-10
,共5页
李峰%郭艳幸%曹向阳%朱小磊%李沛
李峰%郭豔倖%曹嚮暘%硃小磊%李沛
리봉%곽염행%조향양%주소뢰%리패
关节炎,类风湿%光化学疗法%贯叶连翘%金丝桃素%病理形态学%兔%动物实验
關節炎,類風濕%光化學療法%貫葉連翹%金絲桃素%病理形態學%兔%動物實驗
관절염,류풍습%광화학요법%관협련교%금사도소%병리형태학%토%동물실험
Arthritis,rheumatoid%Photochemotherapy%Hypericum perforatum%Hypericin%Pathomorphism%Rabbits%Animal experimentation
目的：观察贯叶连翘灌胃联合光动力疗法对类风湿关节炎白兔膝关节滑膜组织病理形态的影响。方法：将36只12周龄新西兰大白兔随机分为正常对照组（空白组）12只、模型组12只、治疗组12只。模型组和治疗组用鸡卵蛋白诱导建立类风湿关节炎模型。造模后1周，治疗组以1500 mg·mL-1贯叶连翘药液灌胃，空白组和模型组以生理盐水灌胃，每天1次，连续灌胃7 d。随机选取治疗组大白兔一侧膝关节作为贯叶连翘联合光动力疗法组，另一侧膝关节作为贯叶连翘组。贯叶连翘联合光动力疗法组于每次灌胃后2h采用氦氖激光治疗仪照射膝关节，每天1次，连续照射7d；贯叶连翘组膝关节避光。治疗结束后2周，处死白兔，取各组白兔膝关节并分离出滑膜组织，采用HE染色法观察膝关节滑膜的组织形态学变化，并按照滑膜病理5级评分法对炎性细胞浸润、滑膜细胞增生及滑膜纤维组织增生3项指标进行评分。结果：①膝关节滑膜形态观察。空白组滑膜衬里层细胞多呈单层，排列规则，滑膜组织较为疏松，无炎性细胞浸润；贯叶连翘联合光动力疗法组滑膜细胞增生层数较少，炎性细胞浸润程度及滑膜纤维组织增生程度较模型组及贯叶连翘组明显减轻。②膝关节滑膜病理指标评分。各组滑膜炎性细胞浸润评分比较，差异有统计学意义（F＝30．130，P＝0．000）。组间两两比较，空白组评分[（0．50±0．36）分]低于模型组[（2．92±1．00）分]、贯叶连翘组[（2．67±0．65）分]和贯叶连翘联合光动力疗法组[（1．58±0．51）分][q＝11．973，P＝0．000；q＝10．735，P＝0．000；q＝5．365，P＝0．000]；模型组评分高于贯叶连翘联合光动力疗法组（q＝6．603，P＝0．000）；模型组评分与贯叶连翘组比较，差异无统计学意义（q＝1．238，P＝0．386）；贯叶连翘联合光动力疗法组评分低于贯叶连翘组（q＝5．365，P＝0．000）。各组滑膜细胞增生评分比较，差异有统计学意义（F＝30．910，P＝0．000）。组间两两比较，空白组评分[（0．92±0．67）分]低于模型组[（3．33±0．78）分]、贯叶连翘组[（2．92±0．67）分]和贯叶连翘联合光动力疗法组[（1．75±0．62）分]（q＝12．187，P＝0．000；q＝10．084，P＝0．000；q＝4．200，P＝0．005）；模型组评分高于贯叶连翘联合光动力疗法组（q＝7．982，P＝0．000）；模型组评分与贯叶连翘组比较，差异无统计学意义（q＝2．103，P＝0．144）；贯叶连翘联合光动力疗法组评分低于贯叶连翘组（q＝5．884，P＝0．000）。各组滑膜纤维组织增生评分比较，差异有统计学意义（F＝25．700，P＝0．000）。组间两两比较，空白组评分[（0．75±0．62）分]低于模型组[（2．83±0．83）分]、贯叶连翘组[（2．67±0．49）分]和贯叶连翘联合光动力疗法组[（1．67±0．65）分]（q＝10．903，P＝0．000；q＝10．034，P＝0．000；q＝4．780，P＝0．001）；模型组评分高于贯叶连翘联合光动力疗法组（q＝6．108，P＝0．000）；模型组评分与贯叶连翘组比较，差异无统计学意义（q＝0．874，P＝0．540）；贯叶连翘联合光动力疗法组评分低于贯叶连翘组（q＝5．234，P＝0．001）。结论：贯叶连翘灌胃联合光动力疗法能有效地抑制类风湿关节炎白兔膝关节炎性滑膜细胞浸润，减轻其滑膜细胞增生和滑膜纤维组织增生，但其具体作用机制尚不明确，有待进一步研究。
目的：觀察貫葉連翹灌胃聯閤光動力療法對類風濕關節炎白兔膝關節滑膜組織病理形態的影響。方法：將36隻12週齡新西蘭大白兔隨機分為正常對照組（空白組）12隻、模型組12隻、治療組12隻。模型組和治療組用鷄卵蛋白誘導建立類風濕關節炎模型。造模後1週，治療組以1500 mg·mL-1貫葉連翹藥液灌胃，空白組和模型組以生理鹽水灌胃，每天1次，連續灌胃7 d。隨機選取治療組大白兔一側膝關節作為貫葉連翹聯閤光動力療法組，另一側膝關節作為貫葉連翹組。貫葉連翹聯閤光動力療法組于每次灌胃後2h採用氦氖激光治療儀照射膝關節，每天1次，連續照射7d；貫葉連翹組膝關節避光。治療結束後2週，處死白兔，取各組白兔膝關節併分離齣滑膜組織，採用HE染色法觀察膝關節滑膜的組織形態學變化，併按照滑膜病理5級評分法對炎性細胞浸潤、滑膜細胞增生及滑膜纖維組織增生3項指標進行評分。結果：①膝關節滑膜形態觀察。空白組滑膜襯裏層細胞多呈單層，排列規則，滑膜組織較為疏鬆，無炎性細胞浸潤；貫葉連翹聯閤光動力療法組滑膜細胞增生層數較少，炎性細胞浸潤程度及滑膜纖維組織增生程度較模型組及貫葉連翹組明顯減輕。②膝關節滑膜病理指標評分。各組滑膜炎性細胞浸潤評分比較，差異有統計學意義（F＝30．130，P＝0．000）。組間兩兩比較，空白組評分[（0．50±0．36）分]低于模型組[（2．92±1．00）分]、貫葉連翹組[（2．67±0．65）分]和貫葉連翹聯閤光動力療法組[（1．58±0．51）分][q＝11．973，P＝0．000；q＝10．735，P＝0．000；q＝5．365，P＝0．000]；模型組評分高于貫葉連翹聯閤光動力療法組（q＝6．603，P＝0．000）；模型組評分與貫葉連翹組比較，差異無統計學意義（q＝1．238，P＝0．386）；貫葉連翹聯閤光動力療法組評分低于貫葉連翹組（q＝5．365，P＝0．000）。各組滑膜細胞增生評分比較，差異有統計學意義（F＝30．910，P＝0．000）。組間兩兩比較，空白組評分[（0．92±0．67）分]低于模型組[（3．33±0．78）分]、貫葉連翹組[（2．92±0．67）分]和貫葉連翹聯閤光動力療法組[（1．75±0．62）分]（q＝12．187，P＝0．000；q＝10．084，P＝0．000；q＝4．200，P＝0．005）；模型組評分高于貫葉連翹聯閤光動力療法組（q＝7．982，P＝0．000）；模型組評分與貫葉連翹組比較，差異無統計學意義（q＝2．103，P＝0．144）；貫葉連翹聯閤光動力療法組評分低于貫葉連翹組（q＝5．884，P＝0．000）。各組滑膜纖維組織增生評分比較，差異有統計學意義（F＝25．700，P＝0．000）。組間兩兩比較，空白組評分[（0．75±0．62）分]低于模型組[（2．83±0．83）分]、貫葉連翹組[（2．67±0．49）分]和貫葉連翹聯閤光動力療法組[（1．67±0．65）分]（q＝10．903，P＝0．000；q＝10．034，P＝0．000；q＝4．780，P＝0．001）；模型組評分高于貫葉連翹聯閤光動力療法組（q＝6．108，P＝0．000）；模型組評分與貫葉連翹組比較，差異無統計學意義（q＝0．874，P＝0．540）；貫葉連翹聯閤光動力療法組評分低于貫葉連翹組（q＝5．234，P＝0．001）。結論：貫葉連翹灌胃聯閤光動力療法能有效地抑製類風濕關節炎白兔膝關節炎性滑膜細胞浸潤，減輕其滑膜細胞增生和滑膜纖維組織增生，但其具體作用機製尚不明確，有待進一步研究。
목적：관찰관협련교관위연합광동력요법대류풍습관절염백토슬관절활막조직병리형태적영향。방법：장36지12주령신서란대백토수궤분위정상대조조（공백조）12지、모형조12지、치료조12지。모형조화치료조용계란단백유도건립류풍습관절염모형。조모후1주，치료조이1500 mg·mL-1관협련교약액관위，공백조화모형조이생리염수관위，매천1차，련속관위7 d。수궤선취치료조대백토일측슬관절작위관협련교연합광동력요법조，령일측슬관절작위관협련교조。관협련교연합광동력요법조우매차관위후2h채용양내격광치료의조사슬관절，매천1차，련속조사7d；관협련교조슬관절피광。치료결속후2주，처사백토，취각조백토슬관절병분리출활막조직，채용HE염색법관찰슬관절활막적조직형태학변화，병안조활막병리5급평분법대염성세포침윤、활막세포증생급활막섬유조직증생3항지표진행평분。결과：①슬관절활막형태관찰。공백조활막츤리층세포다정단층，배렬규칙，활막조직교위소송，무염성세포침윤；관협련교연합광동력요법조활막세포증생층수교소，염성세포침윤정도급활막섬유조직증생정도교모형조급관협련교조명현감경。②슬관절활막병리지표평분。각조활막염성세포침윤평분비교，차이유통계학의의（F＝30．130，P＝0．000）。조간량량비교，공백조평분[（0．50±0．36）분]저우모형조[（2．92±1．00）분]、관협련교조[（2．67±0．65）분]화관협련교연합광동력요법조[（1．58±0．51）분][q＝11．973，P＝0．000；q＝10．735，P＝0．000；q＝5．365，P＝0．000]；모형조평분고우관협련교연합광동력요법조（q＝6．603，P＝0．000）；모형조평분여관협련교조비교，차이무통계학의의（q＝1．238，P＝0．386）；관협련교연합광동력요법조평분저우관협련교조（q＝5．365，P＝0．000）。각조활막세포증생평분비교，차이유통계학의의（F＝30．910，P＝0．000）。조간량량비교，공백조평분[（0．92±0．67）분]저우모형조[（3．33±0．78）분]、관협련교조[（2．92±0．67）분]화관협련교연합광동력요법조[（1．75±0．62）분]（q＝12．187，P＝0．000；q＝10．084，P＝0．000；q＝4．200，P＝0．005）；모형조평분고우관협련교연합광동력요법조（q＝7．982，P＝0．000）；모형조평분여관협련교조비교，차이무통계학의의（q＝2．103，P＝0．144）；관협련교연합광동력요법조평분저우관협련교조（q＝5．884，P＝0．000）。각조활막섬유조직증생평분비교，차이유통계학의의（F＝25．700，P＝0．000）。조간량량비교，공백조평분[（0．75±0．62）분]저우모형조[（2．83±0．83）분]、관협련교조[（2．67±0．49）분]화관협련교연합광동력요법조[（1．67±0．65）분]（q＝10．903，P＝0．000；q＝10．034，P＝0．000；q＝4．780，P＝0．001）；모형조평분고우관협련교연합광동력요법조（q＝6．108，P＝0．000）；모형조평분여관협련교조비교，차이무통계학의의（q＝0．874，P＝0．540）；관협련교연합광동력요법조평분저우관협련교조（q＝5．234，P＝0．001）。결론：관협련교관위연합광동력요법능유효지억제류풍습관절염백토슬관절염성활막세포침윤，감경기활막세포증생화활막섬유조직증생，단기구체작용궤제상불명학，유대진일보연구。
Objective:To study the effect of intragastric administration of hypericum perforatum combined with photodynamic therapy on the pathological morphology of synovial tissue of knee joints in rabbits with rheumatoid arthritis.Methods:Thirty-six 1 2-week-old New Zealand white rabbits were randomly divided into 3 groups,1 2 cases in normal control group(blank group),1 2 cases in model group,and 1 2 cases in treatment group.Rabbits in model group and treatment group were induced into the models of rheumatoid arthritis by using chicken ovalbumin.Rabbits in treatment group were intragastric administrated with the liquor of hyperforin perforatum with dose of 1 500 mg/mL,while rabbits in blank group and model group were intragastric administrated with normal saline 1 week after modeling.Rabbits in each group were intragastric administrated once a day for consecutive 7 days.Unilateral knee joints of these rabbits in treatment group were ran-domly recruited into hyperforin perforatum combined with photodynamic therapy group(combination therapy group),and the others were re-cruited into hyperforin perforatum group.The knee joints of former group were treated with He-Ne laser irradiation 2 hours after intragastric administration once a day for consecutive 7 days,while the knee joints of latter group were protected from light.These rabbits were executed and the knee joints were fetched out for separating synovial tissues 2 weeks after the end of treatment.The morphological changes of synovial tissues in knee joints were observed after HE staining;and inflammatory cell infiltration,synovial cell hyperplasia and synovial fibroplasia were assessed according to the synovial pathological scores.Results:Synovial lining cells spread in monolayer regularly in blank group,and the synovial tissue was relative sparsate and no inflammatory cells infiltrating were found.Less layer of synovial cells hyperplasia was found in combination therapy group,and the degree of inflammatory cell infiltration and synovial fibroplasia were alleviated significantly,compared to model group and hyperforin perforatum group.There were statistical differences in the scores of synovial inflammatory cell infiltration be-tween the groups(F=30.1 30,P=0.000).Further pairwise comparison showed that the scores of blank group(0.50+/-0.36 points)were lower than those of model group(2.92+/-1 .00 points),hyperforin perforatum group(2.67+/-0.65 points)and combination therapy group (1 .58+/-0.51 points)(q=1 1 .973,P=0.000;q=1 0.735,P=0.000;q=5.365,P=0.000);Model group surpassed combination ther-apy group in scores(q=6.603,P=0.000);There were no statistical differences in the scores between model group and hyperforin perfora-tum group(q=1 .238,P=0.386);The scores of combination therapy group were lower than those of hyperforin perforatum group(q=5.365,P=0.000).There were statistical differences in the scores of synovial cell hyperplasia between the groups(F=30.910,P=0.000).Further pairwise comparison showed that the scores of blank group(0.92 +/-0.67 points)were lower than those of model group (3.33+/-0.78 points),hyperforin perforatum group(2.92+/-0.67 points)and combination therapy group(1 .75 +/-0.62 points)(q=12.187,P=0.000;q =10.084,P=0.000;q =4.200,P=0.005).Model group surpassed combination therapy group in scores(q =7.982,P=0.000);There were no statistical differences in the scores between model group and hyperforin perforatum group(q=2.1 03, P=0.1 44);The scores of combination therapy group were lower than those of hyperforin perforatum group(q=5.884,P=0.000).There were statistical differences in the scores of synovial fibroplasia between the groups(F=25.700,P=0.000).Further pairwise comparison showed that the scores of blank group(0.75 +/-0.62 points)were lower than those of model group(2.83+/-0.83 points),hyperforin per-foratum group(2.67+/-0.49 points),and combination therapy group(1 .67 +/-0.65 points)(q=1 0.903,P=0.000;q=1 0.034,P=0.000;q=4.780,P=0.001 ).Model group surpassed combination therapy group(q=6.1 08,P=0.000);There were no statistical differ-ences in the scores between model group and hyperforin perforatum group(q=0.874,P=0.540).The scores of combination therapy group were lower than those of hyperforin perforatum group(q=5.234,P=0.001 ).Conclusion:Intragastric administration of hyperforin perfora-tum combined with photodynamic therapy can effectively inhibit inflammatory cell infiltration and reduce synovial cell hyperplasia and synovi-al fibroplasia in knee joints of rabbits with rheumatoid arthritis,but its specific mechanism of action is unclear and need to be further studied.
