上海针灸杂志
上海針灸雜誌
상해침구잡지
SHANGHAI JOURNAL OF ACUPUNCTURE AND MOXIBUSTION
2015年
5期
455-459
,共5页
梁楚西%费飞%肖红%郭妍%金晓飞%郭长青
樑楚西%費飛%肖紅%郭妍%金曉飛%郭長青
량초서%비비%초홍%곽연%금효비%곽장청
小针刀%骨关节炎,膝关节%髌韧带%白介素4%基质金属蛋白酶3%聚集蛋白聚糖%兔
小針刀%骨關節炎,膝關節%髕韌帶%白介素4%基質金屬蛋白酶3%聚集蛋白聚糖%兔
소침도%골관절염,슬관절%빈인대%백개소4%기질금속단백매3%취집단백취당%토
Little needle knife%Osteoarthritis,knee joint%Patellar ligament%Interleukin-4%Matrix metalloproteinase-3%Aggrecan%Rabbit
目的：通过观察针刀干预对膝骨关节炎(KOA)兔行为学、髌韧带(PT)力学特性及膝关节软骨白介素4(IL-4)、基质金属蛋白酶-3(MMP-3)、聚集蛋白聚糖(Aggrecan)表达的影响,探讨针刀“调筋治骨”法治疗KOA 的作用机制。方法将40只新西兰兔随机分为空白组、模型组、针刀组和电针组,每组10只。模型组、针刀组和电针组采用改良后Videman伸直位固定法建立兔KOA模型。针刀组和电针组造模后分别给予针刀、电针治疗。造模后及治疗后采用改良Lequesne MG的膝关节级别评估法对各组进行行为学评价。治疗后取材,应用Bose Electro Force 3300疲劳试验机对PT进行拉伸、应力松弛和蠕变力学测试,应用ELISA方法检查软骨细胞IL-4表达,应用Real-time PCR法检测MMP-3、Aggrecan mRNA表达水平。结果造模后,模型组Lequesne MG评分与空白组比较,差异具有统计学意义(P＜0.01)；针刀组、电针组Lequesne MG评分与模型组比较,差异均无统计学意义(P＞0.05)。针刀组和电针组治疗后Lequesne MG评分与模型组比较,差异均有统计学意义(P＜0.01, P＜0.05)；针刀组治疗后Lequesne MG评分与电针组比较,差异具有统计学意义(P＜0.05)。模型组PT最大应力、最大位移、弹性模量及应力松弛率、蠕变率与空白组比较,差异均具有统计学意义(P＜0.01,P＜0.05)。针刀组治疗后PT最大应力、最大位移、弹性模量及应力松弛率、蠕变率与模型组比较,差异均有统计学意义(P＜0.01,P＜0.05)；电针组治疗后弹性模量与模型组比较,差异有统计学意义(P＜0.01)。模型组造模后IL-4含量、Aggrecan mRNA表达均显著下降,MMP-3 mRNA表达显著上升,与空白组比较差异均有统计学意义(P＜0.01,P＜0.05)；针刀组及电针组治疗后IL-4含量较模型组明显升高(P＜0.01, P＜0.05),两组Aggrecan mRNA表达均有上升趋势, MMP-3 mRNA表达均有下降趋势,针刀组在调整Aggrecan、MMP-3 mRNA表达方面优于电针组,但与模型组比较差异均无统计学意义(P＞0.05)。结论针刀治疗KOA的作用机制可能是通过改善韧带力学特性,调整关节内应力环境,通过IL-4力学信号通路,调整Aggrecan、MMP-3 mRNA表达,阻抑软骨退变,从而起到“调筋治骨”的治疗作用。
目的：通過觀察針刀榦預對膝骨關節炎(KOA)兔行為學、髕韌帶(PT)力學特性及膝關節軟骨白介素4(IL-4)、基質金屬蛋白酶-3(MMP-3)、聚集蛋白聚糖(Aggrecan)錶達的影響,探討針刀“調觔治骨”法治療KOA 的作用機製。方法將40隻新西蘭兔隨機分為空白組、模型組、針刀組和電針組,每組10隻。模型組、針刀組和電針組採用改良後Videman伸直位固定法建立兔KOA模型。針刀組和電針組造模後分彆給予針刀、電針治療。造模後及治療後採用改良Lequesne MG的膝關節級彆評估法對各組進行行為學評價。治療後取材,應用Bose Electro Force 3300疲勞試驗機對PT進行拉伸、應力鬆弛和蠕變力學測試,應用ELISA方法檢查軟骨細胞IL-4錶達,應用Real-time PCR法檢測MMP-3、Aggrecan mRNA錶達水平。結果造模後,模型組Lequesne MG評分與空白組比較,差異具有統計學意義(P＜0.01)；針刀組、電針組Lequesne MG評分與模型組比較,差異均無統計學意義(P＞0.05)。針刀組和電針組治療後Lequesne MG評分與模型組比較,差異均有統計學意義(P＜0.01, P＜0.05)；針刀組治療後Lequesne MG評分與電針組比較,差異具有統計學意義(P＜0.05)。模型組PT最大應力、最大位移、彈性模量及應力鬆弛率、蠕變率與空白組比較,差異均具有統計學意義(P＜0.01,P＜0.05)。針刀組治療後PT最大應力、最大位移、彈性模量及應力鬆弛率、蠕變率與模型組比較,差異均有統計學意義(P＜0.01,P＜0.05)；電針組治療後彈性模量與模型組比較,差異有統計學意義(P＜0.01)。模型組造模後IL-4含量、Aggrecan mRNA錶達均顯著下降,MMP-3 mRNA錶達顯著上升,與空白組比較差異均有統計學意義(P＜0.01,P＜0.05)；針刀組及電針組治療後IL-4含量較模型組明顯升高(P＜0.01, P＜0.05),兩組Aggrecan mRNA錶達均有上升趨勢, MMP-3 mRNA錶達均有下降趨勢,針刀組在調整Aggrecan、MMP-3 mRNA錶達方麵優于電針組,但與模型組比較差異均無統計學意義(P＞0.05)。結論針刀治療KOA的作用機製可能是通過改善韌帶力學特性,調整關節內應力環境,通過IL-4力學信號通路,調整Aggrecan、MMP-3 mRNA錶達,阻抑軟骨退變,從而起到“調觔治骨”的治療作用。
목적：통과관찰침도간예대슬골관절염(KOA)토행위학、빈인대(PT)역학특성급슬관절연골백개소4(IL-4)、기질금속단백매-3(MMP-3)、취집단백취당(Aggrecan)표체적영향,탐토침도“조근치골”법치료KOA 적작용궤제。방법장40지신서란토수궤분위공백조、모형조、침도조화전침조,매조10지。모형조、침도조화전침조채용개량후Videman신직위고정법건립토KOA모형。침도조화전침조조모후분별급여침도、전침치료。조모후급치료후채용개량Lequesne MG적슬관절급별평고법대각조진행행위학평개。치료후취재,응용Bose Electro Force 3300피로시험궤대PT진행랍신、응력송이화연변역학측시,응용ELISA방법검사연골세포IL-4표체,응용Real-time PCR법검측MMP-3、Aggrecan mRNA표체수평。결과조모후,모형조Lequesne MG평분여공백조비교,차이구유통계학의의(P＜0.01)；침도조、전침조Lequesne MG평분여모형조비교,차이균무통계학의의(P＞0.05)。침도조화전침조치료후Lequesne MG평분여모형조비교,차이균유통계학의의(P＜0.01, P＜0.05)；침도조치료후Lequesne MG평분여전침조비교,차이구유통계학의의(P＜0.05)。모형조PT최대응력、최대위이、탄성모량급응력송이솔、연변솔여공백조비교,차이균구유통계학의의(P＜0.01,P＜0.05)。침도조치료후PT최대응력、최대위이、탄성모량급응력송이솔、연변솔여모형조비교,차이균유통계학의의(P＜0.01,P＜0.05)；전침조치료후탄성모량여모형조비교,차이유통계학의의(P＜0.01)。모형조조모후IL-4함량、Aggrecan mRNA표체균현저하강,MMP-3 mRNA표체현저상승,여공백조비교차이균유통계학의의(P＜0.01,P＜0.05)；침도조급전침조치료후IL-4함량교모형조명현승고(P＜0.01, P＜0.05),량조Aggrecan mRNA표체균유상승추세, MMP-3 mRNA표체균유하강추세,침도조재조정Aggrecan、MMP-3 mRNA표체방면우우전침조,단여모형조비교차이균무통계학의의(P＞0.05)。결론침도치료KOA적작용궤제가능시통과개선인대역학특성,조정관절내응력배경,통과IL-4역학신호통로,조정Aggrecan、MMP-3 mRNA표체,조억연골퇴변,종이기도“조근치골”적치료작용。
Objective To explore the mechanism of therapeutic action of needle knife “regulating sinews and treating bones” on knee osteoarthritis (KOA) by observing the effect of needle knife intervention on KOA rabbit behaviors, mechanical characteristics of patellar ligament (PL), and expressions of interleukin-4 (IL-4), matrix metalloproteinase-3 (MMP-3) and aggrecan in knee cartilages.Methods Forty New Zealand rabbits were randomly allocated to blank, model, needle knife and electroacupuncture groups, 10 rabbits each. A rabbit model of KOA was made by the modified Videman method of immobilization in extension position. After model making, the needle knife and electroacupuncture groups received needle knife and electroacupuncture treatments, respectively. A behavioral assessment was made using the modified Lequesne MG knee grade evaluation method in every group after model making and treatment. The samples were taken after treatment. PL tension, stress relaxation and creep state were tested using a Bose Electro Force 3300 protracted test machine. Cartilage cell IL-4 expression was examined by ELISA. MMP-3 mRNA and aggrecan mRNA expressions were detected by real-time PCR.Results After model making, there was a statistically significant difference in the Lequesne MG score between the model and blank groups (P<0.01); there was no statistically significant difference in the Lequesne MG score between the needle knife or electroacupuncture group and the model group (P>0.05). There was a statistically significant post-treatment difference in the Lequesne MG score between the needle knife or electroacupuncture group and the model group (P<0.01,P<0.05) and between the needle knife and electroacupuncture groups (P<0.05). There were statistically significant post-treatment differences in PL maximum stress, maximum displacement, elastic modulus, stress relaxation rate and creep rate between the model and blank groups (P<0.01,P<0.05). There were statistically significant post-treatment post-treatment differences in PL maximum stress, maximum displacement, elastic modulus, stress relaxation rate and creep rate between the needle knife and model groups (P<0.01,P<0.05). There was a statistically significant post-treatment difference in elastic modulus between the electroacupuncture and model groups (P<0.01). The IL-4 content and aggrecan mRNA expression decreased significantly and MMP-3 mRNA expression increased significantly in the model group after model making and there were statistically significant differences compared with the blank group (P<0.01,P<0.05). After treatment, the IL-4 content increased significantly in the needle knife and electroacupuncture groups compared with the model group (P<0.01,P<0.05) and aggrecan mRNA expression tended to increase in the two groups. The regulation of aggrecan mRNA and MMP-3 mRNA expressions was better in the needle knife group than in the electroacupuncture groups, but there was no statistically significant difference compared with the model group (P>0.05).Conclusion The mechanism of action of needle knife treatment on KOA may be that it improves ligament mechanical characteristics, regulates intra-articular stress environment, and modulates aggrecan mRNA and MMP-3 mRNA expressions and inhibits cartilage degeneration through IL-4 mechanical signal pathway, to produce the therapeutic effect of “regulating sinews and treating bones”.
