CAJ | 학술논문

目的：研究电针配穴联合自制威灵仙浸膏外敷治疗实验性日本大耳白兔膝骨关节炎合并关节腔积液的效果及作用机制。方法将日本大耳白兔36只随机分为模型组、电针组、威灵仙组及联合组，4组均于第1，3，7天各注射1次弗氏完全佐剂（0．1 mL）于左膝关节腔内造模；造模成功后电针组取足三里、血海、阳陵泉为主穴电针刺激30 min，威灵仙组于膝骨关节处每日涂抹威灵仙浸膏，联合组在电针足三里、血海、阳陵泉30 min后膝骨关节处每日涂抹威灵仙浸膏，均治疗2周。分别于造模前及治疗后2周测定关节积液中炎症递质前列腺素E2（ PGE2）、透明质酸（ HA）、白细胞介素－1β（ IL－1β）水平；计算足趾关节肿胀率及消肿时间，并于治疗结束后取动物关节软骨测定软骨MMP－1细胞阳性表达率。结果治疗2周后，联合组PGE2、IL－1β水平，MMP－1细胞阳性表达率及足趾关节肿胀率均明显低于治疗前及电针组、威灵仙组（P均＜0．05），消肿时间明显短于电针组、威灵仙组（P均＜0．05），HA水平高于电针组、威灵仙组（P均＜0.05）。结论电针配穴联合自制威灵仙浸膏外敷治疗日本大耳白兔实验性膝骨关节炎合并关节腔积液效果好。其作用机制可能是电针刺激可激发经气，降低痛阈，威灵仙浸膏经皮吸收后可促进局部血液循环及局部病变组织新陈代谢，增加HA分泌，抑制IL－1β的合成，二者协同促使病变组织恢复，减轻关节疼痛。
목적：연구전침배혈연합자제위령선침고외부치료실험성일본대이백토슬골관절염합병관절강적액적효과급작용궤제。방법장일본대이백토36지수궤분위모형조、전침조、위령선조급연합조，4조균우제1，3，7천각주사1차불씨완전좌제（0．1 mL）우좌슬관절강내조모；조모성공후전침조취족삼리、혈해、양릉천위주혈전침자격30 min，위령선조우슬골관절처매일도말위령선침고，연합조재전침족삼리、혈해、양릉천30 min후슬골관절처매일도말위령선침고，균치료2주。분별우조모전급치료후2주측정관절적액중염증체질전렬선소E2（ PGE2）、투명질산（ HA）、백세포개소－1β（ IL－1β）수평；계산족지관절종창솔급소종시간，병우치료결속후취동물관절연골측정연골MMP－1세포양성표체솔。결과치료2주후，연합조PGE2、IL－1β수평，MMP－1세포양성표체솔급족지관절종창솔균명현저우치료전급전침조、위령선조（P균＜0．05），소종시간명현단우전침조、위령선조（P균＜0．05），HA수평고우전침조、위령선조（P균＜0.05）。결론전침배혈연합자제위령선침고외부치료일본대이백토실험성슬골관절염합병관절강적액효과호。기작용궤제가능시전침자격가격발경기，강저통역，위령선침고경피흡수후가촉진국부혈액순배급국부병변조직신진대사，증가HA분비，억제IL－1β적합성，이자협동촉사병변조직회복，감경관절동통。
Objective It is observe the effect of electro acupuncture combined with self-made Clematis extract by external application on the Japanese big ear rabbits of experimental knee osteoarthritis (KOA)with joint effusion, and to explore its anti inflammation mechanism .Methods 36 white rabbits were randomly divided into model group , electro-acupuncture group , Clematis group and combined treatment group .All the rabbits were given complete Freund's adjuvant (0.1 mL) in the left knee joint cavity one time on the first , third and 7th day to establish models of KOA .After the models successfully estab-lished, electro-acupuncture group was treated with electro-acupuncture at Zusanli , Xuehai, Yanglingquan for 30 min;Clema-tis group was treated with Clematis extract on knee joint daily by external application ; combined treatment group was treated with both electro-acupuncture and Clematis extract .All the treatment lasted for 2 weeks.The levels of PGE2 , HA, IL-1βin joint effusion were determined before model establish and 2 weeks after treatment in all groups;toes swelling rate and swelling time of joint were counted , and the animal articular cartilage was gotten to detect the positive expression rate of MMP -1 carti-lage cells at the end of treatment .Results After 2 weeks'treatment, the levels of PGE2 , IL-1β, the positive rate of expres-sion of MMP-1 cell rate and the toe joint swelling rate were significantly lower than that before treatment and the other two groups , swelling time was shorter while the level of HA was higher in combination group compared with that in the other two groups .Conclusion Electro-acupuncture combined with self-made Clematis extract topical therapy can be effective in the treat-ment of Japanese big ear rabbits of experimental knee osteoarthritis with joint effusion .The mechanism may be that: electro-acupuncture can arouse the Qi and decrease pain threshold , the extract can promote the local blood circulation and local tissue metabolism, increase the secretion of HA, inhibit IL-1βproduction, thus to promote the recovery of pathological tissue and relive joint pain together .